Bilateral gonarthrosis of 1 degree: causes and treatment
Joint diseases now occupy a huge niche among pathologies of the musculoskeletal system. Among them, an important place is occupied by gonarthrosis.
What is it?
Under gonarthrosis is understood an inflammatory disease of a degenerative nature, affecting the knee joint. This disease is widespread everywhere and develops mainly in middle-aged and elderly women. The incidence of this pathology is higher in rural areas than in cities.
The disease is characterized by depletion of the articular cartilage, changes in congruence of the joint, and the development of bone growths in the joint( osteophytes) region. When gonarthrosis changes the volume of active movements, the configuration of articular surfaces.
The disease has a high risk of disability of patients, a significant deterioration in their quality of life. If the process is not diagnosed in time, the prognosis regarding recovery and complete restoration of the impaired joint function worsens.
Among the reasons provoking the development of gonarthrosis, we can distinguish the following:
- Hereditary predisposition. According to statistics, the risk of developing gonarthrosis in patients whose parents suffered from this disease is high enough.
- Heavy static work. In this case, prolonged stagnation of blood and lymph in the joint region, its overload, which significantly increases the load on the articular cartilage. This factor often serves as a prerequisite for the development of gonarthrosis 1 degree.
- Injury to the joint. They are the most common cause of gonarthrosis development as long-term effects or complications. Causes immediate damage to the cartilage, which subsequently undergoes resorption.
- Overweight and osteochondrosis. They are not the direct causes of gonarthrosis, but worsen the course of the disease itself.
- Congenital malformations of the knee joint. Because of incorrect embryonic tissue filling, the joint can not develop fully, which is why the gonarthrosis of the first degree of the knee joint develops.
Features of the disease course
Gonarthrosis has some specificity, which depends on the underlying cause. If the cause is not clearly understood or there are predisposing factors such as excess weight or spine diseases, then in the given situation the bilateral gonarthrosis of the 1st degree develops most often. If the basis of the disease is trauma or some professional characteristics, then in this situation there will be a one-sided defeat of the knee joint.
Joint damage on one side is more favorable for treatment, but it progresses faster than with a bilateral process. Bilateral gonarthrosis of 1 degree is more favorable in terms of prognosis, however, treatment takes more time.
Classification of gonarthrosis
The disease can be divided by the amount of damage( bilateral or unilateral).Unilateral, in turn, is divided into right-sided gonarthrosis and gonarthrosis of the left knee joint.
In terms of severity, three stages of the disease are identified:
- Gonarthrosis of 1 degree( or stage) has no clinical manifestations and is detected only during routine examination or is an accidental finding of diagnosticians. Deformation for this stage is not typical.
- The second stage of gonarthrosis already has some clinical signs( pain after a long walk or static load, some stiffness when moving).The volume of active movements is gradually limited by the initial changes and deformations in the joint.
- Gonarthrosis of the third stage is characterized by a constant pain syndrome, visible deformation and almost complete loss of active movements in the joint. Passive movements are difficult. Walking at this stage is impossible.
Gonarthrosis This stage of gonarthrosis is most favorable for patients. The pathological process can stop at this stage and then not progress. Changes in the joint do not make patients uncomfortable and do not limit their social activity. Two-sided gonarthrosis of the 1st degree develops less often than its one-sided form.
The main symptoms that can occur at this stage are a feeling of discomfort in the knee joint after a long physical work, a low-intensity aching pain that quickly passes after a period of rest. Depending on which joint is affected, a left-sided and right-sided shape is identified. Left-sided gonarthrosis of the first degree develops mainly in left-handers and is characterized by pain in the left knee joint.
Right-sided form is much more common. Suffer it usually jockeys, wrestlers, weightlifters, gymnasts. When carrying out preventive arthroscopy, right-sided gonarthrosis of the 1st degree is diagnosed in 40 percent of the population.
Pain usually appears in the morning and passes in a few minutes( for example, when charging).
