Gonarthrosis of knee joints 2 degrees: causes, symptoms, treatment
Gonarthrosis is a progressive disease in which the cartilage tissue of the knee joint is destroyed, which protects bone structures from damage.
Knee joint gonarthrosis is in the top five most common diseases of the musculoskeletal system. Symptoms of gonarthrosis are observed in 20% of the population over 40, with the most common gonarthrosis of the knee joint of the 2nd degree. The fact is that at 1 degree the symptoms of the disease are almost not expressed: the mobility of the knee is not limited, and few people pay attention to weak pains. The destruction of the joint to 2 degrees causes a strong discomfort in a person, which makes it necessary to seek help from a rheumatologist.
When gonarthrosis of the 2nd degree of a person is concerned with frequent and persistent pains that occur both after minor physical exertion and after a long rest. While at 1 degree of pain appear only after prolonged physical exertion, and manifested rather poorly. Another characteristic feature of the 2nd degree of joint damage is an audible crunch and clicks when walking, bending the leg or other movements that arise due to the depletion of the cartilaginous tissue. In general, the symptoms of the pathology give the patient a palpable discomfort and significantly reduce the quality of his life.
It is impossible to fully cure gonarthrosis of grade 2.But there are accessible therapies that allow you to stop unpleasant symptoms and give the person the opportunity to lead a full life. What is this treatment - read further in the article.
Stages of gonarthrosis and knee joint destruction: at the top - a schematic image, at the bottom - an X-ray. Click on photo to enlarge
The main cause of the disease
Normally, our joints work smoothly and noiselessly during various movements - due to the fact that they have elastic cartilages that are constantly washed with a special "lubricant"( synovial fluid).
When gonarthrosis cartilaginous tissue is destroyed and can not fully perform its damping function. Pathology progresses very slowly and does not bother people for a long time, so the treatable first degree of the disease often goes unnoticed.
The main cause of gonarthrosis of the 2nd degree is the ignoring of the first symptoms of the disease and the later visit to the doctor( rheumatologist) already at the stage of severe joint destruction which causes severe pain and prevents proper movement.
Immediately gonarthrosis of 2 degrees( bypassing the first) can occur after a serious injury.
Also, if the patient ignores the causes of the 1st degree - they are also the causes of the 2nd degree of the disease:
- trauma( meniscus lesions, knee dislocations, shin fractures);
- excessive loads;
- excess weight;
- malnutrition and lifestyle;
- is an inflammation of the joint( arthritis).
Arthritis is one of the causes of
gonarthrosis. Characteristic symptoms of
. On the 2nd degree of disease, the vessels in the affected area are already so worn out that cartilage tissues receive minimal amounts of nutrition and oxygen. Including, therefore, the following symptoms appear:
- severe pain after prolonged rest( starting pain);
- pain after prolonged stress on the knee( after prolonged standing or prolonged walking);
- drying of the leg muscles on the affected leg due to the fact that the patient instinctively transfers the main load to the healthy leg when walking;
- knee swelling without joint deformity.
Characteristic distinctive symptoms of exactly 2 degrees of gonarthrosis: the first signs of deformity of the knees, possibly the defeat of both knee joints.
Knee deformation in gonarthrosis
Five treatments for
Treatment of gonarthrosis of 2nd degree is performed exclusively by conservative methods. According to the doctors and patients, a correctly formulated course of therapy and strict adherence to prescriptions in 50% of cases give positive results: pain completely disappears, edema subsides, and there is a possibility of normal joint movement.
Therapy includes five methods:Method What effect does this treatment have?
1. Treatment with non-steroidal anti-inflammatory drugs. Examples of preparations:
Effectively relieves pain, allows a person to move normally and eliminates inflammation of tissues.
2. Treatment with chondroprotectors: glucosamine and chondroitin sulfate.
Restores cartilaginous tissue.
3. Physiotherapeutic procedures: electrophoresis, magnetotherapy, laser.
Physiotherapy supplies drugs directly to the affected area, and the drugs act quickly and efficiently.
4. Physical therapy.
Restores blood circulation, improves joint mobility. Very well combined with physiotherapy procedures.
Same as LFK.
With gonarthrosis of 2 degrees, cook exclusively boiled, steamed and stewed food - this is necessary to improve the digestion of the body protein and collagen.Need to eat Especially useful
A large number of vegetables
Dishes containing gelatin and collagen: chilli, pudding, jellied.
Foods containing folic acid: bananas, liver, buckwheat, cabbage, lentils.
Lean meat( turkey or chicken)
Foods containing vitamins B6 and B1:
Wholemeal bread with bran
Vegetable and animal proteins:
These dietary recommendations are relevant and the same for all levels of gonarthrosis.
Author: Svetlana Kant
What helps the exercise therapy in gonarthrosis of the knee joint
The affected joint is devoid of cartilaginous "cushion", which leads to the destruction of bones
Pain in the knees is a fairly common complaint that people turn to a surgeon and a rheumatologist. In most cases, the cause of poor health of the patient becomes arthrosis. Like many other diseases, arthrosis has several stages. If stage 3 is diagnosed, the disease is considered serious enough and is treated only with the help of surgical intervention. In the 1 st and 2 nd stages the disease can be overcome with the help of a special exercise program for gonarthrosis of the knee joint.
If the exercises of therapeutic gymnastics are chosen correctly, the result will not be long in coming, and soon the patient will recover. But not only a properly selected program contributes to a speedy recovery. At treatment are important:
- the balanced food, a diet;
- regular massage with gonarthrosis;
- the correct performance of gymnastic exercises;
- reception of prescribed medicines;
- the patient's desire to recover.
Benefits of Medical Gymnastics
LFK in gonarthrosis is an important part of the treatment, and you should not neglect it. An imposed stereotype that they are treated only with medicines has long been in the past. A set of exercises aimed at improving the patient's health is designed specifically to combat this disease.Special exercises for gonarthrosis of the knee joint adapt the muscles to permanent loads, strengthen them. As a result, the damaged joint is kneaded, the stiffness of the muscles passes. This means that the pain that the patient experiences is gradually disappearing. Gymnastics in gonarthrosis is beneficial if the person is engaged in it systematically. In this case, pain passes quickly enough, the patient becomes easier to walk, the functions of the knee joint are gradually restored. Of course, it is unlikely that gonarthrosis will pass without a trace when applying only exercise therapy, but at least it will not progress. The pain will disappear and the patient will be able to return to the usual rhythm of life.
