In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint occupies a leading place.
Gonarthrosis or arthrosis of the knee joint is a disease accompanied by slow destruction of the cartilage tissue of the joint involving the entire joint in the pathological process, including ligaments, synovium, subchondral bone and other elements of the joint.
Under the influence of various factors, such as infectious diseases (colds, flu, typhoid, tuberculosis, syphilis, tonsillitis, etc. ), injuries, functional congestion of the joint (for example, athletes, workers involved in heavy physical labor, ballet dancers)violation of the trophism (nutrition) of the cartilage tissue of the knee joint, as a result of which the cartilage becomes thinner and destroyed, sometimes until complete disappearance.
Who is at risk? First of all, osteoarthritis of the knee is at risk of "winning" women over forty, they have it 2 times more often than in the strong half of humanity. In addition, the risk increases in those women who are prone to being overweight or overweight.
But in general, gonarthrosis is a disease of the elderly. And there is a simple explanation for this. As you know, cartilage tissue is approximately 70-80% water, which is why it is well absorbed. In addition, at a young age, chondrocytes actively "repair" cells. With age, the amount of moisture begins to decrease and therefore the ability to soften 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 appearance of gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors are overweight, physical inactivity, chronic joint injury or systemic joint microtrauma, alcohol abuse, chronic stress, previous or existing knee disease, 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 a number of other pathological conditions.
Quite often it is not possible to identify any specific cause of gonarthrosis of the knee joint, in this case they speak of a combined cause, ie gonarthrosis is the result of several diseases at once.
Also, the disease, due to its causes, is usually divided into two forms: primary and secondary.
Primary osteoarthritis is caused by age and related factors such as:
- Occupational predisposition,
- Overweight,
- Obesity,
- Varicose veins of the lower extremities.
The cause of secondary gonarthrosis can be a previous knee injury (fracture, rupture of the ligament apparatus), called post-traumatic osteoarthritis of the knee joint. The same cause may be a previous infectious disease or inflammation of the knee joint.
Symptoms
The signs of osteoarthritis of the knee joint do not appear overnight, the development of the disease occurs gradually and often takes several months or even years. Pain comes to the fore, which is constant and increases with physical activity - walking, running, descending or climbing stairs, etc. Another symptom characteristic of this disease is the presence of crepitus in the joint, it may be crackingor crunching in the knee.
Also very common manifestations of gonarthrosis are:
- increase in local temperature (the joint is hot to the touch) or total,
- presence of joint swelling,
- increase your volume,
- difficulty moving,
- joint deformity followed by limb curvature.
As the disease progresses, when the cartilage tissue is completely destroyed, the body has no choice but to begin to defend itself. This is manifested by the proliferation of bone tissue on the bones that form the joint in the form of "spikes" (osteophytes), there is a deforming arthrosis of the knee joint. The exudate appears in the joint cavities.
Depending on the size of the osteophytes and the degree of deformity, there are several degrees of gonarthrosis:
- Grade 1 gonarthrosisPatients experience stiffness and mild joint pain in the morning or when sitting or standing for a long time. At this stage there is no deformation of the joint, mobility is fully preserved. An X-ray reveals a small osteophyte.
- Grade 2 gonarthrosis.Painful sensations appear, not only in the morning, but also after prolonged exercise, the joint deforms, the joint surfaces increase, as a result of which the volume of the joint also increases, flexion is difficult, crunch is felt when performing movements. . Radiography shows a pronounced osteophyte, the joint space is not changed.
- Gonarthrosis grade 3.The manifestations are the same as in the second degree, only the symptoms become more pronounced. The pain is constant, does not subside even at rest and sleep. The function of the joint is almost completely lost, patients can neither bend their legs nor straighten it. As a result, lameness appears, movement is possible only with crutches or outside help. There is a pronounced deformation of the knee joint. An X-ray shows a slight narrowing of the joint space.
- There is a fourth stage, in which there is complete immobility in the affected joint with further deformation. X-rays show the phenomena of sclerosis of the subchondral bone and a significant narrowing of the joint space.
