Knee joint gonarthrosis of 2nd degree: treatment with medications and folk remedies
Degenerative and dystrophic joint disease is called gonarthrosis. Today, this ailment is the leader in the group of various lesions of articulations in humans. The symptomatology of the disease, according to statistics, occurs in 15-20% of the total population. In this case, it is most often in women who are diagnosed with gonarthrosis of the knee joint of the 2nd degree. Treatment of the disease is difficult. Because the disease is incurable.
The main causes of
In gonarthrosis, there are degenerative processes of cartilage that covers directly the intraarticular surface of each bone. Uncomfortable sensations in this disease arise precisely because of this.
At first, blood circulation in all small vessels is disturbed. The nutrition of the joint worsens. After a fairly long so-called starvation, the cartilage is thinned, and later completely destroyed.
Partial exposure of the bones creates a kind of friction between them when walking. This causes very severe pain. A person can no longer fully bend or unbend the joint. In the most severe cases, thorns appear. Because of this, the bone deforms, which, in turn, leads to the curvature of the leg.
When gonarthrosis is sometimes observed rapid deposition of calcium salts. As a result, calcification of the soft tissues of the knee occurs. However, this manifestation does not stand out in a separate clinical situation. Usually it does not extend directly to the joint itself.
The main types of disease
This disease is divided into primary and secondary.
Primary gonarthrosis of the knee joint of the 2 nd degree, whose treatment is directed mainly at the elimination of unpleasant symptoms, can occur even in an absolutely healthy person. Many doctors believe that such a disease is provoked by a violation of metabolism, the presence of excessive weight, as well as age-related changes in the joints. There are situations in which primary gonarthrosis has developed as a result of taking some contraceptive hormonal medications. Also, the cause may be poor heredity.
Most often the primary gonarthrosis affects both knees, but it can begin to develop in any of them. Pathological changes over time cover the entire joint and pass to the other leg. One-sided malaise can occur with an uneven load on the legs.
Secondary gonarthrosis of the knee joint of the 2nd degree, the treatment of which must begin in time, almost always one-sided. He has a clear reason.
The most common source is joint trauma. This can be as a hemorrhage in the joint, and a severe bruise or dislocation. The disease sometimes develops after some surgical interventions, with various inflammatory processes and neoplasms in the knee.
The situation can only get worse if you do not go to the doctor on time. Also, one should not engage in self-medication, as often it is fundamentally wrong. And this will only lead to even greater complications.
The main symptoms of
The disease begins with the appearance of pain in the joints after walking, as well as physical activity. But many people do not attach importance to this symptom, because discomfort passes if you rest a little. Sometimes there are mild pains in any one hip.
Characterized by knee joint gonarthrosis:
- increased pain in the knee joint;
- does not go through unpleasant sensations even after rest or sleep;
- severe discomfort when loaded on the knees;
- joint pain after a long walk;
- there is a significant underdevelopment of muscle tissue in the lower extremity of the corresponding side;
- appears a certain crunch in the knee;
- violation of the main function of the joint;
- appearance of the first signs of joint deformation.
By the time when the second degree of gonarthrosis is already determined, the disease covers both joints. One-sided malaise occurs when excessive load on any one leg. In this situation, a person unconsciously begins to shift all his weight to the other side. As a result, the degeneration of the cartilaginous tissue of the articulation develops.
Degrees of disease
There are several degrees of the disease according to the intensity of their development:
- 1 degree( initial).Quite insignificant swelling and pain in the knee after physical exertion. The shape of the joints does not change.
- 2 degree. There is a slight crunch in the joints, the pain becomes stronger. There is a certain stiffness in the joint. The outlines of the knees begin to change outwardly.
- 3 degree. All symptoms manifest themselves in full. Gonarthrosis of the third degree of the knee joint is characterized by pain, which is permanent. The joint is strongly deformed and increases in size. It becomes difficult for a person to walk.
- 4 degree. On X-rays, a strong deformation of the joint is clearly visible. Practically complete absence of joint space. The pain does not stop, the knee is limited in movements.
Diagnosis of the disease
The diagnosis of the specific difficulties is not caused and is carried out on the basis of symptoms indicative of the rapid development of the disease:
- deformation of the knee joint;
- appearance of crunch;
- pain enhancement;
- limitation of joint mobility.
The most clear picture can be seen on radiographic shots. Deforming gonarthrosis of the knee joint of the second degree is characterized by specific edge enlargements and strong narrowing of the slit.
Treatment of altered joints
It is rather difficult to fight this disease. Before examining how to treat gonarthrosis of the knee joint, it should be understood that the disease is considered incurable. After all, no one is able to return the joints to their joint mobility. The most that will be possible to do at all is to reduce the pain sensations only slightly and try to suspend the process for a while.
Only timely diagnostics of the disease will achieve these goals. However, any intervention will be ineffective if you do not learn to unload the affected joints.
Treatment of gonarthrosis should be carried out according to strict rules. To do this, stock up with a lot of patience. It is recommended to completely abandon all bad habits, observe a special diet, as far as possible, completely eliminate all heavy loads.
For gonarthrosis apply:
- Nonsteroidal anti-inflammatory drugs for pain relief( Nimesulide, Movalis, Diclofenac, etc.).
- Preparations, which contain components of articular cartilage( "Chondroitin-sulfate", "Glucosamine", etc.).
- Drug injections in the joint of hyaluronic acid preparations( Synvisc, Fermatron, Duralan).This acid is an analogue of an articular lubricant, which covers the cartilage, thereby reducing friction when moving in the joint.
Special support devices are used that can reduce the load on the joint. It can be like an ordinary cane, and hard knee pads, as well as special orthopedic insoles. Such a device is chosen by the doctor individually for each patient, relying on the degree and severity of his illness.