The benefit of curative gymnastics lies in the fact that it is an excellent prevention of any joint diseases. There are several factors that affect the manifestation of gonarthrosis:
- prolonged stress on the joints;
- excess weight;
- heavy physical exertion.
LFK exercises will help to remove fatigue, relax the muscles, will not allow a person to overwork and give strength.
Gonarthrosis is not an easy disease, it is characterized by the decomposition of cartilage. In order not to aggravate the processes occurring in the body, it is necessary to observe certain rules for performing exercises with gonarthrosis of the knee joint. They will help make gym classes safe and enjoyable.While performing the exercises, do not allow strong pressure on the knee joint. Make soft movements. Feel your body. Respond to any pain, do not ignore them. The actions to be performed should be pleasant and relaxing, not causing pain and discomfort. If you feel very uncomfortable, stop exercising. Give the muscles a rest 1-2 days, and then continue the course.
Classes should be regular, but it is only after the acute pains that a full course starts. The duration of gymnastics can be different. It is advisable to begin with 10 minutes a day, and then, as far as possible, increase this time. The maximum duration of the lesson is 30 minutes. It should be noted that the exercise load should be static, and not dynamic. In a certain position, you can linger. In this case, the muscles get the right load, but the damaged joint remains at rest.
Do not try to quickly increase the duration of exercise and the degree of stress. To strengthen your muscles, they must first become flexible and elastic. Therefore, first of all, start with simple exercises that will prepare your body for longer and more serious stresses.
If you do not understand how to perform the exercise, or do not know when you can, and when you can not increase the time of training, do not be afraid to ask advice from a specialist.
Exercises for maintaining the health of
Examples of such exercises are very diverse. First of all, they are aimed at strengthening and relaxing the muscles. One of the main exercises is done for stretching. To do this, take a piece of cloth 10 cm wide and 20 cm long. Lie down on the floor. Grasp the edges of the tissue strip, and in the loop, thread the leg. It turns out that you pull the ends of the fabric toward you, and in the middle pull your foot in the opposite direction. Try to bring your foot as far as possible. Once you feel that the muscles are tight enough, hold your foot in this position for 15 seconds. Repeat the same with the other leg.
Continuing to stretch the muscles and develop joints, you can make attacks. In order to feel calmer and not lose balance, grasp the back of the chair. Do not make attacks sharply: this can lead to painful sensations.
Get down on the floor and lift the upper part of the trunk. For greater comfort, lean on your elbows. Bend your knees. Now gently level each leg at an angle of 45 degrees. Do not stretch your fingers. Try to delay each time your foot in the air for as long as you can. Repeat the task 10 times with each foot.
Similar exercises well develop muscles, make them more elastic and strong. Lie down on the floor and bend your knees. Place a soft ball between your legs and squeeze it. Maintain this maximum voltage for as long as possible. Then give yourself a rest. Repeat the exercise several times.
Stand with your back against the wall, lean against it with your hands. Rise on tiptoe and slowly go down to the starting position. After that, transfer the weight to your right leg, and try to take the left one to the side. Hold it for a few seconds in the air. Go back to the starting position and repeat the same with the other leg.
Greatly strengthens any muscle walking. Try to walk every day at least half an hour on the street or marching at home in one place. Supplement the complex exercises can be swimming or aqua aerobics. Such lessons will only benefit, because they help restore damaged muscles and joints.
Diet in case of
The food for gonarthrosis should be saturated with products that are important for the successful functioning of the body and maintaining its efficiency. Very useful in this case, vitamin C. It slows the progression of any form of arthrosis and takes part in the creation of collagen. This vitamin is a powerful antioxidant that can reflect the effects of free radicals. When gonarthrosis, the patient should consume 200 mg of vitamin C daily. This is significantly more than the daily rate of a healthy person, but absolutely safe. Vitamin C is found in Bulgarian pepper, oranges, broccoli, cauliflower, melon, strawberry, kiwi.
Beta-carotene is a vital antioxidant, the consumption of which is necessary for gonarthrosis. This substance is safe in any amount, so do not be afraid that patients with arthrosis should consume it in an amount that is 4 times higher than normal. The diet with gonarthrosis of the knee joint implies an increased intake of beta-carotene due to the fact that it feeds cartilaginous tissue and protects it from negative influence. Products with a high content of the substance - boiled spinach, carrots, pumpkin, sweet potato, mango, peaches, red pepper.
Vitamin D plays a significant role in the absorption of calcium, which is necessary for bone tissue and the normal functioning of the joints. If the patient does not eat enough of this substance, arthrosis can continue to develop. Vitamin D is produced by the body during the period of exposure to ultraviolet radiation. To get the body's dose, you need to spend 20 minutes a day in the sun. But not always people have such an opportunity.
To maintain normal functioning of the body and receive vitamin D, it is necessary to eat salmon, mackerel, eggs and milk.
Treatment of gonarthrosis of the knee joint - medicines, chondroprotectors, sport and diet
Knee joint gonarthrosis is a common disease that is a step-by-step drying of the cartilage tissue , causing deformation of the joint with loss of its functions.
This violation is also called osteoarthrosis and deforming gonarthrosis.
Classification of the disease
Types of the disease:
- primary - it affects older people, although it is impossible to trace the pathogenesis of the disease in this case;
- ptorichny - appears due to mechanical damage to the knee or its lesion due to inflammation in the body, has no age restrictions.
Regardless of the type of deviation, 3 stages are distinguished:
- At , the initial stage of , the patient feels a slight pain in the knee that appears after a prolonged load or when walking. Joints in this period are not subject to deformation.
- In the second stage, the pains of begin to increase and become more frequent, and not necessarily because of the loads. The mobility of the joint is worsened, it looks slightly swollen and deformed.
- At the last stage of , the process is characterized by an acute pain syndrome. The patient may have meteosensitivity, and the pain then becomes unbearable. The deformity of the joint can be seen with a normal look, and the knee has a bloated and cyanotic appearance.
