Gonarthrosis is a pathological process in the cartilage tissue of the knee joint, which leads to its deformation. This process is associated with high stress on the knees, wear and salt deposits.
Myths about gonarthrosis
There are 3 most famous myths:
- "The diagnosis of gonarthrosis is the prerogative of people with increased physical activity, and people with predominantly sedentary work do not suffer from it. "In fact, excessive physical exertion actually contributes to the deterioration of cartilage. During sedentary work, a static effect occurs on the knees, blood supply is impeded. In addition, a sedentary lifestyle leads to an increase in body weight.
- "Gonarthrosis of the knee joint is incurable, the disease is progressing every day. "This disease is indeed chronic, but with adequate timely treatment, cartilage deterioration can be prevented.
- "With arthrosis, you need to move as little as possible and lie down more. "A patient with such a pathology is assigned special gymnastics, which strengthens the ligamentous apparatus. Only a few sports are really contraindicated.
Gonarthrosis is the destruction of articular cartilage in the knee joint and adjacent bone surfaces.
Manifestations of arthrosis of the knee joint
Manifestations depend on the severity of the deformity. The more it is expressed, the more pronounced the symptoms.
Gonarthrosis symptoms:
- long asymptomatic period;
- discomfort in the knee area;
- pain syndrome;
- decreased mobility;
- morning stiffness up to half an hour;
- the presence of a crunch during active movement;
- change in gait.
Bilateral gonarthrosis occurs when the knee joints of both limbs are involved in the process. This is one of the most severe forms. Occurs in the elderly.
Right-sided gonarthrosis appears with excessive static or dynamic physical exertion on the right limb. More often in athletes.
Left-sided gonarthrosis occurs in overweight people and in athletes with a load on the left leg.
The reasons for the development of gonarthrosis
Gonarthrosis is primary and secondary. Primary can occur in childhood and adolescence, which is associated with malformed joints, as well as in the elderly due to the natural aging process.
Secondary occurs due to injury or existing diseases. Main reasons:
- fractures, bruises, dislocations;
- excess weight;
- the presence of an inflammatory process in the joint and the lack of adequate therapy;
- metabolic diseases, which are accompanied by the deposition of salts in cartilage tissues;
- operations;
- vitamin D deficiency;
- hormonal disorders;
- lifting weights;
- some sports (running, hockey, football).
Who is at risk?
The risk group includes:
- professional athletes;
- obese people;
- patients who have undergone trauma or surgery;
- people over the age of 45;
- patients with varicose veins;
- those who have had cases of arthrosis in the family.
The risk group also includes women who wear shoes with high heels or flat thin soles.
The exact causes of knee arthrosis are unknown.
The degree of gonarthrosis
Radiologically, this pathology is divided into 5 stages or degrees:
- Stage 0 - X-ray absence of arthrosis;
- Stage 1 - the appearance of a small osteophyte;
- Stage 2 - the osteophyte has clear contours, the joint space is minimally changed;
- Stage 3 - narrowing of the joint space;
- Stage 4 - pronounced narrowing of the gap, sclerosis of the subchondral bone.
Knee gonarthrosis 1 degree
The first degree is characterized by fatigue, limited mobility is slightly expressed, and a crunch is heard. The pain appears after waking up, sitting for a long time and after physical exertion.
There is no deformation at this stage yet. The radiograph shows a narrowing of the joint space.
How to treat gonarthrosis?
For treatment, a special group of drugs is used - chondroprotectors. They contain chondroitin and glucosamine, which restore the structure of the cartilage and increase elasticity. NSAIDs are used to relieve pain.
Primary gonarthrosis is most often bilateral in nature. Even with the development of a one-sided form of the disease, after a while, the second limb is also involved in the pathological process.
Early symptoms of arthrosis of the knee joints are mild and uncharacteristic
Treatment methods
In addition to drug treatment in the remission phase, the following methods are used:
- physiotherapy;
- massages;
- leech therapy;
- ultrasonic exposure;
- radon and hydrogen sulfide baths;
- phonophoresis, electrophoresis;
- paraffin wraps;
- the use of therapeutic mud.
These methods are used regardless of the stage of development of the disease during remission.
Is mud good for knee gonarthrosis? One of the indications for mud therapy is diseases of the musculoskeletal system. The course of therapy is carried out twice a year. It includes from 10 to 15 procedures. The method can be used at home, and the dirt can be purchased at the pharmacy.
At the first degree, the patient is prescribed orthopedic shoes for the period of exacerbation to prevent the development of the deforming process. Women are advised to wear shoes with a dense sole of at least 1 cm, a heel of 5 cm. Normalize the diet - reduce the amount of salt, spicy food. Jellied meat and jelly are included in the diet, as they are natural chondroprotectors.
