Gonarthrosis 2 degrees of knee joint treatment

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.

healthy knee joint and gonarthrosis of 2 degrees

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 pain, arising 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.

stage of gonarthrosis and destruction of the knee joint: a schematic image and an X-ray

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 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 load;
  • excess weight;
  • malnutrition and lifestyle;
  • is an inflammation of the joint( arthritis).
Arthritis of the knee joint may be the cause of gonarthrosis

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.

photo and x-ray of the knee with gonarthrosis

Knee deformation in gonarthrosis

Five treatments for

Treatment of gonarthrosis of 2nd degree is performed exclusively by conservative methods. According to 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 nonsteroidal anti-inflammatory drugs. Examples of preparations:

  • butadione,
  • tselrebex,
  • nimulide,
  • piroxicam,
  • diclofenac,
  • movalis,
  • ketoprofen.

Effectively relieves pain, allows a person to move normally and eliminates inflammation of tissues.

2. Treatment with chondroprotective agents: glucosamine and chondroitin sulfate.

Restores cartilage tissue.

3. Physiotherapeutic procedures: electrophoresis, magnetotherapy, laser.

Physiotherapy deliver 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.

5. Massage.

Same as LFK.

Diet

For gonarthrosis of the 2nd degree, 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

Large number of vegetables

Dishes containing gelatin and collagen: chilli, pudding, jellied.

Nonfat fish

Foods containing folic acid: bananas, liver, buckwheat, cabbage, lentils.

Lean meat( turkey or chicken)

Foods containing vitamins B6 and B1:

  • chicken,
  • carrots,
  • tomatoes,
  • potatoes,
  • nuts,
  • eggs,
  • beans,
  • spinach,
  • peas.

Wholemeal bread with bran

Vegetable and animal proteins:

  • liver,
  • fish,
  • milk,
  • beans,
  • beans,
  • soy.

These dietary recommendations are relevant and the same for all levels of gonarthrosis.

Author: Svetlana Kant

SustavZdorov.ru

Arthrosis of the knee joint of 2nd degree: causes, diagnosis and treatment

2 degree of gonarthrosis of the knee joint can not only reduce the motor activity of the patient, but also worsen the quality of his life as a whole. The reason for this may be not only pain and inability to exercise, which seemed only recently insignificant.

Comparing the changes that have occurred between the initial stage of the disease and its second stage, a person begins to understand: without proper treatment, the situation will only worsen further.

Reason for
Symptoms of
Diagnosis of
Complications of
Treatment of

Causes of

Changes in joints with disease The most common reason for the transition of the disease to stage 2 is the irresponsible treatment and non-compliance with the physician's recommendations regarding locomotor activity and changes in lifestyle.

In a joint already affected by the disease, blood circulation and metabolic processes are slowed to the point where tissues are unable to receive nutrients and oxygen without outside help. If you refuse treatment or postpone it "for later", there is an acceleration of destructive processes in the joint and, as a consequence, the transformation of the disease of their mild stage into a more severe one.

Symptoms of

For the 2nd stage of knee joint gonarthrosis the following manifestations are characteristic:

  • pain enhancement: pain attacks acquire a certain regularity( after night sleep, prolonged rest period, physical exertion, etc.);
  • stiffness in the joint, usually in the mornings, which passes after a short walk;
  • knee joint increases in size, its relief is smoothened - all physiological bulges and cavities on the joint cease to be determined. In the standing position, this can manifest as a skin "hanging" over the kneecap. In the squatting position, it becomes evident that one knee( affected by gonarthrosis) is significantly larger than the second, healthy, and has a spherical shape;
  • when moving in the knee can be heard a characteristic crunch;
  • flexion and extensor movements of the joint are severely limited.

People with 2 degrees of gonarthrosis are rarely able to do without taking pain medication, as pain in the knee begins to bother even during periods of rest. This is due to spike-like growths on the bone tissues of the joint, which have an irritating and traumatic effect on all the structures of the knee.

Diagnosis of

In most cases, a patient who complains of a worsening state of health is already diagnosed with gonarthrosis, and the attending physician can prescribe a radiographic examination to assess the changes that occur in the joint.