Details about gonarthrosis of 2nd degree:
What is the peculiarity of2nd degree knee joint
Under gonarthrosis, we mean the damage to the cartilage and the bony growths that occur on the joint, the xytosis of the articular tissue. Osteoarthritis of the knee - deg. ..
Details about gonarthrosis of 3rd degree:
Is it possible to treat gonarthrosis of the knee joint of the third degree and why does the disability come
Gonarthrosis of the third degree of the knee joint is the heaviest. The disease significantly complicates the life of patients, severely limits work capacity....
Aims and objectives of
treatment The goals of treatment of deforming knee joint gonarthrosis:
- to neutralize pain;
- , if possible, restore the affected cartilage and ligaments;
- to increase the mobility of the joint.
How to cure the disease
Modern medicine offers several techniques.
All medicamental treatment of gonarthrosis can be divided into 2 types: for internal and external use. Among other things, solutions for injections are also used.
In cases of arthrosis, non-steroidal anti-inflammatory drugs are usually used to neutralize pain and inflammation.against a background of severe pain, one can not begin treatment.
Only by eliminating the acute pain, you can subsequently go to massage, gymnastics and those physiotherapy activities that because of the pain would be unbearable.
Among other things, using these tools, it must be borne in mind that all of them have serious contraindications and with long consumption can give tangible side effects.
Therefore, for long-term use it is better to use selective drugs( movalis).
Application of chondroprotectors
Chondroprotectors - glucosamine and chondroitin sulfate - substances that feed cartilaginous tissue and restore the structure of the affected cartilage, the most useful form of treatment for violations.
They influence the cause of the disease: it favors the restoration of cartilage, the improvement of the production of joint fluid and the normalization of its properties.
This effect of the drugs makes them indispensable in the treatment of the initial stage of arthrosis.Chondroprotectors are not very effective at stage 3 of the disorder, when the cartilage is almost destroyed. After all, it is impossible to grow a new cartilage or to return the form to bones by means of glucosamine and chondroitin sulfate.
Treatment with these substances requires competent and long-term administration in combination with other methods of exposure.
Of all the drugs used in the treatment of arthrosis, this group is the most beneficial. In addition, they have almost no side effects.
To achieve a powerful therapeutic effect, chondroprotectors should be applied by courses, regularly, for a long period. It makes no sense to take glucosamine and chondroitin sulfate from case to case.
Ointments and creams can not cure arthrosis of the knees. But they can alleviate the condition and reduce pain in the affected area. To this end, ointments are extremely useful.
So, with arthrosis, without synovitis, warming ointments improve the blood flow in the joint. For this use of menovazine, gevkamen, etc. These ointments usually cause the patient a feeling of pleasant warmth. They rarely give side effects.
Ointments based on non-steroid substances( indomethacin, butadione, dolgite) are used when the course of the disorder is combined with synovitis.
Compressors for compresses are more effective than ointments. Of the topical agents used today, the most common dimexide, bischofite, medical bile.
Sport and gymnastics
Many people think that physical activity is forbidden in case of illness. For the normal operation of the joint, he needs strong developed muscles, which is whymoderate sports activities in the disorder bring only good.
Two-sided gonarthrosis of the knee joint can and should be treated with leisurely exercises. It should be taken into account that the patient joints can not be subjected to sudden movements and heavy loads.
Except gymnastics, long walks in the fresh air are useful.
The diet for gonarthrosis is a powerful way to influence the course of the disease.
The food should be balanced, but too high-calorie food needs to be removed, tk.they can lead to excess weight, which is one of the main causes of gonarthrosis.
The peculiarity of nutrition is that it must be saturated with animal proteins, because they are involved in the structure of muscles. But to feed the cartilage is necessary to use jelly, broth, brewed from the bones.There is also a list of products not recommended for arthrosis of the knees. This alcohol, fatty meat, cabbage, tomatoes, pepper, milk, sour fruit.
Manual therapy for violations of I and II stages gives a remarkable result. Sometimes several sessions are enough to make the patient feel better.This method of treatment is especially effective in combination with joint extension, chondroprotective consumption and intra-articular administration of Ostenil.
Osteoarthritis of the knee joints is a deviation occurring in 3 stages of development.
And if at first you can cure by means of drugs from arthrosis, gymnastics and massages, then if there are already changes in the joint, then the output is the operation.
Today, there are several types of interventions that can eliminate pain and discomfort due to impairment. Some of them, for example, artodes, give a certain immobility to the joint, rather than neutralize the pain.
More modern techniques involve the use of prostheses, which can replace the joint or improve its work through a special plate.How and how to treat polyarthritis of the hands with traditional and traditional medicine.
What sections of the population are at risk of getting trochanthitis and what should be known about the prevention and treatment of this unpleasant disease.
Traditional treatment of knee joint gonarthrosis
In many situations, folk remedies are extremely effective. Tinctures and ointments on herbs give a good effect. So, you can rub a sore spot with camphor oil or make a compress with apple cider vinegar and honey.
Many recipes for the treatment of violations are used as the basis of the leaves of burdock. It is necessary to attach the sheet to the joint, wrap with a film and a warm scarf for the night.
By the same principle, you can use white cabbage leaves. To enhance the effect it is necessary to grease the cabbage leaf with honey.
It is necessary to understand the danger of diseases of knee joints. Means for treatment should be selected carefully, given all the nuances.
At the first manifestations of pain in the knees of , it is worthwhile to find an experienced doctor , which will give effective guidance on preventing this problem.
In the initial stages of gonarthrosis is better treated than late. If you want to live without pain and unnecessary complications, take care of your health and the health of your joints.
Video: Exercises for gonarthrosis
What if my knee is sore and there are suspicions of gonarthrosis? You need to visit a doctor to make a correct diagnosis, and also to study these exercises.
Symptoms, Diagnosis and Treatment of Knee Osteoarthritis 1,2,3 Degrees
Knee joint gonarthrosis is a fairly common disease, the leader of all arthrosis. His active study of physicians of different countries began over a century ago, which causes significant progress in the fight against the disease. At the household level, this pathology is stubbornly called the deposition of salts, although the process of calcification does not play a primary role. The disease is dangerous in its development and can lead to a restriction of mobility and disability.