In some cases, patients may be disturbed by a crunch in the joint, or by the friction experienced during palpation of the joint( it is enough to just put your hand on your knee and bend it several times).
With competent division of labor and rest, gonarthrosis of the first degree of the knee joint stops at this stage. Either flows, but rather slowly. Deterioration of the state is usually observed only after several years( depending on the regime and type of labor).
In rare cases, deforming gonarthrosis of 1 degree may develop. This phenomenon is extremely rare. The development of this form of the disease is prognostically much worse than the classical course.
If there is gonarthrosis 1 degree, treatment may not be required.
2nd stage of gonarthrosis
With progression of the disease, gonarthrosis passes to a new stage. Stage 2( or degree) of gonarthrosis is characterized by a more intense pain syndrome: if at the first stage only the initial pains were noted( in the morning or after a long rest), then unpleasant sensations can appear at any time. Pain is more intense, more difficult to stop with anti-inflammatory drugs.
Because of the intensity of the pain syndrome, atrophy of the muscles of the affected limb can often be observed. This is due to the fact that patients, sparing a sick leg, less and less try to load it.
The main characteristic feature of the 2nd stage is the development of deformation in the joint. Most often, patients can not completely unbend the bent leg. Palpator can determine the inconsistency of articular surfaces( with unilateral gonarthrosis when compared with a healthy leg) or sensation formation on both sides( bilateral gonarthrosis).
Glandarthrosis This stage is almost terminal during the course of the disease, and patients acquire a disability group( if they can not be operated on).
The pain syndrome acquires a permanent character and is not stopped by usual analgesics. Possible use of narcotic drugs( in the hospital).
Deformations become visible to the naked eye, and the volume of active and passive movements decreases significantly, down to total loss. Perhaps the development of X-shaped and O-shaped deformations.
In the affected joint, development of ankylosis is possible, which is why surgical correction of the pathology is indicated.
The articular cartilage completely disappears from the joint cavity. Friction of the articular surfaces becomes more palpable.
In some cases, the third stage of gonarthrosis is characterized by the development of blockade of the knee joint - a condition in which it is impossible to bend the leg or unbend it.
Such patients need joint replacement.
The diagnosis depends entirely on the patient's complaints, his history( life, work), as well as information obtained by examination and using instrumental methods.
During the general examination it is possible to reveal the expressed mismatch of articular surfaces. With palpation, local soreness can be felt( in the case when gonarthrosis of 1 degree, synovitis and bursitis occur).
During movement in the joints are guided by the noise of crackling or crunching during the movement.
In addition to the examination, it is necessary to determine the amount of movement in the joints. The volume of active movements is those movements that the patient can perform himself, and the passive ones with the help of a doctor.
Radiography of the affected joint and endoscopic examination were disseminated from instrumental methods. Radiography allows you to determine the condition of the joint gap, as well as to identify the developing areas of joint deformation. In order to determine gonarthrosis 1 degree, it is necessary to conduct the radiography in the first place. Intra-articular endoscopy allows to determine visual changes on articular surfaces. It should be remembered that endoscopy is an intervening cavity, and can damage the joint, as well as provoke an aggravation of the process.
Treatment of 1 and 2 degrees of gonarthrosis
Like any disease, gonarthrosis requires a certain approach in treatment. Properly selected therapy should organically combine non-drug methods, drug support and physiotherapy procedures.
If there is gonarthrosis 1, 2 degrees, they can be treated at home or in the hospital - with a significant exacerbation. It all depends on the individual characteristics of the patient and the clinical picture. Usually, folk methods and drug support are used for this.
When the patient complains of grade 1 gonarthrosis, the treatment will be performed on an outpatient basis and include symptomatic therapy - non-steroidal anti-inflammatory drugs( "Nimesulide", "Movalis") and general measures - diet, hardening, vitamin therapy.
In the second stage of the disease, injectable anti-inflammatory drugs and analgesics( medicines "Diclofenac", "Tramadol"), as well as means for restoring the synovial fluid synthesis( "Hyaluronic acid" preparation) are added to the above listed preparations. Do not interfere and the means containing the components of the articular cartilage - drugs "chondroitin sulfate", "Don".
