Symptoms, Diagnosis and Treatment of Knee Osteoarthritis 1,2,3 Degrees
Knee joint gonarthrosis is a fairly common disease, the leader of all arthrosis. His active study of physicians of different countries began over a century ago, which causes significant progress in the fight against the disease. At the household level, this pathology is stubbornly called the deposition of salts, although the process of calcification does not play a primary role. The disease is dangerous in its development and can lead to a restriction of mobility and disability.
Knee joint gonarthrosis requires long-term treatment, which is not always able to help without prompt intervention. In order not to appear on the surgical table, it is very important to detect pathological changes in time and start treatment at an early stage. Like most joint diseases, this type of osteoarthritis is easier to prevent, taking preventive measures, than to treat after debilitating pain.
What happens with this disease?
Gonarthrosis, or osteoarthritis of the knee, 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.
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 proceeds with the growth of the following pathological disorders in the joint:
- Disturbance of the metabolic process in the cartilaginous tissue: a constant supply of cartilage occurs due to excretion and absorption of the lubricant when the joint moves, but the disease leads to a change in osmotic pressure and infringement;at sites of the raised pressure there is a thinning of a cartilage.
- Structural changes of collagen fibers: the softening of the patellar cartilage starts, the depreciation function of the cartilage and the metabolic capacity of the chondrocytes are broken - the cartilage loses its elasticity and its instability appears.
- Distortion of articular congruence: the synthesis of bone substance, leading to the growth of osteophytes, is activated. As a result, the synovial membrane is irritated, which generates an inflammatory process in it, the loss of joint mobility begins.
- The most active destructive process occurs in the inner region of the joint and in the gap between the knee and the femur.
Classification of pathology
Classification of gonarthrosis is carried out in accordance with the international system of ICD 10 by code 17.0 - 17.9.There are 2 main types of etiology: primary and secondary osteoarthrosis.
The primary( genuine) type is the development of a degenerative process on healthy cartilage that has not previously been subjected to pathological effects. The process is the result of mechanical and physiological overloads. Secondary form of the disease develops on the joint, previously subjected to pathological effects( trauma, disease), and the beginning of the process is due to a decrease in the durability of cartilage tissues to normal loads. The most common form is posttraumatic gonarthrosis.
Given the localization of lesions, one-sided and two-sided gonarthrosis is different. In turn, a one-sided view is characterized by joint damage on only one limb: right-sided and left-sided gonarthrosis. The most difficult and dangerous is the two-sided type, when the knee joints of both legs are subjected to destruction. The main reason for the appearance of this form is the age factor.
Causes and stages of the disease
In order to start a degenerative-dystrophic process of destruction of cartilage tissue, provoking factors are needed.
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 lesions and complications.
It is subdivided into 3 stages and, accordingly, 4 stages of development:
- 1 stage( 1 degree): the initial phase, characterized by a slight narrowing of the joint gap, visible on the radiograph. There is a feeling of discomfort in the joint, fatigue by the evening, a slight limitation of joint mobility.
- 2 stage( 2 degree): on the roentgenogram there is a significant narrowing of the gap and the appearance of osteophytes, bone growths. There is the appearance of pain syndrome with strengthening with prolonged standing or walking, a crunch in the joint, complicated flexion and extension of the leg in the knee, the angle of extension of the leg is limited, the appearance of signs of atrophy of the quadriceps femoris.
- 3rd stage( 3rd degree): joint deformity with foot axis disturbance, articular instability. There is a sharp increase in pain, even at rest, edema, local temperature, impaired mobility of the joint.
- Stage 3 at 4 degrees of severity: severe joint deformity, complete disappearance of cartilage, impaired mobility of the limb, pain is permanent.
At the initial stage, the symptoms of gonarthrosis are manifested by a feeling of tightening the muscle under the knee and a slight pain after a long hike. In the mornings or after a long sitting, it takes time to "puff up" the joint and eliminate discomfort in the knee. The development of pathology leads to the appearance of a pain syndrome under the knee. When walking, there is a crunch in the joint. Further progression of the disease limits the mobility of the joint, there are problems with squatting and extension of the legs, lame appears. Pain is getting stronger and longer.
Visual inspection of the joint in the initial stages does not reveal any changes. Gradually, the joint deformity becomes noticeable, and then the curvature of the shin. If you put your hand to the knee, then when flexing your legs you can distinguish a distinct crunch. Palpation indicates the presence of a painful patch on the inside of the knee joint.