Knee joint gonarthrosis requires long-term treatment, which is not always able to help without prompt intervention. In order not to appear on the surgical table, it is very important to detect pathological changes in time and start treatment at an early stage. Like most joint diseases, this type of osteoarthritis is easier to prevent, taking preventive measures, than to treat after debilitating pain.
What happens with this disease?
Gonarthrosis, or osteoarthrosis of the knee, is a degenerative-dystrophic joint injury caused by degeneration of the cartilage, until its complete destruction, and leading to deformation of the joint;while less pronounced inflammatory reactions are secondary phenomena and are also generated by degeneration processes.
The onset of pathology is usually associated with structural changes in cartilage tissue at the molecular level, including as a result of circulatory disorders in small vessels. Then the hyaline cartilage is involved in the process, which becomes turbid, decreases in thickness, is stratified and covered with multidirectional microscopic cracks. The pathological process is completed by the complete destruction of small and large cartilage, and at the same time bone articulation is exposed.
The organism instinctively reacts to the disappearance of cartilage by bone growth in peripheral zones, which is expressed in the growth of osteophytes. As a result of abnormal changes, the joint is deformed, the lower limb is bent. Such a result ensured the name of destructive pathology - deforming arthrosis.
Disturbances in gonarthrosis
The development of the disease proceeds with the growth of the following pathological disorders in the joint:
- Disturbance of the metabolic process in the cartilaginous tissue: a constant supply of cartilage occurs due to the liberation and absorption of the lubricant when the joint moves, but the disease leads to a change in osmotic pressure and infringement;at sites of the raised pressure there is a thinning of a cartilage.
- Structural changes of collagen fibers: the softening of the patellar cartilage starts, the depreciation function of the cartilage and the metabolic capacity of the chondrocytes are broken - the cartilage loses its elasticity and its instability appears.
- Distortion of articular congruence: the synthesis of bone substance, leading to the growth of osteophytes, is activated. As a result, the synovial membrane is irritated, which generates an inflammatory process in it, the loss of joint mobility begins.
- The most active destructive process occurs in the inner region of the joint and in the gap between the knee and the femur.
Classification of pathology
Classification of gonarthrosis is carried out in accordance with the international system of ICD 10 by code 17.0 - 17.9.There are 2 main types of etiology: primary and secondary osteoarthrosis.
Primary( genuine) type is the development of a degenerative process on a healthy cartilage that has not previously been subjected to pathological effects. The process is the result of mechanical and physiological overloads. Secondary form of the disease develops on the joint, previously subjected to pathological effects( trauma, disease), and the beginning of the process is due to a decrease in the durability of cartilage tissues to normal loads. The most common form is posttraumatic gonarthrosis.
Given the localization of lesions, one-sided and two-sided gonarthrosis is different. In turn, a one-sided view is characterized by joint damage on only one limb: right-sided and left-sided gonarthrosis. The most difficult and dangerous is the two-sided type, when the knee joints of both legs are subjected to destruction. The main reason for the appearance of this form is the age factor.
Causes and stages of the disease
In order to start the degenerative-dystrophic process of destruction of cartilage tissue, provoking factors are needed.
The following causes of the disease are distinguished:
- metabolic disorder, especially hormonal imbalance;
- circulatory disturbance and capillary fragility;
- excessive body weight;
- knee injury( fracture, cracked bone, ruptured ligament or meniscus);
- inflammatory diseases( rheumatism, arthritis);
- frequent and prolonged physical overload( especially among athletes - gymnasts, football players, athletes, tennis players);
- disorders of the endocrine system;
- genetic abnormalities of the structure of tissues;
- hereditary predisposition, violation of body statics;
- age factor.
The severity of gonarthrosis is determined by the type of injury and complications.
It is subdivided into 3 stages and, accordingly, 4 degrees of development:
- 1 stage( 1 degree): the initial phase, characterized by a small narrowing of the joint gap, visible on the roentgenogram. There is a feeling of discomfort in the joint, fatigue by the evening, a slight limitation of joint mobility.
- 2nd stage( 2nd degree): on the roentgenogram there is a significant narrowing of the gap and the appearance of osteophytes, bone growths. There is the appearance of pain syndrome with strengthening with prolonged standing or walking, a crunch in the joint, complicated flexion and extension of the leg in the knee, the angle of extension of the leg is limited, the appearance of signs of atrophy of the quadriceps femoris.
- 3rd stage( 3rd degree): joint deformity with leg axis violation, joint instability. There is a sharp increase in pain, even at rest, edema, local temperature, impaired mobility of the joint.
- Stage 3 with 4 degrees of severity: severe joint deformity, complete disappearance of cartilage, impaired mobility of the limb, pain is permanent.
At the initial stage, the symptoms of gonarthrosis are manifested by a feeling of contraction of the muscle under the knee and a slight pain after a long hike. In the mornings or after a long sitting, it takes time to "puff up" the joint and eliminate discomfort in the knee. The development of pathology leads to the appearance of a pain syndrome under the knee. When walking, there is a crunch in the joint. Further progression of the disease limits the mobility of the joint, there are problems with squatting and extension of the legs, lame appears. Pain is getting stronger and longer.
Visual inspection of the joint in the initial stages does not reveal any changes. Gradually, the joint deformity becomes noticeable, and then the curvature of the shin. If you put your hand to the knee, then when flexing your legs you can distinguish a distinct crunch. Palpation indicates the presence of a painful patch on the inside of the knee joint.
Signs of gonarthrosis are greatly enhanced if the disease is complicated by synovitis( inflammation of the inner shell).In this case, already at the first stage swelling of the joint is noticeable due to liquid. At further stages, it fills even the popliteal fossa in the posterior articular region( Baker's cyst).Pain syndrome is greatly enhanced.
The primary diagnosis is established by examination, palpation of the joint, changing the direction of the bones, the angulation of the mobility of the joint. Laboratory tests are conducted on general blood and urine tests: determination of ESR, fibrinogen, urea and other biochemical parameters. The ultrasound of the knee joint is performed. The most informative are X-ray studies and magnetic resonance imaging. Only after that the doctor treats the disease.
Tactics and methods of therapy
The question of how to treat gonarthrosis of the knee joint, the doctor decides, taking into account the stage and severity of the disease.
