The main ways to treat 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 affects mainly 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 of stage 1" is not observed. In this case, the disease is most easily cured.
Deformation of the 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.
At the 2nd stage of the disease there are changes in the bone tissue. 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 the 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 previous knee injury( fractures, lesions, 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 affecting the development of the disease are transferred arthritis( rheumatoid, reactive and others), genetic predisposition, weighed heredity, craniocerebral injuries, spinal column injuries, metabolic disorders.
Description of signs and symptoms of
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. X-ray examination allows excluding other pathological processes that can 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 the 2nd degree, 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 attentive attitude, 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 the 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.
Two-sided gonarthrosis of the knee joint, treatment of any degree, diagnosis and prevention of the disease.
Gonarthrosis is a degenerative-type disease. This is the most common type of arthrosis. It is characterized by progressive destruction of the knee cartilage, accompanied by deformation and dysfunction of the entire joint. This disease is observed, as a rule, in people in old age. Most often they suffer from women.
The development of the disease leads to a narrowing of the joint cracks, which causes the rapid deterioration of the cartilage. The process is accompanied by the restructuring and deformation of bone tissue. As a result, there are osteophytes, called spines. Increasing, they cause pain. If the treatment of knee gonarthrosis does not begin on time, then the most unfavorable consequences can be expected in the form of destruction of the cartilage and exposure of the bones under it. The result is a complete deformation of the joint.
This disease has a common name - "salt deposition".And for this there are grounds. Indeed, arthrosis of the knee joints can be accompanied by the deposition of calcium salt in soft tissues, but this process is of an organic nature and does not have clinical significance.
Causes of the disease
Depending on the origin, gonarthrosis can be of two types:
Primary or idiopathic
Scientists have not yet been able to identify its cause. As a rule, this is a bilateral gonarthrosis that occurs in elderly people with excess weight.
It is the result of an earlier knee pathology: trauma, infection, chondromatosis. As a rule, this is a one-sided affliction that appears in people outside of any dependence on age.
The main symptoms of
The insidiousness of the disease lies in the absence of pain at an early stage. Therefore, it may take years before the patient seeks help from a specialist. At first, people feel barely noticeable pain that occurs after long walks or in other situations when their legs experience increased loads, for example, when walking on a ladder.
This disease has 3 degrees of
At first, there is a dull ache. It occurs only after exercise and may be accompanied by swelling of the knees. At this stage, the knee does not yet have a pronounced deformation.
Gonarthrosis of the 2nd degree has already more pronounced symptoms. The pain intensifies and becomes longer in time. Patients complain of stiffness in the morning, they use analgesics. There is a crunch when walking, and the joint increases in size, its flexion or extension is very limited.
GG 2 nd degree has already more pronounced symptoms. The pain intensifies and becomes longer in time. Patients complain of stiffness in the morning, they use analgesics. There is a crunch when walking, and the joint increases in size, its flexion or extension is very limited.
In the third stage of the disease, patients experience almost unceasing painful sensations, which intensify with weather changes. Their gait is disturbed. The knee acquires a larger volume and changes shape. There are valgus - X-shaped deformations and varus - O-shaped.
This disease is diagnosed by X-ray examination, which allows you to put a fairly accurate diagnosis to find out the stage of the disease, and also to track the dynamics of its development. With a disease such as gonarthrosis of the knee, treatment requires a mandatory change in the lifestyle of the patient. It is important to start eating right, and also get rid of bad habits.
To people with a diagnosis of gonarthrosis, gymnastics helps to stop pathological processes and increase muscle tone. There are special sets of exercises, which you need to learn from a specialist, and then do them several times a day. It is necessary to rest lying down after work for at least 40 minutes.
You can reduce pain, and also relieve inflammation with anti-inflammatory non-steroid drugs. For this, medicines from a number of chondroprotectors are used, they replace the synovial fluid. For warming, apply half-alcohol compresses, as well as warm baths with pine needles or sea salt.