If the patient does not already have a chance to save the joint, surgery is recommended. Gonarthrosis of the knee joint is often treated with complex therapy, resorting to surgical intervention only in extreme cases.
There is such an operation option as endoprosthetics. It consists in the fact that the prosthesis is replaced by the whole joint or some of its parts. The operation is most often done when a unilateral gonarthrosis is post-traumatic in nature. This includes the rupture of ligaments, fractures of the knee joint.
Surgical treatment is performed only if the disease is not accompanied by osteoporosis. Another taboo to the operation is the increased fragility of bones.
Comprehensive treatment is complemented by some fairly effective methods:
- special massage;
- thermal therapy and laser physiotherapy;
- exercise therapy;
- UHF, electrophoresis.
Special Therapeutic Exercises
With gonarthrosis of the knee joint, it is impossible to completely exclude physical activity. The individual curative gymnastics program will help to strengthen the weak muscles surrounding the joint, and improve blood circulation.
Because the joints need movement, then physical exercise should be practiced constantly. During such exercises, not only the affected muscles are trained, but the entire musculoskeletal system is trained.
Gymnastics in gonarthrosis of the knee joint can be performed by patients at home. But it is always worth remembering that physical exertion on sick joints is allowed only during the remission of the disease. The presence of edema and pain will simply make any movement unrealistic. Ignoring this nuance can exacerbate the condition to some extent.
When gonarthrosis is strictly prohibited squats, long walking, running, stress knee joints. They will always cause acute pain.
For each degree of the disease, its individual treatment is applied
1 degree - massage, easy medical gymnastics, physiotherapy. To reduce the load on the joints, it is recommended to reduce weight.
At the 2nd degree, the load on the joints should be minimized. Physiotherapy, physiotherapy exercises are prescribed. Anesthetics, anti-inflammatory drugs and some chondroprotectors are used.
Gonarthrosis of the third degree of the knee joint needs therapeutic symptomatic treatment. The patient may be referred for surgical treatment. At the same time, all bone growths are removed, osteoplasty of the cartilage is done. On the last - the fourth - the stage the arthroplasty of the joint is increasingly performed.
We use folk remedies
Various decoctions and sprays made from medicinal plants are used if one or two degrees of a disease such as gonarthrosis of the knee joint is diagnosed. Folk remedies with a serious degree of disease, unfortunately, will not have absolutely no effect.
This is one of the most common methods of combating the disease, widely used by patients who are diagnosed with gonarthrosis of the knee joint of the 2nd degree. Treatment involves the use of blue or red clay. It should be applied only with a plastic or wooden spatula. No contact with metal is allowed.
Clay is diluted with water to a consistency of liquid sour cream. The mixture is spread on a cloth. They put it on a sore knee and wrap it with cellophane or with a warm woolen shawl. This compress is held for a couple of hours, after which the clay is washed off.
Tincture made of ficus
A special tincture from gonarthrosis is prepared from the most common domestic ficus. His leaves are passed through a meat grinder and add a little vodka. Insist for 3 weeks in a dark place. The dishes should be very tightly closed.
First of all you need to take a salt bath. Prepared infusion slightly warmed, and then applied to the affected joint and wrapped in a warm kerchief. Do this for 10 days in a row.
Knee joint gonarthrosis of the 2nd degree: characteristic signs of the disease
Under gonarthrosis, which is also called arthrosis of the knee joint, it means the damage to the cartilage and bony growths appearing along the edge of the joint, as well as xytotic irritation of the joint tissue.
Knee joint gonarthrosis is one of the degenerative-dystrophic diseases of the joints. This disease has 3 degrees of severity, the most common is gonarthrosis of the knee joint of the 2nd degree, because only at this stage people begin to pay attention to this disease and practice treatment, practically ignoring the first degree.
It should be noted that arthrosis in general is a scourge of modern society, this disease was formerly characteristic only of middle-aged and elderly people. Now, arthrosis is not just young, they just do not have age limits, appearing even among young people as a result of injuries.
The risk group for this disease is overweight people, professional athletes and people with varicose veins of the legs experiencing serious physical exertion.
Reasons for the development of
The main cause of the disease is a mechanical factor. There is microtraumatization of articular cartilage, as a result of which begins its degeneration. As a consequence, the load on some parts of the joint surface increases, and further - its destruction. It was also found that with this disease there are changes in metabolism in cartilage tissue. The essence of these changes is a decrease in the saturation of chondroitin sulfate, which is a specific component of cartilage and nowhere else in the body is found.
In general, you can identify such causes of the disease:
- intra-systemic fractures of the bones that form the knee joint;
- arthrosis, which was caused by Paget's disease;
- malignant and benign bone tumors;
- rheumatoid arthritis and ankylosing spondylitis.
Degrees of severity of the disease
When developing gonarthrosis passes several stages of the disease( degrees of severity):
Gonarthrosis 1 degree is the initial stage of the disease, which is often ignored by patients. She periodically has pain( usually after exercise), sometimes the knee swells up, the deformity of the joint is insignificant and invisible.
Gonarthrosis of the knee joint of the second degree is a logical continuation and development of the disease. At this stage, the symptoms intensify, the intensity and duration of pain in the joint increases, and a crunch in the joint and bending difficulties may also appear. Deformation takes a pronounced character.
Gonarthrosis of the third degree is the most severe stage of the disease. It is characterized by pains that occur not only during movement, but also in those moments when the joint is in a state of rest, there is a reaction to changing weather conditions. The gait is greatly disturbed, the mobility of the joint is limited.
Also distinguish primary gonarthrosis( arising initially) and secondary gonarthrosis( occurs against the background of other diseases of the knee joint).
Characteristic signs of gonarthrosis
It is very important to notice the onset of the disease in time. As we have already said, people usually skip the signs of the disease and notice it only when it says "pripeklo."Treatment in this case will be more prolonged and difficult.
