In the group of diseases of the locomotor system of degenerative-dystrophic origin, gonarthrosis of the knee joint occupies a leading place.
Gonarthrosis or arthrosis of the knee joint is a disease that is accompanied by slow destruction of the cartilage tissue of the joint and involves the entire joint in the pathological process, including ligaments, synovial membrane, subchondral bone and other elements of the joint.
Under the influence of various factors, such as infectious diseases (colds, flu, typhus, tuberculosis, syphilis, sore throat and many others), injuries, functional joint congestion (for example, athletes, workers performing heavy physical work, ballet dancers), the trophism (nutrition) of the cartilage tissue changes, as a result of which the knee joint becomes thinner, the cartilage tissue is destroyed until it completely disappears.
Who is at risk?First, women over forty are at risk of developing arthrosis of the knee joint;It occurs 2 times more often in them than in the stronger half of humanity.In addition, the risk increases in women who tend to be overweight or obese.
But gonarthrosis is usually a disease of the elderly.And there is a simple explanation for this.As is well known, cartilage consists of approximately 70-80% water, thanks to which it is well absorbed.In addition, at a young age, the "regenerating" cells, chondrocytes, work actively.As we age, the amount of moisture begins to decrease, and as a result, the cushioning ability of the joint deteriorates, the cartilage dries out, becomes brittle, cracks, and the existing chondrocytes do not have time to repair the damage.In many ways, this explains the occurrence of gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors include overweight, physical inactivity, chronic joint injury or systematic microtraumatization of the joint, alcohol consumption, chronic stress, previous or existing diseases of the knee joint, such as
- knee arthritis,
- sprain, partial or complete rupture of ligaments,
- intra-articular fracture of the femur or tibia,
- metabolic disorders such as gout and many other medical conditions.
Quite often, it is not possible to establish a single specific cause that caused gonarthrosis of the knee joint;in this case, they speak of a combined cause, that is, gonarthrosis was the result of several diseases at the same time.
In addition, according to the causes of its occurrence, the disease is usually divided into two forms: primary and secondary.
The cause of primary arthrosis is age and the presence of related factors, such as:
- professional inclination,
- Overweight
- obesity,
- Varicose veins of the lower limbs.
The cause of secondary gonarthrosis can be a previous injury to the knee (fracture, rupture of the ligament apparatus), which is called post-traumatic arthrosis of the knee joint.The cause may be a previous infectious disease or inflammation of the knee joint.
Symptoms
Signs of arthrosis of the knee joint do not appear overnight;the development of the disease occurs gradually and often takes several months or even years.The pain that comes to the fore is constant and aggravated by physical activity - walking, running, going up or down stairs, etc.Another characteristic symptom of this disease is the presence of crepitus in the joint, which can be a cracking or crunching sound in the knee.
Very common manifestations of gonarthrosis are:
- an increase in local temperature (the joint is hot to the touch) or general,
- the presence of joint swelling,
- increasing its volume,
- movement difficulty,
- deformation of the joint with subsequent curvature of the limb.
As the disease progresses, when the cartilage tissue is completely destroyed, the body has no choice but to defend itself.This is manifested in the growth of bone tissue in the form of "spines" (osteophytes) on the bones that make up the joint, and deforming arthrosis of the knee joint occurs.Discharge appears in the joint cavities.
Depending on the size of the osteophytes and the degree of deformation, several grades of gonarthrosis are distinguished:
- Gonarthrosis 1st degree.Patients feel stiffness and mild pain in the joint in the morning or during prolonged sitting or standing.At this stage, there is no deformation in the joint, mobility is fully preserved.X-ray shows a small osteophyte.
- Gonarthrosis grade 2.Painful sensations occur not only in the morning, but also after prolonged exercise;the joint is deformed, the joint surfaces become larger, as a result of which the volume of the joint increases, bending becomes difficult, and a crunching sensation is felt during movements.The X-ray shows pronounced osteophytes, the joint space does not change.
- Gonarthrosis 3 degrees.The manifestations are the same as in the second degree, only the symptoms intensify.The pain is constant and does not subside even at rest and during sleep.The function of the joint is almost completely lost;patients cannot bend or straighten their legs.As a result, lameness occurs and movement becomes possible only with crutches or assistance.He has a severe deformity of the knee joint.The X-ray shows a slight narrowing of the joint space.