Physiotherapy techniques are also effective in the fight at the initial stage. Patients are treated with phonophoresis with hydrocortisone, diadynamic currents, ultraviolet irradiation, electrophoresis with novocaine, laser and magnetic therapy, UHF, foot massage.
Patients are assigned to wear individual insoles. They use when walking the cane to unload their joints. Sometimes special orthoses are used to relieve pressure on certain bone areas.
When conservative therapy has no effect, one of three operations is performed: arthroplasty, arthrodesis or corrective osteotomy.
- Arthroplasty can restore the lost motor function of the knee. During the operation, a new joint surface is modeled and special pads are placed in it, which replace the affected parts. They are produced from the patient's own tissue or artificial material.
- For arthrodesis, bone fixation is performed using various devices( screws, plates, transplants).After that they fuse. But the restrictions in the movement will still remain. An arthrodesis allows to forget about a pain at an arthrosis.
- An osteotomy is called dissection of bones and their subsequent fixation in a functionally correct position. Due to this operation, the distribution of loads on the joint bones will be more even, with normalization of intraosseous pressure, and pain disappears.
Osteotomy is the dissection of bones and their subsequent fixation in a functionally correct position. Due to this, the distribution of the load on the joint bones becomes more uniform and, as a consequence, intraosseous pressure normalizes, and the pain disappears.
In arthrodesis, the fixation of the ossicles occurs with the help of special devices( grafts, plates, screws).After that, they grow together. Although the motor limitations still remain, but this allows you to get rid of the pain with deforming arthrosis.
Arthroplasty will restore the lost motor functions of the knee. During the operation, new articular surfaces are modeled and special spacers are placed between them, which will replace the affected areas. The gasket is made of an artificial material or the patient's own tissue.
Gonarthrosis 1 degree: treatment and causes
Treatment of medicines is as follows:
- Non-steroidal anti-inflammatory and analgesic drugs include Voltaren, Nrimsil, Movalis and others;
- Chondroprotectors include Artru, Arthron, Don, Teraflex. The listed medicines must be taken at least six months in a dosage that the doctor will prescribe;
- To remove inflammation in the joint, hydrocortisone or Kenalog is administered no more than three times;
- After the inflammation subsides, ostenil, syncope and other similar drugs are injected into the joint. Such treatment is expensive, but it is quite effective;
- To improve the blood supply in the joint and increase the production of lubricant in it, the doctor appoints to make warming compresses with Dimexid and Bishofit;
- Treatment of gonarthrosis is carried out and drawing from soy and avocado plants. It should be treated for at least six months.
We treat the disease with exercise therapy
If the patient has an acute form of the disease, he needs to provide peace. A little later the joints begin to gradually load with physical exertion.
Sick on the back. Raise his straightened legs and hold him in the raised position. Exercise should be done in a smooth and careful movements, so as not to cause pain.
You need to start from ten minutes. After a while, the duration of physical education should be increased by two minutes every day. Exercises for physiotherapy exercises for each patient are selected by the attending physician on an individual basis.
Strictly contraindicated to squat, bend and unbend knees, walk for a long time, as well as perform movements that bring pain in the knee joint.to the table of contents ↑
To reduce inflammation in the joint, accelerate the regeneration of articular cartilage, and also to stop the pain syndrome treatment is carried out with the help of physiotherapy. Bilateral gonarthrosis is treated with electrophoresis with novocaine, diadynamic currents, magnetotherapy, UHF, phonophoresis with hydrocortisone, laser therapy, paraffin or ozocerite applications, mud therapy.
After discharge, the patient is sent to a resort sanatorium.to contents ↑
When the acute period falls, the patient can move with a cane. On the knees special orthoses are worn or orthopedic insoles are used.to table of contents ↑
In case of impaired joint function, and also with significant disability, the doctor performs an arthroplasty operation with prostheses made of biologically intact materials.