In general, the treatment is performed in a complex way, but usually includes the following steps:
- Elimination of the inflammatory response: Non-steroidal anti-inflammatory drugs are prescribed: Diclofenac, Olfen, Diclac, Ibuprofen, Indomethacin, Ketaprofen, Meloksikam,, "Nimesulide";at a complicated stage, injections with the introduction of hormones - drugs "Hydrocortisone", "Kenalog", "Diprospan";To stop degenerative processes, antifoam agents are prescribed - Counterline, Ovomin, Gordoks.
- Anabolic and anti-catabolic effect, restoration of cartilaginous tissue: chondroprotectors - Structum, DONA, Rumalon, Alflutol, Mukosat.
- Normalization of blood circulation, warming and soothing effect: ointments, gels, creams - Finalgon, Fastum gel, Nikofleks, Apizarthron, Feloran.
- Improvement of blood circulation, strengthening of vascular tissues: vasodilating drugs - Cavinton, Trental, Actovegin, Uppsit, Ascorutin.
- Reduction of muscle tension: antispasmodics - "No-shpa", "Midokalm", "Tizalud".
- Restoration of synovial fluid: substitutes - "Otrovysk", "Hyalual", "Fermatron".
Complicated forms of the disease are treated with additional methods, such as: oxygen therapy( introduction of oxygen);introduction of stem cells;laser therapy;the introduction of the protein preparation "Ortokin" on the basis of blood serum.
In the last stages of gonarthrosis, the only effective method is surgical treatment. A surgical operation for prosthetics of the affected tissues is performed. Depending on the severity of the disease, the following operations are performed:
- arthrodesis( removal of the destroyed cartilage along with the joint);
- arthroscopic debridement( removal of deformed cartilage with an arthroscope);
- osteotomy( fixation of bones in another position);
Treatment of gonarthrosis of the knee joint, especially at the initial stage, is carried out in ways that do not involve medical therapy. The therapeutic sports complex allows to improve blood circulation, strengthen the musculoskeletal system, raise muscle tone, maintain joint mobility. LFK is developed by the treating orthopedist under the individual scheme.
Physiotherapy for osteoarthritis involves the use of the following methods: electrophoresis with bischofite, caripain and reinforcement with dimexide;magnetic therapy;ultrasound;microwave exposure;paraffin application;reception of radon and hydrogen sulphide baths;mud baths. Its effectiveness was proved by therapeutic massage and manual therapy, if conducted by a specialist.
Prophylaxis of the disease necessarily provides proper nutrition.
The diet for gonarthrosis excludes the use of pickles, spicy and fatty dishes. The menu recommends the inclusion of increased consumption of low-fat chill( for example, in poultry meat), jelly from natural fruits. It is useful to eat sea fish and seafood.
Loss of capacity for work and a group of disabilities are not threatened if the prevention is carried out with folk remedies. Effective use of infusion based on garlic and lemon with the addition of celery. Recommended tea from the grass of black beans. Especially useful is the grass of moccas, which should be added to various salads. And of course, the welding of beef knees and hoofs, it is better to eat hot, not hardened fat.
Knee joint gonarthrosis treatment, symptoms, causes
For the first time this disease appears after forty years and most often it is diagnosed in women who complain of pain in the knee.
Knee joint gonarthrosis
No one pays special attention to this and everything is written off to the deposition of salts.
But in fact the cause of pain is gonarthrosis of the knee joint. The essence of the development of this disease lies in the dystrophic changes of the hyaline cartilage, which are covered with the tibial condyles, as well as the femur. In the future, gradual destruction of the cartilage takes place and as a result the subchondral surface of the bones forming the knee joint is exposed.
Causes of the appearance of the disease
The causes of this disease are different, it all depends on whether primary or secondary gonarthrosis is diagnosed.
This type of disease appears most often in the elderly, and against a background of complete health. It is suggested that the cause of the disease is a disturbed metabolism, because gonarthrosis is more often diagnosed in patients with obesity and overweight.
There are suggestions that the cause of the disease is a hereditary factor, which can also be affected by the long intake of hormonal drugs and much more. In this case, do not forget that the presence of anomalies in the structure of the joint tissues, not only cartilaginous, but also bone may be the cause of gonarthrosis. Also, the appearance of the disease can significantly affect the various pathologies of the ligament apparatus.
In this version of the disease, the causes are more obvious:
- knee injury - bruises, dislocations and the like;
- surgical operations that a person suffered after a knee injury, removal of the meniks;
- joint disease - arthritis or swelling and other inflammatory diseases in the joints;
- untimely appeal for medical care after the received knee injuries, which leads to the development of gonarthrosis;
- hormonal imbalance. This can be a slow metabolism or a malfunction of metabolic processes in the body;
- excessive intensity of physical exertion on the joint. As a rule, it manifests itself in people engaged in professional sports;
- diseases that adversely affect muscle tone, muscle spasms and clamps, stiffness of muscles.
Symptoms and stages of the disease
Symptoms of gonarthrosis of the knee depends on its stage. There are three main stages of the disease.
Each stage characterizes a certain period of the course of the disease - from the moment of small changes, to serious lesions of cartilaginous tissue and its complete disappearance.
Gonarthrosis 1 degree
In the initial stage, the disease manifests itself stiffness in the knee joint in the morning hours after sleep and a little pain.
Grade 1Gonearthrosis A person notices that pain and stiffness are aggravated by long walking or prolonged stays in a sitting position. However, with the first degree of gonarthrosis, there is no deformation of the cartilage in communication, with which the pain syndrome is not strongly manifested, and the mobility of the joints remains the same. It is for this reason that in many cases the disease remains unnoticed;
Gonarthrosis of 2nd degree
Gradually the pains become stronger and more persistent. They appear not only after sleep, but also with a prolonged load on the knee - for example, if you stand on your feet or climb the stairs for a long time.
Gonarthrosis of the 2nd degree
In the lying position, the pain decreases. The knee deforms and increases in volume, the patient feels a characteristic crunch when flexing the leg. Bony outgrowths - osteophytes - grow on the surface of the joint. Also, there is no full possibility of bending the leg, which leads to a curvature of the vertebra.
Gonarthrosis of 3rd degree
Symptoms are all the same, but they are more pronounced. The pain in the knee is permanent, it tortures a person both during walking and at night, preventing them from falling asleep normally.