In general, the main symptoms of the disease are pain and limitation of mobility in the joint, as well as gait disturbance. Gonarthrosis develops gradually and time passes between the first and second severity severely.
A very characteristic sign of gonarthrosis, which distinguishes this disease from other diseases of the knee joint, is that the pain appears after a state of rest, and then gradually subsides( when a person "diverges").But by the end of the day the pain returns - this is due to the increased load on the affected joint.
Also characteristic of this disease is the appearance of osteophytes( marginal bone growths).Soft cartilage tissues constantly rub against osteophytes, which leads to inflammation of the joint membrane - synovitis, which manifests itself with redness, swelling and an increase in local temperature. Also, when you move or feel the joint, you can feel a crunch.
Diagnosis of the disease consists in interviewing the patient's complaints, checking the volume of movement in the joint and examining the joint itself. Naturally, according to such information, only preliminary conclusions are made, and the main ones are instrumental methods of diagnostics. In the case of gonarthrosis, this is primarily the radiography of the joints. Depending on the overall picture of the disease, the stage of the disease is determined. Also recently, in the diagnosis of gonarthrosis, arthroscopy and ultrasound are often used.
Is it possible to treat gonarthrosis at home?
Now complex treatment of arthrosis is applied, in other words - treatment is not limited to just one method. In this case, the treatment of gonarthrosis does not differ from the treatment of other osteoarthrosis of other location. With this disease, it is recommended to limit the load on the joint. But we must not forget that the practice of physiotherapy in this disease is mandatory, since movements in the joint make it possible to preserve its mobility, to provide an improvement in the nutrition of the joint elements. The complex of exercises is formed by the physician of exercise therapy or a methodologist in therapeutic physical culture. The main condition for choosing exercises is the fact, you can not load the knee, but you need to ensure its maximum mobility. That's why most exercises are done sitting or lying down. Also swimming and swimming in the pool will be very useful - water allows you to remove the load from the joint.
Almost always doctors recommend performing self-massage of the leg and thigh muscles, as well as the area of the knee joint. This improves the blood supply of the joint, allows you to maintain your leg muscles in good condition.
In addition, anti-inflammatory drugs and analgesics are prescribed to relieve the pain syndrome. You can also use various analgesic and irritating ointments. Venotonics, vasos-regulating drugs will also be useful - they will improve the blood supply of the joint. And since the main problem is the state of cartilage, chondroprotectors are appointed for a long time, which are intended to improve his condition.
It often happens that people try to use folk remedies for gonarthrosis of the knee joint of the 2nd degree. Such treatment, in principle, is permissible, but only with the permission and approval of the attending physician, since much of what is printed in newspapers under the guise of "folk remedies" is in fact just a profanation.
Often, conservative therapies are useless or simply do not bring the desired result with a neglected form of the disease.
In such cases, a small surgical intervention( with relative preservation of the motor function of the joint) is possible - arthroscopy. In this case, the joint is washed, the damaged parts of the menisci and cartilage are removed, osteophytes are removed. This operation at low traumatism makes it possible to restore or improve the function of the joint for 2-3 years.
In more serious conditions, more serious operations can be assigned. In the overwhelming majority of cases, they give very good results and make it possible to keep the mobility of the joint for a fairly long time.
But the most common and effective method of advanced form of gonarthrosis, which allows a person to fully return to active life, is the endoprosthesis of the knee joint.
The main ways of treating gonarthrosis
In the inflamed joint, there is no cartilaginous layer and the interarticular cleft
is missing. Gonarthrosis is one of the most common forms of arthrosis. Not everyone knows what the essence of this disease is and how to get rid of it. This ailment implies the presence of a pathological process, which is degenerative-dystrophic in nature and leads to the defeat of hyaline cartilage. The cartilage covering the knee joint is most often affected.
Gonarthrosis is mainly affected by women after forty years. Pathology often occurs in young athletes after receiving injuries. The disease develops slowly, for several years. Important manifestations of the ailment is:
- severe pain during movement;
- accumulation of effusion in the joint.
Classification of disease types
Classification of gonarthrosis by pathogenesis.
- Primary. It occurs in the elderly. The disease has a two-sided nature.
- Secondary. The disease is observed in people with knee joint injuries. It is one-sided and manifests at any age.
Gonarthrosis is divided into three stages. The first is characterized by the initial manifestations of the disease. The patient complains of pain, wearing a stupid character. Painful sensations arise after physical overstrain. Some patients have swelling of the knee joint, which disappears on its own. Deformities in the diagnosis of "gonarthrosis 1 stage" is not observed. In this case, the disease is most easily cured.
Deformation of legs in a patient due to joint damage
In the second stage, symptoms develop. Pain in the knee joint becomes more intense. There is a restriction of motor activity, a slight deformation. Gonarthrosis of the 2nd stage can already be seen with an X-ray examination.
The third is the stage of vivid manifestations of gonarthrosis of the knee joint. The gait changes, the pains acquire a permanent character. Deformation becomes apparent, there is a restriction of movements in the joint.
Pathological changes in the knee joint
At 1 stage of the disease, changes in the joint are insignificant. The blood circulation in small vessels of a bone which provide a supply with hyaline cartilage is a little broken. As a result, the cartilage becomes dry and loses its smoothness, it begins to cover microcracks. As a result, cartilage begins to "cling".There are permanent microtrauma. Gonarthrosis 1 degree is characterized by loss of cartilage of its properties and its further thinning. This is the earliest, initial degree of damage to the joint structure.
In 2 stages of the disease, changes in bone tissue appear. The area for the joint is flattened. The bone located under the cartilage becomes denser. There are osteophytes( this is a proliferation of bone tissue).The disease affects the synovial membrane, the capsule of the knee joint, they begin to acquire a "wrinkled" appearance. Articular fluid becomes viscous, thick, because of this, its properties deteriorate. The cartilage is very much thinner, and in some places it disappears completely.