Operation can not be done with concomitant osteoporosis. After the operation, for three to six months, physiotherapy, exercise therapy, sanatorium treatment are carried out as rehabilitation.to table of contents ↑
Diet in case of
disease If weight is too high, the patient should try to lose weight. For this purpose, foods rich in animal and vegetable proteins are included in its diet. It is recommended to eat low-fat varieties of meat and fish, boiled, stewed and steamed dishes. Useful cheese, cottage cheese, bean products. It is useful to eat cold, to strengthen the cartilage and ligaments in the joints.
Entering fats must be plant. It is also useful to eat butter. The menu must contain products enriched with vitamins of group B.
Gonarthrosis of 1 st degree of knee joint: left-sided, bilateral, deforming, treatment
The term gonarthrosis in medicine denotes degeneration of the cartilaginous tissue of the knee joint, which leads to destructive changes of bonetissues of the heads of bones entering this joint. In this article, we consider gonarthrosis of the first degree, in which a rapid and complete restoration of damaged tissues is possible with the subsequent restoration of the physiological volume of mobility of the lower limbs. It is very important to recognize the pathology at the initial stage of development, this allows us to apply non-surgical methods of treatment.
Gonarthrosis of the first degree of the knee joint can be manifested by minimal symptoms, which are difficult to formulate to the patient at the primary address to the doctor. Typical signs can be short-term pain, crunching and clicks during sudden movements. These symptoms intensify after a busy working day, during which increased physical stress on the knee joints appeared.
Destructive changes do not appear in any way. When the radiograph is taken, the thickness of the cartilaginous layer is seen to decrease. There may appear a decrease in the amount of synovial fluid and a decrease in its biochemical properties.
Causes of bilateral first-degree gonatrosis
As mentioned above, bilateral gonarthrosis of the 1st degree is well suited to conservative treatment, pathology can be completely stopped. With the right approach, it is possible to achieve a stable remission, the beginning of a complete regeneration of damaged tissues. But as with any other disease, an important factor of therapy is the elimination of probable causes that contributed to the destruction of cartilaginous tissue. Therefore, it is worth investigating the causes that cause gonarthrosis. They can include the following pathogenic factors:
- excess body weight, which is accompanied by a deficiency in the development of muscle mass of the femoral and gastrocnemius muscle groups;
- incorrect placement of the foot, which leads to an incorrect position of the heads of bones in the cavity of the knee joint;
- heredity and the presence of systemic connective tissue diseases;
- concomitant diseases of the hip, ankle, spine;
- trauma and predisposing working conditions;
- infection during medical manipulations.
This is not an exhaustive list of possible causes, but they are highly likely to provoke destructive processes. Therefore, they should be excluded first.
What is a bilateral deforming gonarthrosis of the 1st degree?
Double-sided gonarthrosis of the 1st degree is the most common diagnosis in case of systemic involvement of the joint tissues. In the traumatic nature of the disease, a one-sided degenerative process arises. In the initial diagnosis it is important to understand how much the cartilage tissue is weakened and whether there are reliable signs of a change in the bone structure.
Deforming gonarthrosis of the 1st degree differs in that, with a significant change in the depreciation properties of cartilage, there is an increased mechanical stress on the head of the bones. As a result, microscopic cracks may appear, which are filled with deposits of calcium salts. Radiographically, it can look like outgrowths, thorns, roughness. There are no external signs at the initial stage. Pain during movement can occur after severe physical exertion.
Double-sided deforming gonarthrosis of the 1st degree can be diagnosed already at the age after 30 years. The risk group includes persons engaged in manual labor with the primary load on the knee joints. Symptomatically, this can manifest as a slight stiffness in the morning hours after awakening. After a short walk, all the pains disappear. In the evening and at night, there may be cramps in the calf muscles, pulling pains, restless legs syndrome.
To answer the question about what is deforming gonarthrosis of the 1st degree, it can be very simple. This pathology, which in the absence of timely treatment can go into the pronounced destruction of the articular tissues. This inevitably leads to disability and significant difficulties in the independent movement of a person.