Gonarthrosis of 3rd degree
Sharply disrupted joint function - the patient can not bend the leg in the knee even at ninety degrees.
There is lameness, a person falls on an affected leg or is unable to move without assistance at all.
Deformation of the joint can be seen immediately, on the X-ray, a change in its structure is diagnosed. The bone surfaces are so deformed that there is practically no gap between them, which is necessary for movements and the person has to experience continuous cutting pain.
Treatment with medical and folk remedies
The gonarthrosis of the knee joint is treated for a long time, and the treatment requires doctors to be highly professional, and the patient must be patient. But you can not get rid of the disease forever, but it is quite possible to slow its development.
Medication therapy involves the administration of the following drugs:
- means for getting rid of pain. To do this, anti-inflammatory non-steroid drugs are prescribed: diclofenac, indomethacin, paracetamol and others. But they are taken according to the doctor's prescription, a long reception of these medicines can cause an exacerbation of gastritis or stomach ulcers. It should be noted that the action of these drugs is aimed at reducing inflammation and the manifestation of a feeling of pain. Therefore, they only hide the unpleasant symptomatology and do not relieve the disease;
- chondroprotectors. These drugs contain chondrocytes, which will restore the structure of the cartilage. The drugs help to increase the mobility of the affected joint and stop the development of the disease. However, chondroprotectors have a positive effect on the initial stages of the development of pathological changes in the knee joint. They are absolutely useless in the complete destruction of cartilage. These medications are very slow acting and need to be systematically used in certain doses for several courses over a period of one to one and a half years;
- anti-inflammatory drugs. These are corticosteroids, which are hormonal drugs with a strong effect. When the cartilage tissue is destroyed, an inflammatory process occurs and a fluid forms in the joint, and corticosteroids are injected into the joint itself. This hydrocortisone, Kenalog and much more. Assign and hormonal gels with ointments - Diclofenac, butadione and others;
- preparations of hyaluronic acid. A film is formed on the damaged joint, which prevents further destruction of the cartilage by reducing the friction between the articular cavities. As a result, the cartilaginous tissue becomes much more elastic and elastic, including its depreciation abilities. The treatment of gonarthrosis with hyaluronic acid preparations is carried out by courses.
Methods of treatment without the use of medications
This is a physiotherapy that can reduce pain in the affected joint and relieve inflammation. In most cases, electrophoresis is used, because with its help, external drugs penetrate much deeper than the usual application to the skin. Also, to improve nutrition and microcirculation of tissues in medicine, magnetic devices, ultrasound, laser radiation are used.
Medical gymnastics together with manual therapy will relieve overexertion from muscles and joints, improve the condition and mood of the patient. Wellness gymnastics is an indispensable component of successful treatment of gonarthrosis. Exercise helps to strengthen the muscular system of the lower leg and thigh, thereby increasing mobility of the limb and improving the condition of the ligaments.
In some cases, surgical treatment is prescribed. As a rule, it is necessary in cases when pronounced deformity of the knee joint is observed and its complete immobilization arises and at the same time conservative methods of treatment are not effective. This is endoprosthetics and arthroscopic debridement. In the first case, the patient is placed with a ceramic, metal or plastic prosthesis. In the second case, with the help of an arthroscope, the painful, broken parts of the cartilage are removed.
Folk recipes do not lose their relevance. The joint use of "grandmother's recipes" and medications will have a good therapeutic effect.
It is recommended to rub the joint joint with camphor oil, apply a mixture of apple cider vinegar and honey, or apply a compress from the burdock leaves to the affected knee.
Also, the section of traditional medicine advises you to tie a heated shredded horseradish root at night to your knee, and with pains, drink three times a day a glass of broth from onions, which is prepared by calculating two onions per 1 liter of boiling water. In addition, it is useful to take a bath twice a week with a decoction of grass hay and malt. If there is a pronounced inflammatory process, wipe the knee joint with a lemon wedge.
Prevention of gonarthrosis
The most important thing in the prevention of this complex disease is muscle training and constant maintenance of them in tone. Very often, having heard advice from a doctor to do gymnastics, a person neglects this and very much in vain. Exercises will help to adapt the body to constant loads, because when they are performed, the muscles of the legs are strengthened.
Prevention of gonarthrosis
Excess weight is also a risk factor for the onset of gonarthrosis. This same gymnastics will help him to fight, because the fat people are constantly stressed by joints due to weight.
One of the causes of the disease is trauma. Therefore, while skating, skiing should be cautious and if you do not imagine your life without it, then take care of good protective equipment and use quality knee pads.
Vitamins are especially useful for prevention. This vitamin E, D and C, so you need to periodically use vitamin complexes.
Calcium fortress will take care of calcium fortress, a high amount of calcium is found in eggs, sesame and celery.
The right diet will help the joints. The food should be balanced and correct, for the prevention of gonarthrosis you need to consume a lot of fresh vegetables, cakes and sweets replace with fruits. In winter it is useful to eat cranberries with honey. Homemade cottage cheese, milk and cheese will also help to strengthen joints with bones.
Knee joint gonarthrosis 1, 2 and 3 degrees: treatment, causes, symptomsWhat is this - gonarthrosis is a non-inflammatory disease of the knee that disrupts the blood supply of the cartilage covering the joint surfaces of the femoral and / or tibia. As a result, the cartilage is destroyed, the parts of the bones begin to rub against each other, as a result of which they become denser and expand. This is often accompanied by inflammatory phenomena. Symptoms of the disease are due only to the above processes;calcium salts, if they are deposited in the joints, the cause of the pathology is not. Pathology most often develops in individuals 40 years and older, mainly women and people who are engaged in professional sports or having knee injuries. Articular cartilage does not regenerate, so the disease must be detected and treated early in the early stages.
Causes of gonarthrosisThe disease develops with a combination of several causes:
- fractures of the bones of the lower leg involving the knee joint;
- trauma of cartilage interlayers of the joint - meniscus;
- tears of knee joints;
- increasing the load on the joint - running, squatting, lifting weights from the vertical position of the body - after 40 years of age, especially if a person does not exercise regularly;
- excess weight
- joint inflammation( arthritis), which has a different - psoriatic, gouty, rheumatoid or reactive - etiology;
- genetically determined weakness of the ligamentous-capsular apparatus of the joint, due to which its looseness occurs;
- pathology of joint innervation, characteristic for craniocerebral and spinal cord injuries;
- metabolic disease.