If a doctor has a reason to suspect joining other gonarthrosis, CT, MRI and laboratory blood tests can be recommended. This is necessary in order to exclude infections that can penetrate the joint through the bloodstream, and the complicated course of gonarthrosis, with soft tissue damage.

Complications of

Complications of the disease In the absence of treatment or insufficiently responsible to it, gonarthrosis of the 2nd degree can quickly overcome the last "stage" and go to the final stage, in which the pain becomes a constant companion, and the joints undergo irreversible changes and deformations.

In addition, weakened joint tissues become vulnerable to infections, and any viral or bacterial systemic disease can cause serious complications during gonarthrosis. The most common, but no less dangerous, is the infection of the joint cavity with the formation of purulent contents that can spread to soft tissues - muscles, skin.

Treatment of

In the treatment of grade 2 gonarthrosis, attention is focused on the removal of pain syndrome, slowing or completely stopping the degenerative process in the joint, preventing complications and improving knee mobility.

Medication

Medicines used in the treatment of grade 2 gonarthrosis are divided into the following groups:

  • Anti-inflammatory drugs. These include non-steroidal anti-inflammatory drugs( NSAIDs) of the latest generation, which eliminate the inflammatory process in the joint and, as a result, reduce pain. When gonarthrosis is used Ketoprofen, Nimesulid, Diclofenac, etc.
  • Glucosamine Chondroprotectors( Glucosamine, Dona, etc.).This group of drugs can protect cartilaginous tissues from further destruction and enhance regeneration processes in them.
  • Hyaluronic acid preparations( Fermatron, Gyuralan, etc.), which are analogues of natural lubrication of the inner surface of the joint. Reducing friction in the knee joint, these drugs prevent further wear and destruction of the cartilage. In some cases, intra-articular injections of hyaluronic acid are indicated( for example, with very poor blood circulation in the joint, which prevents other forms of the drug from reaching the affected tissues).
  • Auxiliary means. These include vitamin preparations, immunostimulants, bioactive extracts from plants( aloe, echinacea, etc.), which are designed to improve blood circulation in the joint tissues and thus accelerate the metabolic processes in them.

Physiotherapy, massage, exercise therapy

Such methods of treatment as physiotherapy, massage and exercise therapy can be considered auxiliary for the treatment of the 2nd degree of gonarthrosis of the knee and are rarely used as independent methods of treatment.

Physiotherapy( UHF, phonophoresis, ultrasound therapy, magnetotherapy) is used to improve blood circulation in the joint and stimulate recovery processes in it.

Massage Massage is recommended for courses of 10-15 sessions, one session a day or every other day. Massage, improving the blood supply in the joint, normalizes the metabolic processes in it and provides a more effective effect of medicines on diseased tissues.

With the diagnosis of arthrosis of the knee joint of the 2nd degree, massages with the use of medicines( chondroprotectors, anti-inflammatory or irritating ointments, cooling and anesthetic external agents, etc.) are often prescribed. The choice of a specific drug remains with the doctor - the appointment depends on the clinical picture of the disease, the severity of the symptoms andother factors.

The complex of physiotherapy exercises is assigned to treating physicians after evaluating the effectiveness of drug treatment, and is selected taking into account the individual characteristics of the course of the disease and the overall health of the patient.

Lifestyle Correction

Lifestyle correction is one of the most important conditions for effective treatment. For gonarthrosis of grade 2, the following rules must be adhered to:

  • Reduces the burden on the affected joint. To do this, orthopedic canes are used, which allow you to distribute the load during movement so that the knee joint is minimally involved. It is important to choose the right cane for growth - it should be the length from the wrist to the floor when you are standing.
  • Diet. With this disease, it is recommended to reduce the intake of foods containing animal protein( eggs, meat, fish, whole milk), carbohydrates( baked goods, sweets) and any foods and beverages containing synthetic flavors, sweeteners, preservatives.
  • Weight loss. Obesity is one of the risk factors that increases the likelihood of metabolic disorders in all tissues, including joint tissues. In addition, overweight - this is an extra burden on the joints.

Surgical treatment

Surgical treatment can be divided into two types: arthroscopy and endoprosthetics.

Each operation has its own list of indications, under which the intervention will be most effective.