Left-sided gonarthrosis of the 1st degree and its distinctive features
Left-sided gonarthrosis of the 1st degree is not common. Usually, the predecessor of the disease is a trauma in the form of stretching of the ligamentous apparatus, dislocation of the knee joint, stroke, inflammation of the meniscus, detachment of the patella and much more. In a number of patients, pathology may occur after medical intervention for arthroscopy or an operation to restore the integrity of the meniscus.
On the right side, a pathological process occurs in a similar way. It is worth noting the inflammatory component in the development of subsequent destruction. An aseptic inflammatory reaction with a compensatory purpose is possible if the physical properties and volume of the synovial fluid are disturbed.
Differential diagnosis is performed with various forms of arthritis, bursitis, traumatic lesions. It is not necessary to exclude the possibility of irradiation of the pain syndrome in the hip joint lesion.
Treatment of gonarthrosis of the 1st degree by the methods of manual therapy
For the treatment of gonarthrosis of the 1st degree, official medicine suggests using mainly non-steroidal anti-inflammatory drugs in combination with chondroprotectors. Additional methods of therapy can be therapeutic exercise, massage physiotherapy. However, often the measures taken are not sufficient to stop the destructive process.
We recommend that you use manual therapy techniques in addition to traditional methods of treatment. In our clinic, effective programs have been developed that allow the restoration of knee joints to be started at the expense of hidden reserves in the human body.
For the treatment of gonarthrosis of the 1st degree, osteopathy and therapeutic massage, a course of gymnastics and reflexotherapy are widely used. For each patient an individual technique is developed that takes into account possible causes leading to this disease. In particular, the specialists of our clinic work with overweight the patient, recommend changes in the diet, develop a program to increase physical activity.
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Knee joint gonarthrosis of 1, 2 and 3 degrees: treatment, causes, symptomsWhat is it - gonarthrosis is a non-inflammatory disease of the knee that disrupts the blood supply of cartilage covering the joint surfaces of the femur and / or tibia. As a result, the cartilage is destroyed, the parts of the bones begin to rub against each other, as a result of which they become denser and expand. This is often accompanied by inflammatory phenomena. Symptoms of the disease are due only to the above processes;calcium salts, if they are deposited in the joints, the cause of the pathology is not. Pathology most often develops in individuals 40 years and older, mainly women and people who are engaged in professional sports or having knee injuries. Articular cartilage does not regenerate, so the disease must be detected and treated early in the early stages.
Causes of gonarthrosisThe disease develops with a combination of several causes:
- fractures of the bones of the lower leg involving the knee joint;
- trauma of cartilage interlayers of the joint - meniscus;
- tears of knee joints;
- increasing the load on the joint - running, squatting, lifting weights from the vertical position of the body - after 40 years of age, especially if a person does not exercise regularly;
- excess weight
- joint inflammation( arthritis), which has a different - psoriatic, gouty, rheumatoid or reactive - etiology;
- genetically determined weakness of the ligamentous-capsular apparatus of the joint, due to which its looseness occurs;
- pathology of joint innervation, characteristic for craniocerebral and spinal cord injuries;
- metabolic disease.
- 1) Primary. It occurs against the background of full joint health( without pre-injury or inflammation).It is based on metabolic diseases, long reception of hormonal means, genetic predisposition of articular cartilage. The process is usually two-sided( although it can begin as one-sided).It develops more often in the elderly.
- 2) Secondary. Develops due to injuries, inflammations, tumors transferred to the joint operations. Can develop at any age. The process is usually one-sided.
Symptoms of gonarthrosis of the knee jointHow the disease manifests itself will depend on how far the degenerative process has progressed. Depending on this, three stages of the disease are distinguished, each of which has its own symptomatology. As a rule, the first degree of gonarthrosis of the knee joint is manifested by certain symptoms, which are worth paying attention to: the
- feeling of constriction under the knee;
- stiffness in the knee, which manifests itself after sleep, prolonged sitting or prolonged immobility of the joint;
- joint pain:
- arising during prolonged walking, squats, walking on stairs;
- aggravated after standing or physical exertion
- joint swelling may occur for a short time, passes by itself.