Signs of gonarthrosis are greatly enhanced if the disease is complicated by synovitis( inflammation of the inner shell).In this case, already at the first stage swelling of the joint is noticeable due to liquid. At further stages, it fills even the popliteal fossa in the posterior articular region( Baker's cyst).Pain syndrome is greatly enhanced.
The primary diagnosis is established by examination, palpation of the joint, changing the direction of the bones, the angulation of the mobility of the joint. Laboratory tests are conducted on general blood and urine tests: determination of ESR, fibrinogen, urea and other biochemical parameters. The ultrasound of the knee joint is performed. The most informative are X-ray studies and magnetic resonance imaging. Only after that the doctor treats the disease.
Tactics and methods of therapy
The question how to treat gonarthrosis of the knee joint, the doctor decides, taking into account the stage and severity of the disease.
In general, treatment is carried out in a complex manner, but usually includes the following steps:
- 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.
- Anabolic and anti-catabolic effects, restoration of cartilaginous tissue: chondroprotectors - Structum, DONA, Rumalon, Alflutol, Mukosat.
- Normalization of blood circulation, warming and soothing effect: ointments, gels, creams - "Finalgon", "Fastum gel", "Nikofleks", "Apizarthron", "Feloran".
- Improvement of blood circulation, strengthening of vascular tissues: vasodilating drugs - "Cavinton", "Trental", "Actovegin", "Upsavit", "Ascorutin".
- Reduction of muscle tension: antispasmodics - "No-shpa", "Midokalm", "Tizalud".
- Restoration of synovial fluid: substitutes - "Otrovysk", "Hyalual", "Fermatron."
Complicated forms of the disease are treated with additional methods, such as: oxygen therapy( introduction of oxygen);introduction of stem cells;laser therapy;the introduction of the protein preparation "Ortokin" on the basis of blood serum.
In the last stages of gonarthrosis, the only effective method is surgical treatment. A surgical operation for prosthetics of the affected tissues is performed. Depending on the severity of the disease, the following operations are performed:
- arthrodesis( removal of the destroyed cartilage along with the joint);
- arthroscopic debridement( removal of deformed cartilage with an arthroscope);
- osteotomy( fixation of bones in another position);
Treatment of gonarthrosis of the knee joint, especially at the initial stage, is carried out in ways that do not involve medical therapy. The therapeutic sports complex allows to improve blood circulation, strengthen the musculoskeletal system, raise muscle tone, maintain joint mobility. LFK is developed by the treating orthopedist under the individual scheme.
Physiotherapy for osteoarthritis involves the use of the following methods: electrophoresis with bischofite, caripain and reinforcement with dimexide;magnetic therapy;ultrasound;microwave exposure;paraffin application;reception of radon and hydrogen sulphide baths;mud baths. Its effectiveness was proved by therapeutic massage and manual therapy, if conducted by a specialist.
Prophylaxis of the disease necessarily provides proper nutrition.
The diet for gonarthrosis excludes the use of pickles, spicy and fatty dishes. The menu recommends the inclusion of increased consumption of low-fat chill( for example, in poultry meat), jelly from natural fruits. It is useful to eat sea fish and seafood.
Loss of capacity for work and a group of disabilities are not threatened if the prevention is carried out with folk remedies. Effective use of infusion based on garlic and lemon with the addition of celery. Recommended tea from the grass of black beans. Especially useful is the grass of moccas, which should be added to various salads. And of course, the welding of beef knees and hoofs, it is better to eat hot, not hardened fat.
The disease of gonarthrosis is quite common these days. First of all, it affects people involved in sports. Two-sided gonarthrosis and one-sided affects the knee joints, leads to:
- circulatory disturbance;
- drying of cartilaginous tissue;
- deformation of the joint.
Otherwise, this disease is also called osteoarthritis, arthrosis and deforming arthrosis, which affects the knee joint. It starts at the molecular level, progressing over time into a complex disease. As a result of its course, the cartilage can completely disappear, which will lead to the exposure of the bone. It goes without saying that in this case it is extremely difficult to make any movements, because the pain syndrome manifests itself very strongly.
The subsequent progress of bilateral primary gonarthrosis leads to the inability to perform flexion in the knees, which threatens to completely immobilize the knee joints and eventually splice the bones.
Causes of the disease
It is not a secret that the knee joint of a person is one of the largest. It allows not only a person to make moves with his feet, but, and is recognized, to support a heavy human body. As a result of this accumulation of obligations, this area is considered to be the most traumatic. The most common cause of the emergence of primary gonarthrosis bilateral is old age, when the joints and cartilaginous tissue are in a very worn and battered state. However, there are other reasons that contribute to the premature development of the disease. Among them:
- The presence of any knee damage. As a result of the injury, the patient begins to develop posttraumatic arthrosis in the knee area.