At 3 stages of gonarthrosis, irreversible changes in knee joints are noted. Bone tissue is deformed. The joint is limited in movements. There is almost no cartilaginous tissue. Treatment requires emergency measures and even surgical intervention.
Causes and prerequisites for the onset of
The most common causes of the disease are several, not just one. Thirty percent of patients diagnosed with gonarthrosis associate the disease with a previously received knee injury( fractures, injuries, ligament ruptures, etc.).The disease makes itself felt three to five years after the injury, but an earlier manifestation of symptoms is possible.
The cause may be excessive load on the knee joint. Many people after forty years begin to engage in regular exercise to maintain the body in a tone. But they do not think about the fact that their joints have already undergone age-related changes, so heavy loads on them are harmful. Very dangerous are sharp squats and jogging.
The causes of gonarthrosis are covered in the overweight body of the patient. If a person weighs a lot, the load on the knee and other joints increases significantly. The risk of a disease such as gonarthrosis increases dramatically.
The factors influencing the development of the disease are transferred arthritis( rheumatoid, reactive and others), genetic predisposition, weighed heredity, craniocerebral trauma, spinal column injuries, metabolic disorders.
Description of signs and symptoms of the disease
Inflammation in the knee joint causes aching pains and edema
Symptoms of the disease do not appear immediately. Gonarthrosis develops rather slowly. At the first stage of the disease symptoms are almost invisible. Patients feel soreness in the knee joints during movement( for example, ascent, descent from the stairs), slight stiffness. The disease has an important symptom in the form of "starting pain".It occurs when a person begins to move after sitting. But the pain does not last long. When walking for a long time, it decreases or disappears.
At external examination the knee joint is not changed at all. The knee may have a slight puffiness. There are cases of fluid accumulation in the joint cavity, this leads to the development of synovitis. Gonarthrosis of the knee joint of the 1st degree is well treatable.
With the 2nd degree of the disease, the symptoms become brighter. Soreness is intense and occurs with prolonged walking. Localization of pain - anterior-internal surface of the knee joint. After rest, the pain passes, and when walking again arise. As soon as the gonarthrosis starts to progress, the mobility of the joint decreases. When bending the leg in the knee, there is a sharp pain, you can hear the crunch. Very often a large amount of fluid accumulates in the joint cavity. Treatment is possible both operative and conservative.
In patients with gonarthrosis of the knee joint of the 3rd degree, patients complain of severe pain. Soreness does not pass either when walking or at rest. Gonarthrosis at this stage leads to complete deformation of the joint. The affected joint increases in size. Moving becomes very difficult, since it is difficult both to flex and bend the knee.
X-ray picture is the optimal way to diagnose joint disease
To diagnose knee joint gonarthrosis, one should conduct a patient examination, evaluate the symptoms and send a person to do an x-ray. The last method of investigation is considered the most informative. Radiographic examination allows excluding other pathological processes that may affect the femur or tibia( for example, tumor formations).But in an early stage gonarthrosis can not appear on the roentgenogram. Computer and magnetic resonance imaging are also effective diagnostic methods. Their results help the doctor to detail gonarthrosis.
Treatment for such a disease should be started as soon as possible. Patients with a similar diagnosis are treated by orthopedic doctors. Reception of medicines takes place strictly under the supervision of a specialist. The doctor may prescribe the following medicines.
- Chondroprotectors are medicines that significantly improve the metabolic processes in the joint cavity. Gonarthrosis is primarily treated with these drugs, although it is impossible to completely get rid of the disease.
- Drugs replacing synovial fluid.
- Treatment by inserting hormonal agents into the joint cavity. Anesthetics. Since this disease is accompanied by severe pain, analgesics are very relevant.
Gonarthrosis of the 1st degree supposes restriction of loads on the knee joint, administration of drugs of the oxicam group. When treating the disease at any stage, non-drug methods are mandatory:
- physiotherapy exercises( all exercises are conducted in a quiet environment, slowly, sudden movements are excluded).
Patients diagnosed with gonarthrosis are required to follow a diet. From food, it is necessary to exclude salt, mayonnaise, chips, smoked products. If the patient is overweight, you must limit the intake of high-calorie foods. The best option is to eat fruits and vegetables. Pathology in the remission phase can be effectively treated at resorts.
Treatment of a disease such as gonarthrosis of the knee joint, takes time and fully corresponds to the treatment of arthrosis of the hip joint. The knee joint is in second place after the hip in size. Osteoarthritis of the hip joint is very common, as is gonarthrosis.
Surgery as a method of treatment
Surgical intervention is an extreme method of treatment. It is indicated in the following cases:
- if the patient has gonarthrosis of the knee joints of the third degree( cartilaginous tissue is practically absent);
- symptoms are not stopped by drugs: painkillers do not have an effect or have, but a short-term;
- if a person has gonarthrosis of the knee joint of 2 degrees, the pathology will not be cured definitively, but for some time there will be no severe pain( from six months to three years).
Gonarthrosis is operated in such ways.
- Artrodes. The purpose of the operation is to remove the joint. Very radical method. Currently, it is infrequent.
- Arthroscopic debridement. Essence - removal of necrotic parts of cartilage. The operation gives only a temporary result.
- Periarticular osteotomy. This operation does not help to recover from gonarthrosis forever. In the modern world, this surgical intervention is rarely used.
- Endoprosthetics. A very common method of intervention. The essence of the operation is that the joint is replaced with a prosthesis. Endoprosthesis can last for at least twenty years.
Traditional methods of treatment and prevention
Treatment with folk methods does not always give a positive effect. But gonarthrosis can be treated with their help in combination with medications. A few useful recipes.