- joint pain becomes more intense, lasts longer. It disappears after rest.
- pain is felt inside the joint or on the inside of the knee.
- there is a crunching in the knee when walking.
- in the morning it is impossible to unbend the knee.
- closer to night and at night there are pains in calves. The
- does not fully extend the leg.
- joint swells, acquires signs of initial deformation.
- 1) Pain in the joint is worried constantly, regardless of the physical activity of the person.
- 2) Pain syndrome increases with changing weather.
- 3) The mobility of the joint is limited, due to which the person limps.
- 4) The knee is enlarged and deformed. When the process progresses, the joint becomes an X-shaped or O-shaped.
Diagnosis of gonarthrosisIt is possible to suspect the presence of gonarthrosis of the knee in the patient already on the basis of his complaints and objective examination data. The diagnosis is confirmed with the help of such instrumental studies:
- 1) Radiography. This method may be uninformative at the first stage of the disease, but subsequently it visualizes the narrowing of the joint gap, the compaction of the bone zone below the articular cartilage, and the sharpening of the edges of the condyles.
- 2) Computed tomography of the joint. This is more expensive, but more informative( even at stage I) method based on x-ray radiation. Visualizes the joint itself and surrounding tissues in more detail and layer by layer.
- 3) Magnetic Resonance Tomography - a method based on a non-radiological, considered harmless radiation, which can be used for contraindications to CT.Also layer-by-layer displays the picture in the joint, but is more informative regarding the surrounding soft tissues.
- 4) Arthroscopy is an invasive technique for joint research, when a fiber optic device is inserted into the hole made under local anesthesia, allowing the specialist to examine the joint from the inside.
- 5) The knee ultrasound is informative for the diagnosis of such complication of gonarthrosis as synovitis.
Treatment of knee joint gonarthrosisA doctor who is treating this disease is an orthopedist. Drug therapy of the disease includes the following groups of drugs:
- 1) Non-steroidal anti-inflammatory and pain medications: Voltaren, Celebrex, Rofika, Nimesil, Movalis.
- 2) Chondroprotectors: "Artra", "Arthron", "Dona", "Teraflex", "Chondroitin complex".These drugs are taken for at least six months in the dosage prescribed by the doctor.
- 3) In the joint with pronounced inflammatory phenomena, enter "Hydrocortisone" or "Kenalog" no more than 3 times.
- 4) The preparations of hyaluronic acid are shown, which must be inserted into the joint when the inflammatory phenomena in it subsided: "Hyalurum", "Ostenil", "Sinocrom".These medications show a very good effect, they are administered only a few times, while having a fairly high cost.
- 5) Heating compresses with "Dimexid", "Bischofite", medical bile to improve the blood supply of the joint, increase the production of "lubricating" liquid in it.
- 6) The preparation on the basis of drawing from soya and avocado plants - "Piascladin" - has also proved to be an effective tool in the treatment of gonarthrosis of the knee joint. At the same time, the treatment course is not less than six months.
Physiotherapy for gonarthrosisIn an acute period a person needs to provide complete rest for the 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 - basic concepts
Knee joint gonarthrosis
Knee joint gonarthrosis is a very common disease, especially for professional athletes and weightlifters. In its essence, it represents a gradual drying out of the cartilaginous tissue, which entails deformation of the entire joint and subsequent loss of its functions. Also, this ailment is often known as osteoarthritis and deforming gonarthrosis.
Most often, gonarthrosis is at risk for people of age, people who get intense and frequent physical activity. People who are overweight also overload their joints unnecessarily, and most often gonarthrosis is found in women.
1 degree of arthrosis of the knee joint is the easiest and most favorable for patients. It is characterized by the appearance of minor changes in the tissue of the articular cartilage. Symptoms of this disease, as a rule, do not bring any serious restrictions to the patients' life. In addition, in most cases at this stage of gonarthrosis progression of the disease stops.
Osteoarthritis of the knee joint of the 1st degree develops long and gradually. Therefore, patients almost never can tell the exact time of onset of the disease.