Treatment of 3 severity
With worsening of the condition and diagnosing "gonarthrosis of 3 severity", conservative treatment becomes mostly ineffective( possibly using narcotic analgesics).
To correct joint disorders, surgical treatment should be resorted, usually to joint prosthetics.
This operation allows you to replace both affected articular surfaces( femoral and tibial) bones. Indications for such an operation are persistent disruption of movements in the joint, as well as completely destroyed articular surfaces with loss of ability to walk.
In some cases( if the patient can not tolerate such an operation or if the patient refuses the prosthesis), it is possible to remove the formed bone outgrowths by means of an arthroscope-a device inserted into the joint cavity. This intervention is less traumatic and can be performed under local anesthesia.
Complications of gonarthrosis
In case of untimely diagnosis of the disease, some complications may develop. Among them, one can distinguish those that directly affect the affected limb, and those that will have an effect on the body as a whole.
Gonarthrosis 1 degree does not lead to the development of complications and is the most favorable form.
Local complications include the development of total ankylosis( the formation of a single fusion between the bones), gankrene of the shin and foot( may occur when the vessel falls between the affected bones and their adhesion to the compression of the artery).Possible infringement of passing nerves with development of an intensive painful syndrome and infringement of function of a finiteness.
To total complications include the development of osteochondrosis, scoliosis( due to improper load distribution on the limbs), muscle atrophy of the affected half of the body. Often there is a development of arthritis( due to the redistribution of the load) and herniated intervertebral discs. With the progression of total complications, involvement of internal organs is possible.
In some cases, pain shock may develop.
Prevention of gonarthrosis
Like any disease, gonarthrosis 1 degree is easier to prevent than cure.
The main preventive measures include a healthy lifestyle, proper nutrition( saturated with calcium, glucuronic acid, vitamin D), getting rid of excess weight, rejection of bad habits.
If possible, spend less time on your feet. Uniform distribution of workload and working conditions helps prevent joint overload and delay the development of the disease.
It is also necessary to consult a doctor more often in order to diagnose the disease in time and take early action.
Treatment of concomitant diseases of the musculoskeletal system and metabolism is also important.
With all the above measures, the likelihood of developing knee arthrosis is extremely low. A high risk, however, remains with a family history of a family history( if there were cases of development of the disease in close relatives).
What is the peculiarity of2 nd degree of knee joint? Under gonarthrosis is meant the damage to the cartilage and bony growths that occur on the joint, xytic irritation of the articular tissue.
Knee Osteoarthritis - is a degenerative-dystrophic disorder .
This deviation is 3 degrees of severity, the most common is gonarthrosis of the knee joint of 2nd degree, because only at this stage people notice the disease and are engaged in treatment.It should be noted that arthrosis is a problem of the current society, this deviation was formerly characteristic only of older people.
Now the disease has no age restrictions, appearing even among young people because of injuries.
Causes of the disease
The main cause of the disease is a mechanical factor.
Microtraumatization of the cartilage of the joint is observed, which causes its destruction. As a consequence - the load on individual parts of the joint surface increases, and then - its destruction.
It is also proved that with this violation, changes in metabolic processes in the cartilage .These changes consist in decreasing the amount of chondroitin sulfate, which is a special component of cartilage.
There are such causes of the lesion:
- fractures of the bones of the knee joint;
- arthrosis in Paget's disease;
- bone formation;
- rheumatoid arthritis and ankylosing spondylitis.
If you suffer from polyarthritis, treatment at home will be a great help to traditional medicine. Recipes and advice will be relevant at any stage of the disease.
The stages of the disease
In development, the deviation goes through several stages:
- The initial stage of the violation is the initial stage of the disorder, which is often neglected by patients. With it periodically there are pains, sometimes the composition swells, deformation of the joint is insignificant and imperceptible.