Another method is weight correction. Reducing body weight to an optimal level for a given patient will reduce the load on the musculoskeletal system.
Grade 2 gonarthrosis
In the second degree, the pain intensifies, due to which the movement is significantly limited. Long-term walking long distances causes severe pain syndrome. The patient needs to rest to continue.
If treatment is not started (or is ineffective), arthrosis of the knee joint progresses further.
The crunching becomes loud, lameness appears. The affected joint is deformed. An inflammatory process occurs in the inner membrane of the joint.
On the plain X-ray, a narrowing of the joint space, the appearance of spines on the bone (osteophytes) is found.
Treatment
Drug therapy is based on the use of NSAIDs. They have analgesic and anti-inflammatory effects. Further, chondroprotectors are prescribed.
After the exacerbation has passed, physiotherapy exercises, massage are prescribed.
Diet recommendations:
- increase the amount of vegetables;
- include jelly and jellied meat in the diet;
- eat lean fish twice a week;
- give preference to lean meat;
- eat bran bread.
It is also recommended to include in the diet bananas, nuts, eggs, spinach, legumes, liver, cabbage.
In addition to orthopedic shoes, special knee pads are prescribed.
From surgical interventions, arthroscopic removal of deforming tissue is used. This method has a short-term effect of 2-3 years.
Knee gonarthrosis, symptoms and treatment of grade 3
The most severe degree. Pain syndrome occurs during movement and at rest. Mobility in the knee is as limited as possible, and sometimes impossible. Deformation is pronounced. There is practically no joint space on the roentgenogram.
The progressive destruction of cartilage and bones in the last stages leads to the development of ugly deformities of the knee, which increases in size.
Treatment
At this stage, in addition to NSAIDs, the patient is prescribed hormonal drugs. They are injected intravenously or inside the joint. Severe pain syndrome is relieved by painkillers.
At stage 3, the operation is already shown - endoprosthetics. Either individual bone elements or the entire joint are replaced. Contraindication: osteoporosis.
Complications of arthroplasty:
- marginal skin necrosis;
- rejection of the prosthesis;
- neurovascular disorders (paresis, thrombosis).
In addition to endoprosthetics, there is arthrodesis operation - removal of deformed tissue and joint. It is rarely used.
Osteotomy - excision of the edges of the bones to redistribute the load.
Physiotherapy
Exercises for gonarthrosis of the knee joint can relieve pain, strengthen the muscular apparatus, and stimulate blood flow to them.
- Exercise # 1. The patient lies on his back, raises his straight leg up and holds it for at least 30 seconds, then the second. The execution time should be brought to 2 minutes.
- Exercise number 2 "Bicycle". Lying on your back imitate cycling with your feet. Repetitions 20 to 50 times.
- Exercise number 3. The patient lies on his stomach, alternately bends his legs, trying to reach the buttocks with the heel. Repetitions 20-50 times.
- Exercise number 4. It is done in the same way as the previous one, only statically. That is, the patient fixes the limb in this position for 20-30 seconds.
Patients are advised to stretch:
- Exercise # 1. In a standing position, bend over, trying to reach the floor without bending your knees. Hold for 20 seconds, inhaling air through the nose, exhaling through the mouth.
- Exercise number 2. Sitting on the floor with straight legs, try to wrap your arms around your feet, while keeping your knees straight. Hold this position for up to 30 seconds. Perform 2-3 approaches. If flexibility is not enough to reach the feet, they take the leg by the lower leg and try to pull the body as close to the legs as possible.
- Exercise number 3. The same position as when performing the previous one. The patient takes the foot by the foot, tries to straighten it and holds it as high as possible above the floor. If the exercise is difficult to do, then the leg is taken in the lower leg area. Hold the position for 10-30 seconds, then do it with the other leg.
A contraindication is the period of exacerbations and the presence of an acute inflammatory process. Patients are prohibited from running, long walking and squatting.
After carrying out physiotherapy exercises, it is useful to massage the muscles of the thigh, lower leg on the affected limb. The joint itself should not be influenced, this will increase the inflammation.
Disease prevention
This disease is not hereditary, so its development can be prevented. This requires:
- avoid injury while playing sports;
- do stretching and joint gymnastics, yoga;
- eat properly;
- maintain a normal body weight;
- if you experience any discomfort in the knee area, consult a doctor;
- drink enough water;
- after 40 years, take prophylactically chondroprotectors;
- do not overcool the joints;
- in the presence of early stages of the process and during remission, do not increase physical activity, do not run;
- wear orthopedic shoes;
- use knee pads when playing sports.