Long before the onset of patients' pains, the feeling of discomfort in the joint may be troubling. Usually people do not attach importance to this, writing off all not ordinary fatigue, hypothermia or recent trauma.
However, this symptom may already be the first sign of arthrosis of the knee joint, as the initial changes in the structure of the joint have already begun to occur, which is manifested clinically.
After a while, patients begin to experience pain in the knee. They may be weak enough that the patient does not pay due attention to them and does not consider themselves sick.
As a rule, pain manifests itself in the morning, after sleep. After awakening and walking, the joint is developed and the pain passes. Often, pain occurs during the day, after a long sitting or lying.
Such pains are called "starting", because they occur when the movement starts after a long rest, and after the joint work passes.
During the day, the pain may appear again. Especially often this happens when climbing or descending the stairs. The pains are caused by the fact that the weight of the whole body rests on the knee bent in the knee. Because of this, the articular cartilage contracts and abuts against each other.
Sometimes the initial sign of the disease may be a crunch in the joint. It arises from the fact that the deformed articular surfaces, as it were, cling to each other while moving.
Also a fairly infrequent manifestation of the first degree of arthrosis of the knee joint may be weakness of the muscles on the affected leg. Diagnosis
For an experienced physician to suspect that a patient has arthrosis of the knee joint of the first degree is not a big problem. More often for this purpose it is enough to correctly estimate the symptoms of the disease and the peculiarities of their occurrence.
Radiography of the knee joints should be performed to confirm the diagnosis. When using this method, a narrowing of the joint gap is usually found.
Treatment with ointments synovitis knee joint treatment is described by reference.
Treatment of knee arthritis pricks http: //sustavprof.ru/lk/ lechenie-artrita-kolennogo-sustava.html.
Gonarthrosis of the second stage is characterized by an increase in the symptoms that appeared in the first stage. The pain syndrome becomes more prolonged and intense. Patients mark the appearance of a crunch in the joint with motion of the knee. Many complain of stiffness in the joints in the mornings, which passes after a short walk. At this stage, patients periodically use analgesics. There is an insignificant limitation of flexion and extension in the knee joint. The joint is enlarged in volume.
The third degree of arthrosis of the knee joint is considered to be the heaviest. The disease significantly complicates the life of patients, severely restricts their ability to work and often becomes the cause of disability.
At the third degree of gonarthrosis the structure of the knee joint undergoes very serious changes. Articular cartilage is practically absent. This leads to the fact that the articular surfaces of the bones are sharply compressed, which is clearly visible on the X-ray.
Osteophytes( bone growths) on them becomes much larger. Also, with this degree of gonarthrosis, a pronounced narrowing of the joint gap is observed.
Among the symptoms, an important place is occupied by pain in the affected joint. They worry patients constantly and almost never pass. Even in bed, patients are constantly trying to find a "painless" position for the affected leg.
Another important symptom of the third degree of gonarthrosis is joint deformation and severe restriction of movements in it. It is extremely difficult for the patient to bend the leg in the knee even at a right angle. Many patients also can not fully unbend the aching leg.
Osteoarthritis of the knee joint of the third degree often leads to X or O-shaped deformation of the joint, which, in turn, is the cause of various abnormalities of the gait.
Sometimes with this disease, the so-called blockade of the knee joint can develop: a condition in which a person can neither bend his leg nor unbend it.
With this disease, both therapeutic treatment and surgical treatment can be used. The therapeutic does not differ much from the treatment of other degrees of gonarthrosis: decreased exercise, pain relief, chondroprotectors, physiotherapy, massage, diet, etc.
Patients with grade 3 gonarthrosis, whose treatment is not effective with conservative methods, can be used for surgical intervention.
Surgical treatment of arthrosis of the knee joint includes two large technologies:
Joint operations aimed at removing outgrowths and deformed elements that "prevent" the joint from working normally. The operations are carried out with the help of an arthroscope - a special device that allows you to carry out all these manipulations without opening the joint completely, but by making several holes. Prosthetic joints - an operation aimed at replacing the "native" joint elements with their artificial counterparts.