- The presence of a disease that has a disastrous effect on cartilaginous tissue. To such diseases it is possible to carry an arthrosis.
- Genetic predisposition.
- Admission of specific drugs.
Stages of the disease
Like any other disease, bilateral deforming gonarthrosis can be observed in three stages. Each of the stages is accompanied by a certain process of change in the joint region. So, the first stage is assigned at the very beginning of the disease, when no clear signs of gonarthrosis are observed. For this period, the symptoms of a pain symptom in a dull form are characteristic after physical exertion, jogging or long walking. At this stage, the periodic appearance of a tumor in the knee region, which after a time without intervention disappears. Deformation of the joint at the initial stage does not occur.
Two-sided gonarthrosis of the 2nd degree is assigned when the symptoms begin to bear a rather revealed character. Pain manifestations during this period accompany the patient much more often, and are expressed most intensively. This stage is characterized by the appearance of a crunch in the knee region, which can occur as a result of movement. After a long period of inactivity, there is some stiffness in the joints, especially during the hours after sleep. Such stiffness can pass after charging. This period is characterized by an increase in the joint and its defogurirovannost.
The third stage of the disease, of course, is the most difficult. During this period, the previous symptomatology develops, while the pain syndrome accompanies the patient almost always, regardless of the position of the knee. The appearance of pain can depend on the weather factors, while the motor activity is reduced to a minimum. Bilateral gonarthrosis of the third degree can be manifested in O-shaped and X-shaped deformations.
In order not to start the development of the disease and start its treatment on time, it is necessary to consult a doctor when the slightest symptoms appear. It goes without saying that it is with the visit of a specialist that the process of diagnosing a primary gonarthrosis bilateral disease begins. After the examination, the doctor sends the patient to the X-ray, as a result of which the doctors manage to note the deformation of the knee joint, and also after a time after the first picture to track the dynamics of the disease.
The initial stage of the disease, for example, bilateral Gonarthrosis 1 degree can be detected and using magnetic resonance imaging. To avoid the error of diagnosis, the patient is sent for the delivery of various tests.
Treatment of bilateral primary gonarthrosis
After diagnosing the disease, the patient is first of all assigned conservative treatment. It goes without saying that such treatment can be carried out only at the initial stage of gonarthrosis, because this treatment is not calculated for more complex stages. It is worth noting that the treatment of gonarthrosis is carried out in a complex way, which allows achieving a positive result in a much shorter period.
- First and foremost, therapy is prescribed, where the main place is taken by taking various analgesics and anti-inflammatory drugs. With their help, it is possible to significantly reduce the intensity of the pain syndrome, and also to remove the inflammation in the affected area. In this case, the basis of drug treatment is made up of drugs called chondroprotectors. In addition, the patient is prescribed the use of drugs aimed at replacing the synovial fluid.
- The second component of the treatment is physiotherapy. Its basis is therapeutic gymnastics, electrophoresis, magnetotherapy and other varieties of such treatment. Therapeutic gymnastics today plays a big role in the treatment of diseases associated with joints. Specialists prepare a set of exercises for patients with bilateral deforming gonarthrosis, which can improve blood flow, reduce pain and restore mobility to the joints.
- The third component of the treatment is orthopedic treatment. To this option applies the use of various orthopedic adaptations, for example, canes, orthosis and others. With their help, it is possible to achieve unloading of the joint, which is simply necessary for bilateral gonarthrosis of the 2nd degree and other stages.
- The last option is surgical treatment. This option is necessary at the advanced stage of the disease, when no other treatment can produce the proper effect. Surgical intervention can be performed only with the permission of the patient. The doctor in advance is obliged to discuss with the patient all the conditions of the operation, the subsequent recovery period, and also to report on possible alternative options. Most often, patients with a grade 3 bilateral gonarthrosis resort to this option.
One of the most important components of the treatment of diseases associated with cartilaginous tissue and joints is strict adherence to diet, no exception is gonarthrosis bilateral, whether it be 1 degree, or what other. Before starting treatment, the doctor must adjust the patient's diet. It is very important in this case to observe the daily calorie intake, and not to allow its excess. This is most significant for people who are overweight. In the diet should be included protein food, in addition, it should pay special attention to various broths and jellies, no exception are flooded.
Among products that negatively affect the development of gonarthrosis primary bilateral, a special place is taken by alcohol, milk and some types of vegetables. These foods should be eliminated from the diet. Compliance with such a diet will positively affect the patient's condition, and will also promote a speedy recovery.