Arthroscopy

Arthroscopy Arthroscopy is a low-traumatic surgical method, in which the operation is performed using miniature lighting, surgical and video devices inserted into the joint cavity through small punctures.
Indication:
  • the presence of bone lesions( osteophytes), impeding the mobility of the joint;
  • deformation of the joint tissues, which can be adjusted without large-scale surgical intervention;
  • the need for chondroplasty, which can significantly slow the progress of the disease and restore the motor ability of the joint.

Contraindications to arthroscopy are acute infectious diseases, blood clotting disorders and a small amplitude of movements in the joint - the inability to fully extend or flex the joint does not allow the surgeon to carry out the necessary manipulations.

Endoprosthetics

Endoprosthetics Endoprosthetics - replacement of the knee joint by artificial, made of strong and hypoallergenic material, identical in structure to natural bone tissues.

Over time, the prosthesis takes over all the functions of the "native" joint and allows you to return to a normal lifestyle.

Indication:
  • no effect after a long course of conservative treatment;
  • rapid disease progression;
  • changes that occur in the joint, significantly impair the motor activity of the patient, have caused severe and frequent pain and / or cause the risk of disability.

Among the contraindications, only certain systemic diseases are absolute, making any surgical manipulations impossible. In this case, the attending physician weighs the risks and benefits of surgical treatment and, based on the findings, decides whether to perform the operation or continue a conservative course of treatment.

ArtrozamNet.ru

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.

The problem of gonarthrosis of the knee joint

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 joint, is degenerative-dystrophic joint damage 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.

Changes in the joint with gonarthrosis

The body instinctively reacts to the disappearance of cartilage by bone growth in the 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 occurs with the growth of the following pathological disorders in the joint:

  1. Disturbance of the metabolic process in the cartilaginous tissue: a constant supply of cartilage occurs due to the separation and absorption of 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.
  2. Structural changes of collagen fibers: the softening of the patellar cartilage begins, the depreciation function of the cartilage and the metabolic capacity of the chondrocytes are broken - the cartilage loses its elasticity and its instability appears.
  3. 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.
  4. 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.

Stages of gonarthrosis

The 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, there is a one-sided and two-sided gonarthrosis. 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 a degenerative-dystrophic process of destruction of cartilage tissue, provoking factors are needed.

Excess weight - the cause of gonarthrosis

There are following causes of the disease:

  • 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.

Arthritis - the cause of gonarthrosis of the knee

It is subdivided into 3 stages and, accordingly, 4 stages of development:

  1. 1 stage( 1 degree): the initial phase, characterized by a slight 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.
  2. 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.
  3. 3rd stage( 3rd degree): joint deformity with foot axis disturbance, joint instability. There is a sharp increase in pain, even at rest, edema, local temperature, impaired mobility of the joint.
  4. Stage 3 with 4 degrees of severity: severe joint deformity, complete disappearance of cartilage, impaired mobility of the limb, pain is permanent.

Symptoms of

At the initial stage, the symptoms of gonarthrosis are manifested by a feeling of tightening the muscle under the knee and a slight pain after a long hiking trip. 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.

Treatment of gonarthrosis in the doctor

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 is decided by the doctor, taking into account the stage and severity of the disease.

"Диклофенак" для лечения гонартроза

In general, treatment is carried out in a complex manner, but usually includes the following steps:

  1. Elimination of the inflammatory reaction: Non-steroidal anti-inflammatory drugs are prescribed: Diclofenac, Olfen, Diclac, Ibuprofen, Indomethacin, Ketaprofen, Meloxicam, 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.
  2. Anabolic and anti-catabolic effect, restoration of cartilaginous tissue: chondroprotectors - Structum, DONA, Rumalon, Alflutol, Mukosat.
  3. Normalization of blood circulation, warming and soothing effect: ointments, gels, creams - "Finalgon", "Fastum gel", "Nikofleks", "Apizarthron", "Feloran".
  4. Improvement of blood circulation, strengthening of vascular tissues: vasodilating drugs - Cavinton, Trental, Actovegin, Uppsit, Ascorutin.
  5. Reduction of muscle tension: antispasmodics - "No-shpa", "Midokalm", "Tizalud".
  6. 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.

The principle of arthroscopic debridement

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);
  • endoprosthetics.

Preventative measures

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 ability to work and the group of disability is 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.