For reasons of occurrence, the disease is divided into two large groups: primary and secondary arthrosis of the knee joint.
With the primary form of the disease, the exact cause that caused this disease is unknown.
The secondary form is spoken of when there is already a problem in the joint( for example, inflammation, trauma, etc.), and osteoarthrosis, as it were, is layered again on the already changed joint.
The exact cause of gonarthrosis is unknown to date. But the risk factors leading to the appearance of this disease are well studied.
There are three large groups of causes, or risk factors for knee arthrosis.
The first group of reasons: hereditary and age factors.
The second group of causes: congenital and acquired diseases of the musculoskeletal system.
Pain sensations in gonarthrosis do not appear immediately. For a long time, many months or even years, there are minor pains that occur solely with prolonged walking, exercise, walking on a ladder or getting up from a chair.
If the pain in the knee has arisen sharply, and before there were no pains, it usually indicates some other disease or damage - for example, pinching of the meniscus or getting a piece of cartilaginous tissue between the cartilage of the knee. There are three stages of arthrosis of the knee:
I stage of gonarthrosis is characterized by fatigue of the limb, moderate restriction of movements in the joint, a slight crunch is possible. Usually, pain occurs at the beginning of the walk( "starting pain") or after a long load. At rest and with a small load, pain is absent. In the first stage, the bones of the knee retain their original shape and are almost not deformed. An x-ray reveals some narrowing of the joint gap.
In the II stage of arthrosis of the knee joint, there are restrictions of movement. Pain at this stage accompanies almost any movement in the affected knee. But especially the knee hurts after a long walk, wearing even small weights. The pain syndrome decreases only after a long rest. There is a noticeable crunch in the knee joint during movements, deformation of the joint, muscle hypotrophy, lameness. X-ray reveals narrowing of the joint gap 2-3 times in comparison with the norm, osteophytes appear( marginal growth of the bone).Synovitis( congestion in the joint of the pathological fluid) at this stage of gonarthrosis happens much more often and is much more pronounced than at the beginning of the disease, at its first stage.
In the third stage of gonarthrosis, pain in the knee is further intensified. The mobility of the knee joint is reduced to a minimum. Pain in the third stage of arthrosis of the knee joint is preserved and at rest, do not pass after rest. There is a noticeable deformation of the bones of the knee joint. It is difficult for a patient to find a comfortable position in bed, arrange an affected knee so that it does not hurt. If the destruction of the joint is combined with a violation of blood circulation, the joints begin to "twist" and in the middle of the night, usually when the weather changes - "to rain."X-ray joint joint is almost completely absent. The articular surface is deformed, the marginal growths are expressed.
A common symptom of gonarthrosis is a feeling of stiffness in the joint, "pulling" under the knee, pain in the knee after a long walk. Many patients with gonarthrosis( arthrosis of the knee joint) complain of difficulty in walking mostly in the morning, after a dream or after a long sitting. A person needs to "disperse" in order to become easier. With the development of gonarthrosis, pain in the knee, especially on the inner side, becomes more stubborn and permanent. Often, patients with gonarthrosis feel a crunch when moving the knee joint. Further, the limitations of flexion and extension of the leg develop. When the disease progresses, lameness develops. In more neglected cases, a person can not move without the help of outsiders, support or without crutches. Often in the lying position the pain subsides, but it happens that at night a person suffers from pain.
When examining the knee joint in the initial stage of the disease, external changes are usually not detected. With the course of the disease, the deformity of the knee joint, the contours of the bones forming the joint, the coarse, the contracture( incomplete flexion or extension), the curvature of the shin are very noticeable. Putting a palm on the front surface of the knee, you can feel the crunching or extensor movement crunch in the knee joint of varying intensity and duration. A similar sensation can be obtained by shifting the patella outward in the transverse direction( positive patello-cordillary symptom).