- There is also a fourth stage, in which complete immobilization occurs in the affected joint with further deformation.X-rays show sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of arthrosis of the knee joint
In order to achieve good treatment results, it is necessary to seek help from a qualified rheumatologist, and if he is not there, then a therapist, since they know how to cure knee arthrosis.Under no circumstances should you try to treat it yourself, it can only make an already bad situation worse.Before starting the treatment, it is extremely important to establish the correct diagnosis, because the correct diagnosis is the key to successful treatment.
Treatment of gonarthrosis is a rather lengthy process and depends on many factors (type of arthrosis, cause of arthrosis, extent of the disease).Treatment is complex and includes drug and non-drug therapy, and in some cases surgical treatment is warranted.
Drug treatment of arthrosis of the knee joint is primarily aimed at alleviating the main manifestations of the disease, such as:
- Pain;
- Inflammation of the joints and periarticular tissues.
In addition to relieving the symptoms of the disease, the drugs are also used to:
- restoration of joint tissues,
- improving its trophism and blood circulation,
- strengthening the body's defenses,
- elimination of allergic reactions.
Various non-narcotic pain relievers are used to relieve pain symptoms;in rare cases, narcotic pain relievers are prescribed for a short period of time.The most commonly used drugs belong to the group of non-steroidal anti-inflammatory drugs.They have a combined anti-inflammatory, analgesic and antipyretic effect.
Chondroprotectors are used to restore cartilage tissue and improve joint mobility.Medicines stimulate the activity of chondrocytes - chondrocytes - and help tissue repair.Intra-articular administration of chodroprotectors gives a good effect.In recent years, a new, effective product based on hyaluronic acid has appeared.Due to its effect, this drug is called "liquid prosthesis".After injection into the painful joint, this drug forms a protective film over the damaged cartilage and gradually restores the normal lubricating characteristics of the joint.
Muscle relaxants are used to relieve muscle spasms;in addition to their relaxing effect, they have a positive effect on the blood circulation of the affected joint.
Among the non-pharmacological methods of treating gonarthrosis, manual and physical therapy are widely used.Magnet therapy, acupuncture, electrophoresis and massage, hardware traction (joint traction) and others are the most important.Recently, the practice of treating arthrosis included methods such as laser therapy and cryotherapy (exposure to liquid nitrogen).In addition to physiotherapy, exercise therapy for arthrosis of the knee joint also has a good effect.Gymnastics therapy is the application of various physical exercises for therapeutic purposes.
Gymnastics for arthrosis of the knee joint
At the beginning of the disease, physical stress on the affected joint should be reduced to a minimum.No running, jumping, lifting weights, brisk walking or squatting.Exercises related to arthrosis of the knee joint can only be performed after the end of the course, under the supervision of the attending physician.
Exercises should be chosen that help strengthen the muscles and ligaments of the affected knee joint, but do not lead to excessive mobility of the joint.In other words, the exercises should be performed with minimal dynamic activity.It is useful to perform exercises to stretch the ligaments and joint capsules.The rules are the same here, do the exercises gently and effortlessly.
When performing any gymnastic exercise, it is important to follow some rules:
- Do not exercise while dealing with pain,
- If an exercise causes pain, it should be changed to a more gentle one.
The arthrosis massage of the knee joint has a beneficial effect on restoring the functions of the knee joint.In the place of exposure, blood vessels dilate, blood circulation improves and metabolism accelerates.Massage procedures improve lymph flow and this helps eliminate residual inflammation.Massage strengthens the muscular system, increases the flow of oxygen, improves gas exchange, normalizes their tone and increases plasticity.
Diet for arthrosis of the knee joint
Recently, medical experts have established that there is no direct relationship between the occurrence of gonarthrosis and nutrition.However, it is an indisputable fact that the development of arthrosis is greatly influenced by the presence of excess weight in a person.If the cause of the disease was precisely excess weight, then it is obvious that nutrition for arthrosis of the knee joint should be aimed at gradually reducing body weight.This will require a change in diet and a change in diet.Food should be lower in calories, fried foods and high-fat foods should be excluded from the diet.Eat more vegetables, fruits and fluids.
Prevention of arthrosis of the knee joint
In order to keep the joints healthy for as long as possible, it is necessary to participate in physical education and gymnastics regularly, but one should not get too carried away with this, lest this leads to overloading of the joints.Swimming provides the best effect and minimal strain on the joints.If you play professional sports, you must use joint protection.It is useful to alternate physical activity with rest;you shouldn't stay still for long.
Observance of all these simple rules, as well as a healthy lifestyle and proper nutrition, will not allow arthrosis of the knee joint to ruin a person's life.