- Grade 2 gonarthrosis is already significantly more serious, and therefore requires more attention, pains appear both after sleep and during physical exertion on the joint. On the x-ray, deformation of the subchondral parts of the bones and a decrease in the joint gap are observed. This degree is accompanied by the rapid fatigue of and the occurrence of moderate pain in the knee. Also a sign of difficulty in flexing and flexing, combined with a crunch in the joint, deformation and an increase in the volume of the knee is observed.
- The third stage of the is the most difficult stage. It is characterized by pain, arising both during movement and at rest, meteorological dependence is observed. The gait is greatly disturbed, the mobility of the joint is limited.
Types of the disease
There are such types of gonarthrosis:
- right-sided deforming arthrosis, affecting the right knee;
- left-sided is a disease that causes lesions in the left knee joint;
- unilateral - arthrosis, affecting only one knee;
- bilateral - a disease of both knees.
Basically, in the latter case, the cartilage tissues in both joints are destroyed at the same rate, but sometimes the lesion of one joint progresses faster than the other - this may be related to the specific work or sport that the patient is engaged in, as well as to congenital deformity of the joints.
Signs and symptoms of the disease
Arthrosis of the knee of the 2nd degree is more intense, and its manifestations are more worrisome to the patients.
Pain in the broken joint is increasing and increasing. In addition to the standard pains that appear in the morning or after a long rest, pain occurs after a long walk or standing. They last long and pass only at rest after a while.
Pain often increases with exercise. Patients spare the sick knee and try not to step on the leg slightly. Because of this, there may be underdevelopment of the muscles of the affected leg.
If there is a deviation at this stage, there is a crunch in the knee. As the changes develop, it increases and becomes more pronounced.
At this stage of the disease, the first manifestations of deformity of the unhealthy joint are observed. Patients often can not fully bend their legs in the knee.
Grade 2 gonarthrosis mainly occurs after the first stage of the disease, so the diagnosis of the patient is usually already known to the doctor. The progression of the lesion is indicated by the appearance of new manifestations: pain intensification, joint deformation, limitation of mobility, crunch.
Diagnosis consists of interviewing a patient, checking the volume of movement in the joint and examining the joint itself. Naturally, according to this information, only preliminary conclusions are made, and the leading ones are instrumental methods of diagnosis.
Most often this is an x-ray of the joints. Depending on the general picture of the disorder, the stage of the disease is determined. Also, if gonarthrosis is detected, arthroscopy and ultrasound are used.
How to treat
disease When diagnosed, treatment of grade 2 gonarthrosis should begin without delay. First you need to "unload" the joint.
This is achieved in several ways:
- weight loss;
- load limit;
- using a walking stick or crutches;
- exercises physical therapy, aimed at strengthening the muscles of the aching legs.
For this, non-steroidal anti-inflammatory drugs( ibuprofen, ketoprofen), non-narcotic analgesics are prescribed.
Arthrosis preparations containing cartilage tissue components( chondroitin-sulfate, glucosamine) are effective. They contribute to the restoration of cartilage, i.e.help the body repair it. They can be taken in tablets, in the form of injections in the muscle, ointment or cream.
In some cases, injections of hyaluronic acid into the joint can be prescribed. In the absence of inflammation, physiotherapy can be used.
Physical exercises should always accompany the treatment of any form of arthrosis. Gymnastics precludes the development of contractures, retains muscletone. Movement is the anticipation of any arthrosis.
Physiotherapy measures quickly eliminate pain, inflammation and restore the volume of movements in the knee. Laser and UHF therapy, phonophoresis, and massage are used. All procedures are appointed by a specialist.
For the fixation of the knee, knee pads and rigid orthoses are used.
With obvious disruption of the joint, the uselessness of conservative treatment and the destruction of cartilage, surgical methods are used:
- endoprosthetics - replacing the affected joint with an artificial one;
- osteotomy - excision of bone changes or restoration of the limb axis;
- arthroscopic intervention is performed by instruments injected through the puncture of the skin in the knee. By means of this low-traumatic method, parts of the destroyed cartilage are extracted from the joint cavity, drugs are introduced.