- 1) Primary. It occurs against the background of full joint health( without pre-injury or inflammation).It is based on metabolic diseases, long reception of hormonal means, genetic predisposition of articular cartilage. The process is usually two-sided( although it can begin as one-sided).It develops more often in the elderly.
- 2) Secondary. Develops due to injuries, inflammations, tumors transferred to the joint operations. Can develop at any age. The process is usually one-sided.
Symptoms of gonarthrosis of the knee jointHow the disease manifests itself will depend on how far the degenerative process has progressed. Depending on this, three stages of the disease are distinguished, each of which has its own symptomatology. As a rule, the first degree of gonarthrosis of the knee joint is manifested by certain symptoms, which are worth paying attention to: the
- feeling of constriction under the knee;
- stiffness in the knee, which manifests itself after sleep, prolonged sitting or prolonged immobility of the joint;
- joint pain:
- arising during prolonged walking, squats, walking on stairs;
- aggravated after standing or physical exertion
- joint swelling may occur for a short time, passes by itself.
- joint pain becomes more intense, lasts longer. It disappears after rest.
- pain is felt inside the joint or on the inside of the knee.
- there is a crunching in the knee when walking.
- in the morning it is impossible to unbend the knee.
- closer to night and at night there are pains in calves. The
- does not fully extend the leg.
- joint swells, acquires signs of initial deformation.
- 1) Pain in the joint is worried constantly, regardless of the physical activity of the person.
- 2) Pain syndrome increases with changing weather.
- 3) The mobility of the joint is limited, due to which the person limps.
- 4) The knee is enlarged and deformed. When the process progresses, the joint becomes an X-shaped or O-shaped.
Diagnosis of gonarthrosisIt is possible to suspect the presence of gonarthrosis of the knee in the patient already on the basis of his complaints and objective examination data. The diagnosis is confirmed with the help of such instrumental studies:
- 1) Radiography. This method may be uninformative at the first stage of the disease, but subsequently it visualizes the narrowing of the joint gap, the compaction of the bone zone below the articular cartilage, and the sharpening of the edges of the condyles.
- 2) Computed tomography of the joint. This is more expensive, but more informative( even at stage I) method based on x-ray radiation. Visualizes the joint itself and surrounding tissues in more detail and layer by layer.
- 3) Magnetic Resonance Tomography - a method based on a non-radiological, considered harmless radiation, which can be used for contraindications to CT.Also layer-by-layer displays the picture in the joint, but is more informative regarding the surrounding soft tissues.
- 4) Arthroscopy is an invasive technique for joint research, when a fiber optic device is inserted into the hole made under local anesthesia, allowing the specialist to examine the joint from the inside.
- 5) The knee ultrasound is informative for the diagnosis of such complication of gonarthrosis as synovitis.
Treatment of knee joint gonarthrosisA doctor who is treating this disease is an orthopedist. Drug therapy of the disease includes the following groups of drugs:
- 1) Non-steroidal anti-inflammatory and pain medications: Voltaren, Celebrex, Rofika, Nimesil, Movalis.
- 2) Chondroprotectors: "Artra", "Arthron", "Dona", "Teraflex", "Chondroitin complex".These drugs are taken for at least six months in the dosage prescribed by the doctor.
- 3) In the joint with pronounced inflammatory phenomena, enter "Hydrocortisone" or "Kenalog" no more than 3 times.
- 4) The preparations of hyaluronic acid are shown, which must be inserted into the joint when the inflammatory phenomena in it subsided: "Hyalurum", "Ostenil", "Sinocrom".These medications show a very good effect, they are administered only a few times, while having a fairly high cost.
- 5) Heating compresses with "Dimexid", "Bischofite", medical bile to improve the blood supply of the joint, increase the production of "lubricating" liquid in it.
- 6) The preparation on the basis of drawing from soya and avocado plants - "Piascladin" - has also proved to be an effective tool in the treatment of gonarthrosis of the knee joint. At the same time, the treatment course is not less than six months.
Physiotherapy for gonarthrosisIn an acute period a person needs to provide complete peace for a diseased knee. Then proceed to the gradual introduction into his regime of the day of physical exertion. Exercises are carried out in the position of the patient lying on his back, they consist mainly in lifting the straightened legs, keeping them in the raised position. It is important to perform exercises smoothly, carefully, so that they do not cause pain. Begin with 10 minutes, gradually, 2 minutes a day, increasing the duration of classes. Increase and the amplitude of movements, which should be selected by specialists individually for each.
Pain in the knee
Why does gonarthrosis occur?
There are cases when the cause of gonarthrosis is unclear: there were no injuries, inflammation of the joint, the person did not take any special drugs or food that could worsen the blood flow. This disease is called "primary gonarthrosis."It occurs more often in the elderly against the background of a general decrease in the rate of blood flow and deterioration of the properties of blood vessels. Among the diseased, a larger percentage are women whose cartilage changes usually begin immediately in two knee joints.
Secondary gonarthrosis is when the cartilage begins to deteriorate some time after trauma, inflammation of the joint, after an operation performed near the knee.
A predisposing factor for the onset of gonarthrosis is a diet with a high content of meat products( especially those made from animals grown on improper feed), carbohydrate and fatty foods.
Stages of development of the disease
For gonarthrosis are characterized by several degrees of development:
- The first degree of the disease is characterized by minimal manifestations of the disease. Pain in the knee - periodic, it occurs after a long or heavy load. Joints can increase in size, but for a short while, it goes by itself.
- Gonarthrosis of 2nd degree is manifested by more intense pain, which appears already and at rest, becomes more prolonged. At this stage, a person can also feel a crunch in the joint when moving. The knee is swollen, its contours are changed. A characteristic symptom is this: the knee( one or both) is almost impossible to bend in the morning, but during the day the mobility improves. In the photo you can see the swelling.
- In the third stage, the pain almost does not stop, it increases with changing weather. The shape of the joint is changed, because of which the aching leg seems to be deployed in the outer or inner side. The gait of the patient changes, as the person tries not to step on the aching leg.
X-ray study gives a more realistic picture of the nature and extent of the disease.
How are doctors treated with gonarthrosis?
