In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint occupies a prominent place.
Gonarthrosis or arthrosis of the knee joint is a disease accompanied by the slow destruction of the cartilaginous tissue of the joint, involving 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, typhoid fever, tuberculosis, syphilis, sore throat and a number of others), injuries, functional congestion of the joint (for example, athletes, workers involved in heavy physical work, dancers), the trophism (nutrition) of the cartilaginous tissue of the knee joint is disturbed, as a result of which the cartilage becomes thinner and destroyed, sometimes to the point of complete disappearance.
Who is at risk?Firstly, women over forty are at risk of developing arthrosis of the knee joint;It occurs in them 2 times more often than in the stronger half of humanity.Furthermore, the risk increases in women who are prone to being overweight or obese.
But, in general, gonarthrosis is a disease of the elderly.And there is a simple explanation for this.As you know, cartilaginous tissue consists of approximately 70-80% water, thanks to which it is well absorbed.In addition, at a young age, “regenerating” cells, chondrocytes, work actively.With age, the amount of moisture begins to decrease and, consequently, the ability to cushion the joint deteriorates, the cartilage becomes dry, brittle and 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 excess weight, physical inactivity, chronic joint damage or systematic microtraumatization of the joint, alcohol abuse, 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, for example, gout and a number of other pathological conditions.
It is often not possible to establish a specific cause that caused gonarthrosis of the knee joint;in this case, they speak of a combined cause, that is, the gonarthrosis was the result of several diseases at the same time.
In addition, the disease, according to the reasons for its occurrence, is usually divided into two forms: primary and secondary.
The cause of primary osteoarthritis is age and the presence of associated factors, such as:
- Professional predisposition,
- Overweight
- obesity,
- Varicose veins of the lower extremities.
The cause of secondary gonarthrosis may be a previous injury to the knee (fracture, rupture of the ligamentous apparatus), called post-traumatic arthrosis of the knee joint.The cause may also be a previous infectious disease or inflammation of the knee joint.
Symptoms
Signs of osteoarthritis of the knee joint do not appear overnight;The development of the disease occurs gradually and usually takes several months or even years.The pain that comes to the surface is constant and worsened by physical activity – walking, running, going up or down stairs and so on.Another characteristic symptom of this disease is the presence of crepitus in the joint, which may be a popping or grinding sound in the knee.
Also very common manifestations of gonarthrosis are:
- increase in local temperature (the joint is hot to the touch) or general,
- the presence of swelling of the joint,
- increasing its volume,
- difficulty moving,
- 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 begin defending itself.This is manifested by the growth of bone tissue in the bones that form the joint in the form of “spikes” (osteophytes), and deforming arthrosis of the knee joint occurs.Exudate appears in the joint cavities.
Depending on the size of the osteophytes and the degree of deformation, several degrees of gonarthrosis are distinguished:
- 1st degree gonarthrosis.Patients experience stiffness and mild joint pain in the morning or during prolonged periods of sitting or standing.There is no deformation of the joint at this stage, mobility is completely preserved.An x-ray reveals a small osteophyte.
- 2nd degree gonarthrosis.Painful sensations appear not only in the morning, but also after prolonged exercise;the joint is deformed, the articular surfaces are widened, as a result of which the volume of the joint also increases, flexion is difficult and there is a feeling of crushing when performing movements.The x-ray shows a pronounced osteophyte, the joint space is not altered.
- Gonarthrosis 3 degrees.The manifestations are the same as in the second degree, only the symptoms become more vivid.The pain is constant and does not decrease even with rest and 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.There is severe deformation of the knee joint.An x-ray reveals a slight narrowing of the joint space.
- There is also a fourth stage, in which there is complete immobilization of the affected joint with greater deformation.Radiographs reveal sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of osteoarthritis of the knee joint
To obtain good treatment results, you should seek help from a qualified rheumatologist and, if he is not available, from a therapist, as they are the ones who know how to cure osteoarthritis of the knee joint.Under no circumstances should you try to treat it yourself, as this may only make an already bad situation worse.Before starting treatment, it is extremely important to make a correct diagnosis, as correct diagnosis is the key to successful treatment.