Read more about the treatment of knee joint gonarthrosis in our article.
Treatment of knee joint gonarthrosis - medications, chondroprotectors, sport and diet
Knee joint gonarthrosis is a common disease that is a gradual drying out of the cartilage tissue that causes joint deformity. ..
Forecast and complications
When the joint is damaged, the biomechanics of the spine and other joints,which causes the appearance of a herniated intervertebral disc and arthritis of other joints.
Treatment is carried out for life, because the process is constantly progressing. But with a competent selection of funds and timely start of treatment, it is possible to significantly stop the process and prevent disability.
- weight control and its reduction with excess body weight;
- regular physical education;
- preventing large loads on the knees;
- for injuries or inflammation of the knee - an urgent request to a specialist for help.
Gonarthrosis is a chronic disorder that is aggravated over time. In order for the process not to become neglected, every effort should be made to prevent and treat under the supervision of experienced doctors.
Video: Knee joint gonarthrosis 2-3 degrees
Application shock wave therapy( UVT) for the treatment of gonarthrosis of the knee joint 2-3 degrees.
Gonarthrosis is a disease of the knee joint, which is characterized by gradual destruction of articular cartilage, deformation and proliferation of bone tissue, and also narrowing of the joint space.
The disease can significantly reduce the quality of life of patients and even lead to disability.
Causes of gonarthrosis
Osteoarthritis of the knee joint can be primary( when the cause is not clear) and secondary( when there is an exact cause).In the development of primary right-sided gonarthrosis, several main causes can be identified:
- Increasing the load on the right knee joint( due to the presence of excessive weight, curvature of legs, or with professional need for a long time on their feet).
- Possible effects of hormonal disorders in women who are observed during menopause.
- Genetic predisposition
Secondary right-sided gonarthrosis can develop as a consequence of a serious injury to the right knee joint.
The main symptom of the disease is pain in the right knee. In the early stages of arthrosis, they worry patients only in the morning. In the future, pain can appear after a long walk or stay on their feet. In the late stages of gonarthrosis, pain constantly worries patients.
Patients are also concerned about the feeling of stiffness in the right knee that occurs in the morning. This symptom is called morning stiffness.
A characteristic crunch appears, the severity of which increases as the disease progresses.
The most unfavorable manifestation of right-sided gonarthrosis is deformation of the right knee joint, as a result of which the movements in the joint are gradually limited.
An experienced doctor may suspect that the patient has a right-sided gonarthrosis for only one symptom.
To confirm the diagnosis, an X-ray examination is performed, according to which the doctor can draw a conclusion about the severity of the disease.
Principles of treatment
For successful treatment, it is necessary to relieve the load from the right knee joint. For this, you need to take measures to get rid of excess weight, limit the time of walking and standing on your feet, perform special exercises to strengthen the muscles of your right leg.
In medical treatment, the focus is on reducing pain, reducing inflammation, restoring the structure of the cartilage.
In severe joint deformities with a sharp restriction of mobility, surgical treatment can be used.2 comments
I'm only 28 years old and I did not think that I would have this senile disease. But since the spring of last year, the knee, right, began to ache heavily. After X-ray the doctor calmed and appointed to take diclofenac 0.75 for 2 tablets a day for 6 days. At first the pain was gone, and 2 weeks after the end of the pill, it started again, and it got stronger.
I sympathize. At such a young age and such a disease. Go again to the doctor. It is necessary to define the diagnosis more precisely and to start the complex treatment
Knee joint gonarthrosis of 1, 2 and 3 degrees: treatment, causes, symptomsWhat is it - gonarthrosis is a disease of the knee that is not of an inflammatory nature, in which the blood supply of the cartilage covering the articular surfaces of the femoral and / or tibia is disturbed. As a result, the cartilage is destroyed, the parts of the bones begin to rub against each other, as a result of which they become denser and expand. This is often accompanied by inflammatory phenomena. Symptoms of the disease are due only to the above processes;calcium salts, if they are deposited in the joints, the cause of the pathology is not. Pathology most often develops in individuals 40 years and older, mainly women and people who are engaged in professional sports or having knee injuries. Articular cartilage does not regenerate, so the disease must be detected and treated early in the early stages.