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 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, since 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 a dream. 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 at the beginning of movement 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 the 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.
With 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 3rd degree of gonarthrosis is joint deformation and a sharp 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 who have grade 3 gonarthrosis, whose treatment is not effective with conservative methods, can be used for surgical intervention.
Operative treatment of arthrosis of the knee joint includes two large technologies:
Joint operations aimed at removing outgrowths and deformed elements that "hinder" the joint to work 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 the development of 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 arose sharply, but 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 knee cartilage. 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.
At the II stage of arthrosis of the knee joint, there are restrictions of movements. 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, knee pain 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.
Source of nanoplast-forte.ru
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 the management 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, since 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 speed of progression of degenerative-dystrophic process always directly depends on the degree of severity and extent of injury of the knee joint, 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, knee instability, often due to 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 gonatrosis - 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.
Gonarthrosis of 2nd degree - what is and how is treated
Degenerative-dystrophic disease, or gonarthrosis of 2 degrees, occurs after the defeat of the cartilage tissue of the knee joints. The ailment causes unpleasant sensations - both soreness, and difficulties of bending of the legs, and deformation of the tissues. Disregard for yourself is fraught with serious consequences, is therefore important in time to seek medical help.IMPORTANT TO KNOW!A new means of restoring joints in 99% of subjects. The pain goes away 100%!Read more here - & gt;
Gonarthrosis is one of the first places among diseases of the musculoskeletal system. Most often they suffer women over 40 years of age, in the stronger sex, the disease manifests itself much less often.
Grade 1 gonarthrosis, in the absence of treatment of which the second develops, appears due to excessive body weight, varicose veins, sedentary work and various knee problems. In addition, it is increasingly being used by athletes who are more prone to damage, such as meniscus ruptures, fractures and bruises.
Symptoms and differences of 1 and 3 degrees
The mechanism of the development of the disease is the following: a slight damage to the cartilage causes degeneration, an increase in pressure on certain areas of the joint surface. About that, what is gonarthrosis of 2 degrees and about all its manifestations the patient learns when the destruction of the knee begins. At the same time there is a metabolic disorder in the connective tissues and the saturation with chondroitin decreases.
Has gonarthrosis of 3 severity, the most common among which is the average, because only then people begin to pay attention to health and treat. This is due to the fact that the disease lasts for a long time imperceptibly, and at first it simply does not matter. To prevent complications and complete immobility, it is necessary to know the course of the course of gonarthosis:
- gonarthrosis 1 degree. Bilateral gonarthrosis 1 degree is difficult to identify - periodically arising pain, swelling and joint changes are insignificant and invisible;
- gonarthrosis of the 2nd degree. At the 2nd stage of gonarthrosis, the intensity of painful sensations increases, they become longer, appear both from physical exertion, and in the mornings. The person begins to worry about the crunch and difficulty of flexing-extension of the leg. The knee deforms and increases in volume. Inflammation of the synovium - this is determined by swelling, fever and redness. The general condition of the patient is characterized by rapid fatigue;
- gonarthrosis of the 3rd degree. It is characterized by constant, persistent pain, the patient becomes sensitive to changes in weather conditions. The walk is severely disrupted, because it can be difficult to move your legs.
Specialists distinguish one-sided and bilateral development of the disease. In the first case, the joints of one of the lower limbs are affected. Thus, left-sided gonarthrosis of the 1st degree leads to more serious consequences in the left leg. But more often a complicated variant is diagnosed, when the knee is subjected to both knees. In addition, rheumatologists classify it depending on the cause:
- primary gonarthrosis. Primary bilateral gonarthrosis of 2nd degree is more common in elderly patients. As its causes are called increased load as a result of excessive weight, leg curvature, genetic predisposition and hormonal disorders.
- secondary gonarthrosis. It occurs after, or against the background of the pathology of the knee joint - infection and trauma. In most cases, it is unilateral and is observed in people of any age.
Prevention and treatment of
Getting rid of gonarthrosis is a complex and lengthy process, for this purpose, therapeutic charging and special massage are widely used. Two-sided gonarthrosis of the 2nd degree is treated with medicines - with non-steroidal anti-inflammatory drugs and hondoprotectors. In addition, a warning and complete relief from an illness requires adherence to the principles of a healthy lifestyle.
Gonarthrosis is a serious disease that has been known for many decades. Until recently, there was an opinion that it is impossible to get rid of the disease, but modern medicine allows us to achieve significant improvement in the condition of patients. It all depends on how quickly the patient will notice signs of ill health, will undergo diagnostic measures and begin treatment.