- Treatment with beef bones. Beef knees and hooves must be boiled. Take 100 g of decoction before meals.
- It is necessary to mix honey( one tablespoon) and apple cider vinegar( three tablespoons).This mixture is applied as a compress.
Gonarthrosis requires careful attention, you can not start a disease. The consequences will be very unpleasant. An illness can be treated at home, inpatient monitoring is not always necessary.
Prevention of disease is very important. To prevent deforming gonarthrosis, you need to intelligently combine the load with breaks for rest, engage in exercise therapy. If a person marks the first signs of the disease, you should immediately seek medical advice from an orthopedic doctor. The earlier the gonarthrosis examination is performed and the treatment is prescribed, the better for the patient. It is necessary to improve the condition of the knee ligaments, for this the patient needs to adhere to certain rules.
- Wearing comfortable shoes.
- Proper nutrition.
- Regular physical exercises( in particular, the exercise "bicycle").
- Elimination of heavy loads on the knee joints.
- The use of vitamins.
Patients who have been diagnosed with gonarthrosis should carefully protect their joints, avoid hypothermia. If symptoms of exacerbation or disease progression appear, you should immediately go to a doctor.
Knee joint gonarthrosis
Gonarthrosis is a deforming arthrosis of the knee joint, a degenerative-dystrophic disease in which the hyaline cartilage covering the joint surfaces of the tibia and femur is affected and gradually degrades. In the late stages of the pathology, when the cartilage tissue is completely destroyed, the bone tissue begins to suffer, the disease acquires the character of osteoarthritis. The bone becomes denser, cystic cavities are formed, osteophytes grow at the edges of the joint, which causes the loss of joint function and disability.
Gonarthrosis is in the first place in terms of prevalence among all arthroses. Mostly middle-aged and elderly people, mostly women, are ill. But gonarthrosis of the knee joint can also occur in young people. In such cases, it is often a secondary process and develops after the trauma of the knee joint( posttraumatic gonarthrosis).
Gonarthrosis develops gradually over many years. The main signs of the disease: pain in the knees, the integration of their mobility and the periodic development of synovitis( accumulation of fluid inside the articulation).At first, the symptoms of arthrosis are almost invisible, but as the joint deteriorates, it becomes more intense and negatively affects the quality of human life.
This is how the knee joint affected by arthrosis
Reasons and types of knee joint gonarthrosis
As a rule, it is impossible to single out one cause that led to the development of gonarthrosis. In most cases, there are 2-3 or more risk factors for the development of the disease.
The main groups of reasons are:
- Increased load on the components of the joint. This situation is observed in athletes, in people engaged in heavy physical labor, as well as in patients suffering from obesity.
- Knee injury, congenital or acquired deformities of the musculoskeletal system. In such situations, the load on the joint is distributed unevenly and some areas of the cartilage are under increased pressure, which causes their destruction. An example of such deformations may be flatfoot, kyphosis, scoliosis, incorrect fusion of bones after fractures, etc.
- Disturbance of the metabolism of cartilaginous tissue and its ability to self renewal. This situation leads to a shortage of substances in the body, necessary for the regeneration of hyaline cartilage, metabolic and endocrine disorders, a decrease in microcirculation in the tissues of the articulation.
- Disturbance of secretion of synovial fluid in the knee joint. As you know, the synovial fluid, which is produced by the synovial membrane of the joint, provides smooth movements, reduces the frictional force, and also nourishes the cartilage, which does not have its own vessels. If, for some reason, the synovia becomes smaller, degenerative changes develop in the cartilage, it cracks and collapses.
There are many more risk factors for gonarthrosis. Their definition is very important not only for treatment, but also for prevention. Having got rid of such negative influence, it is possible to completely stop the development of arthrosis and preserve the full function of the lower limb.
Depending on the causes of the onset, two types of gonarthrosis are distinguished:
- Primary - diagnose when the true cause remains unknown. At risk are women, elderly people, patients with obesity, with metabolic and endocrine diseases.
- Secondary - is established when there is a clear connection between arthrosis and its causative factor. For example, after a joint injury or surgery.
As a rule, the primary gonarthrosis is always bilateral, and the secondary one affects only one knee.
According to ICD-10( International Classification of Diseases 10 revision), gonarthrosis has an M17 cipher.
Strengthened loads of knee joints can cause the development of gonarthrosis
Degenerative gonarthrosis levels
Gonarthrosis is a chronic and slowly progressive disease. Symptoms, prognosis and tactics of treatment depend on the degree of pathological changes in the joint. There are three clinical stages of the disease:
- Arthrosis of the 1st degree is characterized by the appearance of pain or discomfort after an increased stress on the joints, at the end of the working day. After rest, all signs disappear on their own. The amplitude of the movements is not disturbed, there is no deformation of the joint.
- Gonarthrosis of the 2nd degree. At this stage, pathology is diagnosed in most people, because it constantly makes itself felt. Patients complain of pain in the joint even after minor loads. Rest does not give the desired relief, and you have to take various painkillers. There is a limitation of the amplitude of movements in the knee, begins muscle atrophy, you can see the initial stage of limb deformation.
- Osteoarthritis of the knee of the 3rd stage. The pain bothers the person round the clock, for its occurrence it is not necessary even to load a joint. Anesthetics do not help anymore. The mobility of the knee is partially or completely lost, its deformations develop, which is often the cause of disability. Treatment in this case is only surgical.
4 degrees of arthrosis does not happen, but there is a fourth X-ray degree of pathological changes in the joint, which coincides with the third, clinical stage.
Symptoms of the disease
It is difficult to diagnose the initial stage of the disease, as patients do not take the symptoms seriously and perceive them as ordinary fatigue. Most people can not even say that they are concerned about pain, most likely, unpleasant sensations in the knees after work or excessive load of joints, which completely and quickly disappear after rest.