Causes of gonarthrosisThe disease develops with a combination of several causes:
- fractures of the bones of the lower leg involving the knee joint;
- trauma of cartilage interlayers of the joint - meniscus;
- tears of knee joints;
- increased load on the joint - running, squatting, lifting weights from the vertical position of the body - after 40 years of age, especially if a person does not exercise regularly;
- joint inflammation( arthritis), which has a different - psoriatic, gouty, rheumatoid or reactive - etiology;
- genetically determined weakness of the ligamentous-capsular apparatus of the joint, due to which its looseness occurs;
- pathology of joint innervation, characteristic for craniocerebral and spinal cord injuries;
- metabolic disease.
- 1) Primary. It occurs against the background of full joint health( without pre-injury or inflammation).It is based on metabolic diseases, long reception of hormonal means, genetic predisposition of articular cartilage. The process is usually two-sided( although it can begin as one-sided).It develops more often in the elderly.
- 2) Secondary. Develops due to injuries, inflammations, tumors transferred to the joint operations. Can develop at any age. The process is usually one-sided.
Symptoms of gonarthrosis of the knee jointHow the disease manifests itself will depend on how far the degenerative process has progressed. Depending on this, three stages of the disease are distinguished, each of which has its own symptomatology. As a rule, the first degree of gonarthrosis of the knee joint is manifested by certain symptoms, which are worth paying attention to: the
- feeling of tightening under the knee;
- stiffness in the knee, which manifests itself after sleep, prolonged sitting or prolonged immobility of the joint;
- joint pain:
- arising from prolonged walking, squats, walking on stairs;
- aggravated after standing or physical exertion
- swelling of the joint can occur for a short time, passes by itself.
- joint pain becomes more intense, lasts longer. It disappears after rest.
- pain is felt inside the joint or on the inside of the knee.
- feels crunching in the knee when walking.
- in the morning it is impossible to unbend the knee.
- closer to night and at night there are pains in calves.
- does not fully extend the leg.
- joint swells, acquires signs of initial deformation.
- 1) Pain in the joint worries constantly, regardless of physical activity of the person.
- 2) Pain syndrome increases with changing weather.
- 3) The mobility of the joint is limited, due to which the person limps.
- 4) The knee is enlarged in size and deformed. When the process progresses, the joint becomes an X-shaped or O-shaped.
Diagnosis of gonarthrosisIt is possible to suspect the presence of gonarthrosis of the knee in the patient already on the basis of his complaints and objective examination data. The diagnosis is confirmed with the help of such instrumental studies:
- 1) Radiography. This method may be uninformative at the first stage of the disease, but subsequently it visualizes the narrowing of the joint gap, the compaction of the bone 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 abate: "Hyalurum", "Ostenil", "Sinocrom".These medications show a very good effect, they are administered only a few times, while having a fairly high cost.
- 5) Heating compresses with "Dimexid", "Bischofite", medical bile to improve the blood supply of the joint, increase the production of "lubricating" liquid in it.
- 6) The preparation on the basis of drawing from soya and avocado plants - "Piascladin" - has also established itself as an effective tool in the treatment of gonarthrosis of the knee joint. At the same time, the treatment course is not less than six months.
Physiotherapy for gonarthrosisIn an acute period a person needs to provide complete rest for a diseased knee. Then proceed to the gradual introduction into his regime of the day of physical exertion. Exercises are carried out in the position of the patient lying on his back, they consist mainly in lifting the straightened legs, keeping them in the raised position. It is important to perform exercises smoothly, carefully, so that they do not cause pain. Begin with 10 minutes, gradually, 2 minutes a day, increasing the duration of classes. Increase and the amplitude of movements, which should be selected by specialists individually for each.