The following drugs are used for treatment:
- Anesthetics - Nimesulide, Movalis, Diclofenac. They not only relieve pain in the inflamed joint, but also display anti-inflammatory properties( these drugs are also called non-steroidal anti-inflammatory), acting on the hormone-like substances of our body - prostaglandins.
Treatment of gonarthrosis of the 2nd degree
- Drugs that are collectively referred to as "chondroprotectors"( literally "cartilage protectors").These are effective preparations based on synthetic analogues of those substances, of which normal cartilage consists - glucosamine and chondroitin. If you apply them correctly, that is, after a little inflammation is removed( this can be achieved by intra-articular one-two-fold administration of hormones such as Kenalog), and also take them in the correct dosage and for a long time, the effect is excellent.
- Medicines based on hyaluronic acid( Synvisc, Fermatron, Durallan).This acid is an analogue of articular lubrication, which, covering articular cartilage, reduces friction when moving in the joint.
In addition to medicines, physiotherapeutic procedures( ultrasound, phonophoresis, magnetotherapy) are also used. Good results are given by manual therapy and massage, which are used in the absence of exacerbation.
Diet for gonarthrosis of 2nd degree
It is very important that in patients with gonarthrosis a certain diet is observed. Food should not contain many fats or carbohydrates. You can not eat cakes, cakes, chips and crackers, carbonated drinks and alcohol( especially beer), fatty fish and meat.
You can and should eat porridge, especially cereals, but not instant cereals, fruits, vegetables and greens. Meat products and eggs need to eat a little( meat - a maximum of 100 grams per day, eggs - a maximum of 3 pieces) and in the first half of the day. Dairy products must be consumed. Bread and pasta for joints are not harmful.
Lifestyle at stage 2 of the disease
If the diagnosis is accurate, and you have complete certainty that the degenerative-dystrophic process is occurring in the knee, you should not load the affected joint. It is emphasized that the diagnosis should be established by the orthopedist traumatologist after the evaluation of the results of additional studies( X-ray, MRI, CT), since there are diseases with similar symptoms( for example, Bekhterev's disease).And in the case of these certain diseases, the knee joint, on the contrary, needs to be loaded.
Exercise for gonarthrosis of 2nd degree
When gonarthrosis very well reduces the load cane. It should be chosen according to its height( length from wrist to floor in standing position, hands "at the seams").The cane is held in the hand opposite the aching leg. You can also wear special orthoses and insoles, selected by a competent specialist.
Also, with gonarthrosis of the 2nd degree, gymnastics is good. It helps to increase the amplitude of movements in the joint, improve the blood supply of articular cartilage, reduce pain. This gymnastics is important to do correctly: for this you need not only pick up exercises, but also perform them slowly and calmly, without sudden movements. Both legs work alternately.
Here are some exercises:
1) In the supine position on the back, it is necessary to lift the leg straightened at the knee joint by 15 cm from the floor. Doing this is important slowly, while you should not feel pain. If it is, stop doing it. If there is no pain, try to lift the leg 5 times, the next day - 6 times. So gradually, without sharp movements increase the number, and little by little - the amplitude of such movements. The same movements are carried out and a healthy leg, so that it does not turn out that the muscles of one are trained more than the other. This discrepancy will result in reflexively loading the patient, but with strong muscles, a leg.
Lifestyle at stage 2
2) Raise the aching leg a short distance from the floor, without bending it at the knee joint. Hold it for a few seconds. Pains again should not be, but muscle fatigue can be noticeable. This means that you are doing everything right.
3) Lying on the side, bend the lower leg in the knee, the upper one - straighten. Now the upper leg should be slowly raised to an angle of 45 degrees and held by weight for a few seconds. Turn to the other side and do the same with the other leg.
4) Sitting on a chair with a flat back, lift the straightened leg to the maximum possible angle for yourself. Hold for a few seconds, lower it. Do the same with the second leg.
5) We stand near the chair, hold on to his back. Very slowly we rise on the toes, we stay in the maximum position for a couple of seconds, we fall on our feet.
How are folk medics treated for gonarthrosis?
Treatment with folk remedies includes the intake of various decoctions, infusions and tinctures inside, and the use of local herbal and other natural remedies. Here are a few recipes that have proven themselves:
- We take a hot bath with sea salt( or dip your legs so that the knee is warmed up).Then take cabbage leaf, promazyvaetsya honey and superimposed on the joint area. On top, the bandage is bandaged( it is better to take an elastic bandage).Doing this for the night, in the morning just change the sheet without steaming. The effect is good, but does not come immediately.
- Compress with bishofit( sold in pharmacies).The gauze is smeared with bischofite, it is applied to the joint. On it we put oilcloth or polyethylene and bandy. We do the compress 2 times a day.
- Compress with bile medical. It is done the same way as in the case of bischofite.
Joint damage with gonarthrosis
The above methods are not suitable in the case of active inflammation with effusion to the joint. You can try the following tools:
- For this recipe you need to buy a red or blue clay in the pharmacy. Collect it with a wooden spoon( this is a prerequisite), dilute in warm water to the consistency of thick sour cream, put the mixture on gauze. Then, on the leg, previously washed in the joint area, put a gauze with clay, wrapped in a woolen scarf. Leave for 2 hours, remove, wash your feet with warm water.
- Three tablespoons of apple cider vinegar, 1 tablespoon of honey mixed, laid out on a sore knee. From above we cover with cabbage leaves and a burdock. Then cover with oilcloth and wrap with a warm cloth. To apply it is necessary within a month.
When is surgery needed?
The operation is performed in the case of ineffective conservative treatment, when, despite taking medications, massage and physiotherapy, the disease continues to progress.
An example of treatment of grade 2 gonarthrosis
Operative treatment of grade 2 gonarthrosis consists in endoprosthetics - instead of a patient joint, a prosthesis is made of a material that is not inferior in strength to real bones and also does not possess allergenic properties.
The operation is rather lengthy, carried out under general anesthesia or epidural anesthesia. In the early postoperative period, it is very important to perform a set of exercises aimed at reducing the risk of postoperative complications, as well as to correct possible changes in the respiratory and cardiovascular systems.
In the late postoperative period, more exercises are used, exercise on the exercise bike, massage. Sanatorium-and-spa treatment is prescribed.