A characteristic sign is pain during descent or ascent on stairs, as well as starting pain( occurs at the first steps after rest, then disappears).Outwardly, there are no changes. From time to time, patients may note some swelling( reactive synovitis).Also, most people complain of crepitation in the knee( crackling sounds with active and passive movements).
Pain in the knee joint is the first and the main sign of arthrosis
As arthrosis progresses, the pain becomes more intense, appears more often after minor loads. Independently does not pass, which often prevents a person from falling asleep. We have to take analgesics. Synovitis appears more often, have a more persistent current. Also a rough crunch develops during movements. The amplitude of movement decreases. It becomes difficult for a patient to perform familiar things, for example, to get off his knees. The knee joint begins to deform, it becomes wider, the shin bends( the beginning of the formation of O- or X-shaped deformation of the legs).
At the last stage the pain is intense and constant, it is not removed even by medications. Significantly difficult movements in the knee, especially flexion. The leg is in a forced position. The knee is enlarged in volume. There may be varus or valgus deformities of the legs.
Because of the described changes, gait and limb support function are disrupted. This leads to the fact that a person moves only with the help of an additional support( crutches, walking stick) or is not able to walk at all.
At the 2 nd and 3 rd stage, it is not difficult to establish a diagnosis. You can do this at the first, but only if you suspect a disease. Diagnostic program includes:
- examination by a doctor orthopedist or rheumatologist;
- clarifying complaints and identifying risk factors;
- objective examination of knee joints, determination of the amplitude of their movements;
- X-ray examination;
- joint ultrasound;
- in severe cases for diagnosis use MRI or CT;
- standard laboratory tests for blood and urine.
Radiography is a valuable and informative method for diagnosing gonarthrosis
Conservative treatment of
Knee arthrosis therapy consists of several methods, individually they are ineffective, but if you use the whole treatment complex, very soon you will start moving without pain.Read more: How to cure arthrosis of the knee joint?
The main tasks of treatment of gonarthrosis:
- relieve a person from pain;
- to adjust the supply of cartilaginous tissue and accelerate its recovery;
- to improve microcirculation;
- reduce the load and pressure on diseased hyaline cartilage joints;
- to develop a good muscular knee joint corset for protection and support;
- to increase the mobility of the joint;
- prevent deformation and ankylosis.
This can be done using the methods described below.
Not essential, but allows you to quickly eliminate pain and signs of inflammation. Most often prescribe drugs from the group of NSAIDs( diclofenac, meloxicam, ibuprofen, ketoprofen, celecoxib, aceclofenac, etc.).These drugs are used for both systemic therapy( tablets, injections), and for topical treatment( ointments, gels, creams, patches).They quickly and effectively relieve the pain, but they are forbidden to take long courses, as severe adverse reactions may occur.
Chondroprotectors are on the second place. These medicines in their composition have chondroitin and glucosamine( the main structural elements of the cartilage).Thus, it is believed that chondroprotectors with long-term admission can stop the progression of the disease and contribute to the restoration of already destroyed cartilage. Among the most popular drugs worth noting: Arthra, Dona, Structum, Teraflex, Hondrolon, Alflutop. Treatment should start with a monthly course of intramuscular or intra-articular injections, and then switch to 3-4 months of maintenance therapy with tablets. Only in this case it is possible to achieve a positive result.
Dona is a modern and effective chondroprotector
A popular method of treating gonarthrosis are intraarticular injections. Inside the knee can introduce chondroprotectors, as well as glucocorticoid anti-inflammatory drugs of long-term action( Diprospan, Kenalog).The pain passes even after 1 injection, the effect can last for several months.
Also today, the introduction of so-called liquid transplants of synovial fluid( Fermatron, Hyastat, Synvisc, Ostenil) is popular. These drugs are based on hyaluronic acid, which compensate for the synovial deficiency in the joint and promote the resumption of cartilage.
Therapeutic exercises are the most important element of arthrosis therapy. Without regular special physical exercises, it is almost impossible to achieve improvement. Complex exercise therapy is selected individually, depending on the stage of arthrosis, the age of a person, his physical fitness, the presence of concomitant diseases.
Simple and effective complex of exercise therapy for arthrosis of knee joints:
Other methods of
Other methods of conservative therapy are:
- Massage and physiotherapy. They are used during remission, when acute pain is absent. Allow to improve blood circulation in the tissues of articulation, which contributes to the regeneration of damaged structures.
- Orthopedic aids. To protect the joint and prevent the progression of arthrosis, you can use special knee pads for physical work or sports. They perfectly support the articulation and protect it from damage. At the last stage of gonarthrosis, a cane can be used to facilitate movement and reduce pain.
- Treatment with folk remedies. Folk methods of therapy are very popular among the population. There are not one dozen recipes that can help reduce pain, improve the mobility of knee joints. But we must not forget that such treatment should be used only as an additional one, and not replace all other methods. Also, before using any prescription, you need to consult a doctor about possible contraindications.
Operation in gonarthrosis is prescribed in the following cases:
- inefficiency of conservative therapy;
- constant pain, which can not be eliminated in other ways;
- deformity or ankylosis of the joint;
- loss of leg function;
- patient desire.
Before and after arthroplasty of the knee joint
There are 2 groups of operations that are performed with gonarthrosis:
- knee arthroplasty.
All modern organ-preserving surgeries are performed by arthroscopy. There are several options for surgery: arthrodesis, arthroscopic debridement, periarticular osteotomy. The surgeon chooses the necessary procedure depending on the individual characteristics of the patient.
Endoprosthetics is the most effective and widespread type of operation for gonarthrosis. Replacement of the destroyed joint with an artificial prosthesis( in some cases, and bilateral prosthesis) allows you to save the mobility feet and live a full life without pain. It is also important to know that success depends not only on the operation, but also on the correctness of the rehabilitation period. Sometimes only such cardinal measures can help a person to move again without pain.