SpinaZdorov.ru

Knee joint gynarthrosis of 2nd degree

Knee joint gonarthrosis of the 2nd degree is a neglected disease that requires qualified treatment. At this stage of the disease there is already a limitation of mobility in the affected joint. Painful sensations are accompanied by any movement of the foot in the knee, most often they appear after a long walk and carry even small weight. After a long rest the pain gradually passes.

Signs of gonarthrosis

The patient is heard crunching in the joint, and during the radiography in the picture the narrowing of the joint gap is determined. Sometimes a joint fluid accumulates in the joint cavity. Visually, one can see the deformation of the knee region, in the second stage of the disease the patient begins to limp.

What is dangerous gonarthrosis 2 degrees?

If you do not have any medical measures, gonarthrosis of the knee joint of the 2nd degree will gradually move to the next stage - gonarthrosis of the 3rd degree. In this case, the severity of symptoms increases several times. The pain torments the person constantly, and day and night, and does not pass at rest. The movements in the affected joint are limited to such an extent that the patient can not bend the leg to a 90 degree angle, moreover, difficulties arise with the extension of the leg. The lame expression is strong, the person falls on one leg l

for at all can not walk without help. The deformation of the knee region is visible to the naked eye, and on the X-ray images there are gross changes not only of the joint, but also of the bones adjacent to it. The joint gap is practically absent.

There are several stages of gonarthrosis

Diagnosis

The doctor usually interrogates the patient, collects complaints, conducts visual examination of the patient, determines the amount of movements. With the diagnosis of "deforming gonarthrosis of the knee joint," instrumental diagnostic methods are required. It is necessary to take an x-ray, and if necessary - ultrasound and arthroscopy.

Osteoarthrosis( New osteoarthrosis, from other Greek - ὀστέον - bone, ἄρθρον - joint, synonyms: deforming osteoarthritis( DOA), arthrosis, deforming arthrosis) - degenerative-dystrophic joint disease, the cause of which is the destruction of the cartilaginous tissue of the articular surfaces. Some common types of osteoarthritis have been given separate names. In particular, the term "gonarthrosis"( from the Greek-γόνυ-knee) is used to refer to arthrosis of the knee joint

Treatment of

Gonarthrosis of the knee joint of the 2nd degree requires an integrated approach, combining the efforts of the patient and the doctor. Treatment of the lesion of the knee region is no different from treating atroses of another localization. Necessarily prescribed therapeutic exercise: it provides an opportunity to maintain and increase mobility in the joint. During the movement, blood circulation and nutrition of the cartilaginous elements increase.

Are there any methods for treating gonarthrosis?

Where to go and what to do?

Three main methods should be distinguished here:

  • Physiotherapy
  • Medical treatment

A physician or a physiotherapist for physiotherapy will help you to choose the necessary set of exercises.

At the heart of the treatment should be the principle - as little as possible to burden the patient's joint itself, but at the same time ensure its mobility. Therefore, all exercises are performed sitting or lying down. An excellent way to restore mobility and relieve joints is swimming in the pool.

It is impossible to reject such an effective method as self-massage of the knee area, in addition, the muscles of the shin and thigh are additionally massaged. This allows you to maintain muscle tone, improve blood supply and prevent muscle atrophy.

For the removal of symptoms prescribed anti-inflammatory drugs and analgesics. Benefits will also come with ointments with irritating, warming and anesthetic effects.

Venotonizing drugs will help improve circulation.

Because the disease is caused by cartilage damage, do not neglect the chondroprotectors. Known means - хонроитин a sulfate, глюкозамин a sulfate, гиалуроновая acid. Take these medicines should be a long time. In the evening, warm compresses can be applied to the leg.

In severe cases, they resort to surgery - endoprosthetics of the affected joint.

tvoisustavi.ru

Knee joint gonarthrosis of the 2nd degree: what is it and how is it treated

Knee pain

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:

  1. 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.
  2. 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.

    Puffed knee

  3. 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:

  1. 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

  2. Drugs that are collectively referred to as "chondroprotectors"( literally "cartilage protectors").These are effective preparations on the basis of 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.
  3. 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.

sustavu.ru

Among all joints of the human body the knee joint is considered to be the largest. The increased workload, which he daily called to withstand, often leads to the development of various diseases. Osteoarthrosis of the knee joint, at which progressive destruction of articular cartilage occurs, and which is the most common pathology, is called gonarthrosis of the knee joint of the 2nd degree.