Treatment of osteoarthritis of the knee
To achieve good treatment results, you should seek the help of a qualified rheumatologist, and if he is not there, a therapist, as they know how to cure osteoarthritis of the knee. Under no circumstances should you try to treat yourself, this can only make the situation worse. Before starting treatment, it is extremely important to make the correct diagnosis, as the correct diagnosis is the key to successful treatment.
The treatment of gonarthrosis is a rather lengthy process and depends on a number of factors (type of osteoarthritis, cause of osteoarthritis, degree of disease). The treatment is complex and includes drug and non-drug therapy, and in some cases surgical treatment is indicated.
Drug treatment of osteoarthritis of the knee is aimed primarily at relieving the main manifestations of the disease, such as:
- pain;
- Inflammation of the joint and periarticular tissue.
In addition to relieving the symptoms of the disease, the drugs are also used to:
- restoration of joint tissue,
- improving his trophism and blood circulation,
- strengthening the body's defenses,
- elimination of allergic reactions.
Various non-narcotic analgesics are used to relieve the symptoms of pain, in rare cases narcotic analgesics are prescribed for a short time. The most commonly used drugs 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 cartilage tissue and improve joint mobility. The drugs stimulate the activity of cartilage cells - chondrocytes and help them repair tissues. Intra-articular insertion of head protectors gives a good effect. In recent years, a new, effective product based on hyaluronic acid has appeared. For its action, this drug is called a "liquid prosthesis". Once injected into a diseased joint, this drug forms a protective film on the damaged cartilage and gradually restores the normal lubricating characteristics of the joint.
Muscle relaxants are used to relieve muscle spasms, in addition to a relaxing effect, they have a positive effect on blood circulation in the affected joint.
Manual and physical therapy is widely used by non-drug methods to treat gonarthrosis. The most important are magnetic therapy, acupuncture, electrophoresis and massage, traction of the apparatus (expansion of the joints) and others. Recently, methods such as laser therapy, cryotherapy (exposure to liquid nitrogen) have entered the practice of treating osteoarthritis. Along with physiotherapy, exercise therapy for osteoarthritis of the knee joint has a good effect. Lfk is the use of various physical exercises for therapeutic purposes.
Gymnastics for osteoarthritis of the knee joint
At the beginning of the disease, physical activity on the diseased joint should be minimized. You should not go jogging, jumping, lifting weights, brisk walking, squatting. Exercises for osteoarthritis of the knee joint can be performed only after undergoing a course of treatment, under the supervision of your doctor.
It is necessary to choose exercises that help strengthen the muscles and ligaments of the affected knee joint, but at the same time do not lead to excessive mobility. That is, the exercises should be with minimal dynamic activity. It is useful to do exercises to stretch the ligaments and joint capsules. The rules are the same, the exercises are performed carefully without any effort.
When performing any gymnastic exercises, it is important to follow some rules:
- Do not exercise due to pain
- If the exercise causes pain, it should be replaced with another more gentle.
Massage for osteoarthritis of the knee has a beneficial effect on the restoration of the functions of the knee joint. At the site of exposure, blood vessels dilate, blood circulation improves, and metabolism speeds up. Massage procedures improve lymph flow, which in turn helps to eliminate residual inflammation. Massage strengthens the muscular system, increases the flow of oxygen in them, improves gas exchange, normalizes their tone and increases plasticity.
Diet for osteoarthritis of the knee
Recently, medical experts have found that there is no direct link between the incidence of gonarthrosis and diet. However, it is an indisputable fact that the development of osteoarthritis is strongly influenced by the presence of overweight in humans. If the cause of the disease is precisely overweight, then it is obvious that nutrition in osteoarthritis of the knee joint should be aimed at gradual weight loss. This will require a change in diet and a change in diet. Food should be less caloric, 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 stay healthy for as long as possible, it is necessary to exercise regularly and do not exercise too much, so as not to overload the joints. Swimming gives the best effect and minimal stress on the joints. If you do professional sports, joint protection should be used. It is useful to alternate physical activity with rest, you should not stand still for a long time.
Following all these simple rules, along with a healthy lifestyle and proper nutrition, will not allow osteoarthritis of the knee to ruin everyone's life.