Knee joint gonarthrosis( arthrosis): treatment of 1 degree, 2 degrees, 3 degrees.
Along with this, the bone tissue is restructured and deformed, so-called spines or osteophytes are formed. It is they that limit the movement of the joint and cause pain.
If, in the presence of a man diagnosed with knee joint gonarthrosis, treatment should be started, this may result in the disappearance of cartilage, deformation of the joint and exposure of the underlying bone.
First-degree knee joint
The first signs are the appearance of a feeling of discomfort in the joint and periodic pain. As a rule, the disease develops gradually and pain over time is more periodic.
Especially should pay attention to the condition of the joint in the morning, after sleep. Most people complain about the morning pain( after a long period of immobility), but leaving and developing joint pain goes away.
Also a person feels discomfort when climbing and descending the stairs, becausethe weight of the body rests on one leg and the articular cartilages in the knee joint are compressed. It is worth paying attention to crunches in the joints.
Knee joint gonarthrosis of the 1st degree characterizes such features:
- fatigue limb
- moderately restricted movement in the joint
- can be heard a small crunch
In gonarthrosis of the knee joint 1 degree of pain will occur at the beginning of walking, after a prolonged load, and in rest or light load theyare absent. At this stage, the knees still retain their natural form and are practically not deformed. In the joint space, there will be some narrowing.
knee joint gonarthrosis The second degree of knee joint gonarthrosis already restricts in the movement of a person. At this stage, pain will accompany any movement associated with the affected knee. Especially severely affected knee will hurt after a long walk and wearing a light weight.
The pain syndrome can only be reduced after a long rest. Check the joint for flexion right now - if you can not bend your leg in your knee, serious deformations have already begun.
In the second stage, a knee crunch will be well audible, joint deformation will also be visible, the patient will begin to limp and muscle malnutrition will develop. On the x-ray, you can see the narrowing of the joint gap in comparison with the norm 2-3 times.
A pathological fluid may also accumulate in the joint. At the second degree, drug treatment becomes necessary, it is impossible to cope with the disease alone with one's folk remedies.
knee joint gonarthrosis Grade 3 knee joint gonarthrosis will further strengthen the patient's pain syndrome. The mobility of the knee joint will decrease to a minimum. Pain will bother a person even when the knee joint is at rest. Deformation of the joint bones becomes very noticeable.
It will be difficult for the patient to find a comfortable position for rest. In the case when the destruction of the joint is observed and a violation of blood circulation, the joints will twist at night and on the weather.
In the structure of the knee joint articular cartilage is practically absent, because of the sharp sealing of the articular surfaces. Pain relieves patients even when lying down. The likelihood of gait disturbance due to X or O-deformity is very high.
At this level it is advisable to perform arthroscopic surgery of the knee to remove outgrowths and deformed elements, as well as joint replacement - replacing native elements with artificial analogues
. On the x-ray, the joint gap will be practically absent.
How to treat gonarthrosis of the knee joint? Treatment of gonarthrosis should be started as early as possible, as the patient's recovery process will be quite long.
The main task in the treatment is to remove the load on the joint as much as possible. Get rid of excess weight( diet and proper nutrition), do regular massage of the affected part of the joints, practice physical exercises on the recommendation of a doctor( exercises and gymnastics).
In the first stage, the treatment can be conservative and include:
A degenerative-dystrophic disease that affects not only the articular cartilage of the knee, but also the subchondral bone, capsule, ligaments, periarticular muscles and synovial membrane is called knee joint gonarthrosis. According to statistics, this is the most common type of arthrosis joint damage, also called "salt deposition".
Factors provoking the development of
The specialists conventionally divide gonarthrosis into primary( idiopathic gonarthrosis) and secondary, depending on the etiology. The primary occurs more often in the elderly, but in the risk group are also women over 40 who are obese.
Secondary may arise and progress for a number of reasons:
- Injury of the knee, associated with a violation of the integrity of the ligaments or meniscus damage.
- Presence in the anamnesis of inflammatory and non-inflammatory diseases of various etiology( chondromatosis, arthritis).
- Untimely or incorrect treatment of joint lesions, which provoked the development of pathological changes.
- Combination of the suffered knee injury with changes occurring in the body of a woman during menopause.
Knowing the causes of the pathology, you can minimize or completely prevent the risk of its development.
The development of the disease
The destruction of the knee joint is gradual, the process is quite long and almost invisible in the initial phase. The reason is not the deposition of salts, but the dystrophy of the hyaline cartilage covering the condyles of the tibia and femur. The disease can only occur in the left knee( left-sided gonarthrosis) or only in the right( right-sided), and also be bilateral.
Over time, the hyaline cartilage is completely destroyed and the subchondral surfaces of the bones are exposed. Then the bone tissue begins to grow, osteophytes( spines) are formed, and the gonarthrosis passes into deforming arthrosis. Similar changes are detected during X-ray examination and even during palpation of the patient's knee. The synovium also suffers, as a result of which exudate accumulates in the joint cavity.
Depending on the extent of damage or destruction of the joint, three degrees of disease are distinguished.
Gonarthrosis is manifested by limited movements and slight pain in the knee, especially in the morning. After a short pacing, the symptoms disappear. Defeat of 1 degree does not deform the joint and does not disturb its mobility. External changes are also not observed.
Glandarthrosis is characterized by a tumor of the knee joint and an unnatural enlargement of the articular surfaces, which the specialist can identify. Pain in the knee appears not only after sleep, but also due to loads, the leg does not bend to the end and crunches while moving.