The treatment of gonarthrosis is a very long process and depends on several factors (type of osteoarthritis, cause of osteoarthritis, degree of the disease).Treatment is complex and includes drug and non-drug therapy, with surgical treatment being indicated in some cases.
Drug treatment for osteoarthritis of the knee joint is mainly aimed at relieving the main manifestations of the disease, such as:
- Pain;
- Inflammation of articular and periarticular tissues.
In addition to relieving symptoms of the disease, medications are used to:
- restoration of articular tissues,
- improving its trophism and blood circulation,
- strengthening the body's defenses,
- eliminating allergic reactions.
To alleviate pain symptoms, various non-narcotic analgesics are used;In rare cases, narcotic pain relievers are prescribed for a short period of time.The most commonly used medications are from the group of non-steroidal anti-inflammatory drugs.They have a combined anti-inflammatory, analgesic and antipyretic effect.
Chondroprotectors are used to restore cartilaginous tissue and improve joint mobility.The drugs stimulate the activity of cartilage cells - chondrocytes, and help them restore tissues.Intra-articular administration of chodroprotectors produces a good effect.In recent years, a new and effective product based on hyaluronic acid has emerged.Because of its effect, this medicine is called “liquid prosthesis”.After injection into a painful joint, this medication forms a protective film on the damaged cartilage and gradually restores the joint's normal lubricating characteristics.
Muscle relaxants are used to relieve muscle spasms;In addition to the relaxing effect, they have a positive effect on blood circulation in the affected joint.
Among non-drug methods of treating gonarthrosis, manual therapy and physiotherapy are widely used.Of greatest importance are magnetic therapy, acupuncture, electrophoresis and massage, hardware traction (joint traction) and others.Recently, the practice of treating arthrosis has included methods such as laser therapy and cryotherapy (exposure to liquid nitrogen).Along with physiotherapy, exercise therapy for arthrosis of the knee joint also gives a good effect.Exercise therapy is the use of various physical exercises for therapeutic purposes.
Gymnastics for arthrosis of the knee joint
At the onset of the disease, physical stress on the affected joint should be kept to a minimum.You should not run, jump, lift weights, walk quickly or squat.Exercises for osteoarthritis of the knee joint can only be performed after completion of treatment, under the supervision of your attending physician.
It is necessary to choose exercises that will help strengthen the muscles and ligaments of the affected knee joint, but will not lead to excessive mobility of the joint.In other words, the exercises must be with minimal dynamic activity.It is useful to perform exercises to stretch the ligaments and joint capsules.The rules here are the same, perform the exercises smoothly, without making any effort.
When performing any gymnastic exercise, it is important to follow some rules:
- Don't exercise while overcoming pain,
- If an exercise causes pain, it should be replaced with a gentler one.
Massage for arthrosis of the knee joint has a beneficial effect on restoring the functions of the knee joint.At the site of exposure, blood vessels dilate, blood circulation improves and metabolism accelerates.Massage procedures improve lymphatic flow and this, in turn, helps eliminate residual inflammation.Massage strengthens the muscular system, increases the flow of oxygen to them, improves gas exchange, normalizes tone and increases plasticity.
Diet for arthrosis of the knee joint
Recently, medical experts discovered that there is no direct relationship between the incidence of gonarthrosis and nutrition.However, an indisputable fact is that the development of osteoarthritis is greatly influenced by the presence of excess weight in the 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 have fewer calories, fried foods and foods high in fat should be excluded from the diet.Eat more vegetables, fruits and fluids.
Prevention of osteoarthritis of the knee joint
In order for the joints to remain healthy for as long as possible, it is necessary to regularly practice physical education and gymnastics, but do not get too carried away with it, so as not to overload the joints.Swimming provides the best effect and minimum stress on the joints.If you play professional sports, you should wear joint protection.It is useful to alternate physical activity with rest;you should not remain still for a long time.
Compliance with all these simple rules, combined with a healthy lifestyle and proper nutrition, will not allow arthrosis of the knee joint to ruin anyone's life.