When you feel the joint of a patient with gonarthrosis, a painful area is detected, usually on the inside of the joint, at the level of the condyles of the hip, the large burtz, and the joint slit. Often an effusion accumulates in the cavity of the knee joint, ie, synovitis is attached. Such a state is determined by the smoothness of the contours of the knee joint due to bulging, protrusion of the tissues above the patella and from the side of it and a sense of fluctuation when the protrusion is felt with both hands.
Deforming gonarthrosis is one of the problems, the solution of which at the present stage of development of orthopedics is far from ambiguous. However, the generally accepted factor in the progression of degenerative changes is the violation of the limb axis, which leads to a significant overload of articular surfaces of the knee joint. A number of scientific papers devoted to biomechanical correction of the knee joint showed quite good results of treatment.
Current trends in the treatment of this pathology can be reduced to the following. In the first stage, it is advisable to use chondroprotectors, hyaluronic acid preparations, non-steroidal anti-inflammatory drugs of the COX-2 inhibitor group( of which nemesulide is available), glucocorticoids for relief of inflammatory phenomena in the synovial membrane, physiotherapy and sanatorium treatment. In the second stage, surgical methods are added to the above methods of drug therapy - in the form of extraarticular osteotomies. As has been proved by many years of experience, classical arthroplasty operations with joint surface remodeling do not always give a therapeutic effect. At the onset of the third stage, patients are shown endoprosthetics or as an extreme case of arthrodesis.
Dysplastic gonarthrosis should be considered separately, as it does not fit into this scheme due to the need to perform preventive surgical interventions aimed at normalizing biomechanical interrelations in the knee joint both for preventing development and for treating arthrosis.
With the advent of arthroscopy and the accumulation of experience of these operations on the knee joint, we came to the formation of a technique for its use in arthrosis of the knee joint. The value of these operations in minimally invasive and low traumatism.
Posttraumatic gonarthrosis can be a consequence of both chronic trauma of the knee joint and acute acute mechanical damage.
The appearance and rate of progression of the degenerative-dystrophic process always directly depends on the severity and extent of the knee joint injury, as well as on the methods of treatment used for its correction. In most cases, gonarthrosis occurs three to five years after injury. Sometimes the characteristic changes occur much earlier - two or three months after the fracture or dislocation of the knee.
The development of gonarthrosis is facilitated by pinching, tearing and tearing of the meniscus, accompanied by wedging of the knee joint, especially when it was not quickly and timely eliminated. For possible causes of arthrosis can be attributed to cartilage and ligament injuries.
minor, minor injuries sometimes become a source of serious problems, turning into a kind of trigger mechanism for the development of aseptic( avascular) necrosis of the condyle of the hip and tibia. This subsequently threatens to pass into post-traumatic gonarthrosis with all the manifestations typical for this pathology.
To date, instability of the knee joint, which is often a consequence of its significant damage, is considered one of the most common causes of secondary gonarthrosis in young and middle-aged people. In addition, almost universally performed stabilization of the joint by reconstructing its ligamentous apparatus does not prevent the development of deforming arthrosis, but, on the contrary, it leads to the resumption of unrestrained physical injuries and overloads interrupted by the trauma.
The optimal approach to the correction of instability should provide for not only its leveling, but also be designed to further prevent the progression of deforming arthrosis. An important role in this is given to restoring the balance balance of the knee by performing a valgus osteotomy of the tibia.
On average, in 20-30% of cases, the cause of gonarthrosis are various injuries of the knee joint. They suffer mainly the able-bodied category of citizens, to prevent and timely diagnosis of this pathology should be approached extremely scrupulously. This will help in the future to avoid early disability and social disadaptation of such persons. Particular attention should be paid to patients who underwent partial or complete removal of the meniscus during the treatment of injuries. As this leads to increased pressure on the articular cartilage.
Primary bilateral gornatros - ICD 10
Quite often diagnosed complicated version of arthrosis of the knee joint - gonarthrosis bilateral. In this case we are talking about the fact that two legs are struck at once. This kind of gonarthrosis is more common than unilateral arthrosis, and at the same time requires more scrupulous examination and treatment.