Gonarthrosis refers to diseases that lead to degenerative-dystrophic changes in the joint-articular apparatus, and significantly worsen the quality of life. The risk group includes professional athletes, people with excessive body weight, or experiencing persistent physical overload, as well as patients suffering from varicose veins.

Specialists distinguish three degrees of severity of gonarthrosis, but, as a rule, the first degree of gonarthrosis proceeds in a latent( latent) form, so it does not involve any changes and does not cause discomfort. And only when the gonarthrosis of the knee joint of the 2nd degree develops, patients begin to pay attention to their ailment.

Causes of development of gonarthrosis

There are several main reasons that contribute to the onset and development of gonarthrosis. One of them can be considered congenital anomalies in the structure of the ligamentous apparatus and the structure of the joint tissues. The next reason is the mechanical factor, in which the microtraumatization of the hyaline cartilage takes place, leading to degenerative changes in its structure. An important factor in the development of gonarthrosis, especially bilateral, is overweight, which exerts an increased strain on the knee joint.

Often among the common causes can be identified accompanying pathologies:

  • bone fractures and joint trauma;
  • tumors of bone tissue of various etiologies;
  • inflammation, arthrosis;
  • ankylosing spondillitis or rheumatoid arthritis.

Signs of gonarthrosis of 2 degree

If at the beginning of its occurrence gonarthrosis is asymptomatic, or the symptoms are mild, then with the development of gonarthrosis of the knee joint of the 2 nd degree it is possible to reveal by completely certain signs.

The main and characteristic symptom of gonarthrosis development is pain syndrome, which is practically absent at the beginning of the process, and only after a long time it acquires a more intensive character and becomes more and more prolonged. Painful sensations appear when moving, climbing stairs, minor physical exertion, walking at considerable distances.

Gonarthrosis of the 2nd degree is characterized by restriction of joint mobility, difficulty in flexing and extension of the limb due to deformation of the joint tissues and intensification of pain sensations. An external manifestation of these changes is the change in the appearance of the knee and lameness. It is during this period that the patient begins to move with a cane, which helps to limit the load on the affected joint.

On palpation and during movement in the knee joint, a crunch may appear, which occurs due to deformation of the joint, thinning or complete abrasion of the hyaline cartilage. On the roentgenogram, it is easy to determine the narrowing of the joint gap and the formation of osteophytes - bone growths that replace articular cartilage.

As the articular cartilage thinens, the friction of the bone elements increases, as a result of which the inflammation of the joint membrane - synovitis develops. The classic manifestations of this process are:

  • formation of puffiness around the joint;
  • localized hyperthermia - fever.

Treatment of gonarthrosis of 2nd degree

Degenerative and dystrophic knee joint damage is an irreversible process, so diagnosis and treatment of the disease at an early stage ensures complete recovery of the patient. In this case, the diagnosis is carried out by collecting anamnesis on the basis of patient complaints, external examination and radiography, on the basis of which it is possible to determine the extent of knee joint damage.

If knee joint gonarthrosis of grade 2 is diagnosed, the treatment consists in an integrated approach, that is, using various techniques aimed at eliminating the symptoms of the disease, reducing the load on the affected joint, and also alleviating the patient's condition. It should be remembered that only a long and regular implementation of all medical recommendations can lead a patient to recovery.

Currently, treatment of gonarthrosis of the knee joint of the 2nd degree is carried out by therapeutic methods. Complex therapy allows you to achieve the desired effect in a shorter time, and consists of several methods:

  • medication with effective medications;
  • physiotherapy procedures;

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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:

  1. 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.
  2. 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.

    Swollen knee

  3. 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:

  1. 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

  2. Drugs that are collectively referred to as "chondroprotectors"( literally "cartilage protectors").These are effective preparations on the basis of 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.
  3. 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 2 degrees

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 porridges, especially from coarsely ground grits, 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 diseased 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:

  • For this recipe you need to buy a pharmacy red or blue clay. 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 moreover does not possess allergenic properties.

The operation is rather lengthy, it is performed 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.

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