Has more severe symptoms. The pain becomes permanent, the motor function of the joint is severely limited, the person begins to limp, and sometimes even completely loses the ability to move independently, especially if he has a bilateral gonarthrosis. Deformation of the knee joint is clearly pronounced.
At any stage, the development of the disease can be stopped.
To diagnose gonarthrosis of the knee joint, the following characteristics can be detected on an X-ray:
- joint space narrowing;
- of acuminate on the tibia;
- cystic reconstructions in the condyle of contiguous bones;
- ossification on the back of the joint.
This disease is directly related to overeating. Lovers of delicious food often suffer from pathologies in the knee joints. Therefore, the first thing to do is to normalize the diet and lose weight. Also, therapeutic gymnastics helps to achieve results.
The success of gonarthrosis treatment depends not only on the literacy of the doctor, but also on the patient's efforts. The process is rather complicated and time-consuming, includes taking medications, proper nutrition, massage and exercise therapy. Detailed instructions are given by the doctor on the basis of a comprehensive examination of the patient. Treatment of gonarthrosis should begin when the first symptoms appear.
Knee joint gonarthrosis of 1, 2 and 3 degrees: treatment, causes, symptomsWhat is it - gonarthrosis is a disease of the knee that is not of an inflammatory nature, in which the blood supply of the cartilage covering the articular surfaces of the femoral and / or tibia is disturbed. 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;
- increased 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;
- 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 tightening under the knee;
- stiffness in the knee, which manifests itself after sleep, prolonged sitting or prolonged immobility of the joint;
- joint pain:
- arising from prolonged walking, squats, walking on stairs;
- aggravated after standing or physical exertion
- swelling of the joint can 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.
- feels 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.
- does not fully extend the leg.
- joint swells, acquires signs of initial deformation.
- 1) Pain in the joint worries constantly, regardless of 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 in size 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 area below the articular cartilage, 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 a hole made under local anesthesia, allowing a specialist to examine the joint from the inside.
- 5) Knee ultrasound is informative for the diagnosis of such complication of gonarthrosis as synovitis.
Treatment of gonarthrosis of the knee jointThe doctor involved in the treatment of 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", "Artron", "Dona", "Teraflex", "Chondroitin complex".These drugs are taken for at least six months in the dosage prescribed by the doctor.
- 3) Inside 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 established itself as 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 rest 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.
Knee joint gonarthrosis - the development of the disease and its treatment
In the company of degenerative-dystrophic diseases of the musculoskeletal system, the gonarthrosis of the knee joint is one of the first places. For the first time gonarthrosis manifests itself after forty years, and women suffer this pathology somewhat more often than representatives of the stronger sex. Among predisposing factors, it is necessary to allocate excess weight, insufficient motor activity and knee arthritis in the anamnesis( arthritis of the knee joint, intraarticular fracture of the tibia or femur, rupture or sprain of the ligaments, menisci, hemarthrosis).
How the development of the disease occurs
The key role in the development of gonarthrosis is played not by the deposition of salts, as most of our audience mistakenly believe, but the dystrophic changes in the hyaline cartilage that covers the condyles of the femur and tibia.
Changes at the molecular level remain behind the scenes for a long time, but the cartilage gradually collapses, exposing the subchondral surfaces of the bones that form the knee joint. At some point, the hyaline cartilage becomes so thin that it ceases to perform its damping function, and soon it disappears altogether. As a consequence - the condyles of the bones are exposed, and this leads to their destruction.
Further the body includes protective mechanisms, which leads to the appearance of tibia and the femur on the surface of bone growth, spines or osteophytes are formed. These deformations can already be determined with the help of palpation, they are clearly visible even during X-ray examination. Gonarthrosis passes into the stage of deforming arthrosis. The synovial membrane of the joint also suffers, an aseptic synovitis is attached, an exudate is formed in the cavity of the knee joint.
Depending on which stage of destruction and deformation the process has achieved, three degrees of severity of gonarthrosis are distinguished. The clinical picture and complaints of the patient directly depend on the stage of the disease.
grade 1 knee joint gonarthrosis manifests in morning stiffness and minor pain in the affected joint. The patient notes that the pain occurs after a prolonged stay in a sitting or lying position, more often in the morning. It is worth it - and the pain subsides. The joint is not deformed at this stage, there are no external changes, mobility is not violated.
grade 2 gonarthrosis of the knee joint requires more attention. The pains occur not only after sleep, but also due to prolonged exercise, the knee is already deformed, enlarged in volume, and an experienced specialist can determine an unnatural increase in the size of the joint surfaces. Often the patient complains of the inability to bend the leg in the knee "to the end", feels a crunch in the joint during movement.
X-ray, we can already see a bright picture, in which the central place will be allocated deformations of the subchondral bone and narrowing the joint space.
Knee joint gynarthrosis of the third degree shows the same symptoms, but only their severity increases many times. Pain becomes an integral part of the life of such a patient, it tortures him both during walking, and at rest, and even at night, preventing sleep. The function of the joint is severely impaired - the patient is unable to bend the leg in the knee even by 90 degrees, moreover, often he can not fully unbend it. Appears lameness, a person falls on the affected leg, or can not move at all without help. The deformation of the joint is visible to the naked eye, and on the x-ray we see a gross change in the structure of the knee joint.
Disease Treatment of gonarthrosis of the knee joint is a long and complex process that requires the consolidated efforts of the physician and patient. Because there is no inflammation in the joint, anti-inflammatory drugs will not give anything. A key role is given to the regime measures, such as physical therapy, massage, sanatorium treatment.
The patient, if, of course, he wants to keep the joint, must perform a daily exercise program in the morning, during the day, take care of the joint as much as possible, and in the evening apply warming compresses to it. In the physiotherapy room, the patient can undergo a course of electrophoresis with medications that will calm the pain.
In the case of severe deformity, surgical treatment is indicated, which consists in arthroplasty of the joint.