How to treat gonarthrosis of the knee joint of the third degree

Treatment of gonarthrosis( arthrosis of the knee) 1, 2, 3 degrees

Gonarthrosis What is gonarthrosis? Knee joints can rightly be called the most loaded in the human body. The process of walking, as is known, is a fall, which prevents the second leg from setting. Thus, the knee joint( more precisely, the tibia) at every step experiences a load in the form of the weight of the complete human body( except the tibia of the standing leg).

Given the prevalence of obesity, which significantly increases the load on the articular cartilage, the lifting of various weights that also contribute to the gradual destruction of the knee joints, one can understand why the dystrophic degenerative knee injury, called deforming gonarthrosis, is common, especially in adulthood and old age. Disability is often the outcome of gonarthrosis.

Stages of gonarthrosis

Treatment of gonarthrosis should be differentiated, depending on the stage of the disease:

Gonarthrosis
  • in the first stage of deformation of cartilage and articular bag does not happen, there is only swelling of soft tissues;
  • the second stage develops, usually after a few months. It manifests itself in the intensification of pain after minor loads and movements. It can be said that any movement hurts. To the pain has passed, you need a long rest. Osteoarthritis of the knee joint of the 2nd degree is still reversible with proper and timely treatment.
  • Gonarthrosis of the third degree except functional disorders, is manifested by progressive destruction of the cartilaginous tissue. The pain arises even at rest. It is at this stage that the classic aching in the knees "on the weather" begins, there is a significant restriction of movement in the knees. This disease brings considerable suffering, and leads to disability.

How to treat arthrosis of the knee joint

Treatment of all diseases, and gonarthrosis in particular, is only three types:

  • etiotropic, that is, aimed at eliminating the cause of the disease;
  • pathogenetic, directed to one of the links in the development of the disease;
  • is symptomatic, aimed at relieving suffering.

Only all these measures in the complex can give a lasting positive result. Applicable to gonarthrosis, therapeutic effects should be directed to:

  • pain relief( improvement of quality of life) - NSAID group;
  • improvement of trophism and restoration of the surface of articular cartilages - reparants( chondroprotectors);
  • reduction of blood stagnation( ischemia) and improvement of blood circulation in the microcirculatory bed of the periarticular tissues and the joint bag - vitamins, massage, physiotherapy, local treatment;
  • improvement of trophism of muscles of the thigh and lower leg - exercise therapy.

In addition, with various arthrosis is quite effective treatment of folk remedies: phytotherapy, deep warming.
The main groups of drugs used in the treatment of knee arthrosis

  • NSAIDs are non-steroidal anti-inflammatory drugs. Are non-hormonal. They are used to relieve acute pain. Therefore, they are used in the first place, since only after the withdrawal of the expressed pain syndrome other methods of treatment are possible. However, their administration should not be long, as it is possible to develop side effects, for example, such as NSAID-induced gastropathy.
    In addition, removing pain, taking these drugs does not prevent further destruction of the joints, but only improves the quality of life. Representatives of this extensive group of drugs are such as nimesil, tselebrex, movalis, orthophene, voltaren and many others.
    Modern NSAIDs( eg, meloxicam) cause few side effects, and are selective, that is, they exhibit selective, more precise action.
  • Preparations protecting cartilage surfaces from destruction and helping to restore it - chondroprotectors. Their main active substances are chondroitin sulfate, glucosamine and hyaluronic acid( synviscus, fermatron).Simply put, these drugs contribute to the timely "lubrication" of the joint, the preservation of its biomechanical function, reducing friction and pain syndrome.
    Injection of the hondoprotector into the knee joint
    These drugs significantly help in the very beginning of the disease, as well as in the 2nd stage. If the cartilage does not already exist, then the best lubricant will be unable to restore the function. In addition, it has been shown to be effective only in intraarticular administration of the drug, only directly into the joint cavity( Don, Hondrolon, Elbon).
    All tablets( Artra, Teraflex, etc.), which are so expensive, are in fact not more effective than a cold containing approximately the same compounds. The course of treatment with chondroprotective agents is quite long.
  • Local treatment in the form of ointments, creams and applications on the surface of the knees. This is an extremely widespread method of treatment at all stages of the disease. They do not so much heal as they ease the condition and refer to the means of symptomatic therapy. Most often used ointments with a warming effect, able to improve blood circulation in the joint area. There are a lot of them: Nikoflex, Dolgit, Fastum-gel, Kapsikam, Finalgon and many others.
    In the event that a synovitis has joined, that is, there is inflammation and effusion, it is impossible to warm. This can increase swelling of the inflammatory fluid in the joint cavity. In the event that there is effusion, it is possible to use intraarticular injections of hormonal preparations of long-term action( Kenalog, Diprospan) and their analogues.
    Dimexid, penetrating through the skin, and bischofite have a good therapeutic( analgesic and anti-inflammatory) effect. Bishofit is an "oil brine" that accompanies the emergence of oil while drilling wells. It warms well and anesthetizes, if applied in applications and compresses.
  • Of great importance are non-medicinal methods: medical gymnastics, physiotherapy, massage. Special exercises, especially in the pool, with reduced load, have a beneficial effect on the restoration of articular cartilage. Using the cane also reduces the load on the affected joint.
  • Also an important component of the complex therapy of gonarthrosis is a diet. Food should not be monotonous, it is necessary to exclude refined meat byproducts that can cause urine acid diathesis and the attachment of microcrystalline arthritis, which worsen the course of gonarthrosis.

LechenieSpiny.ru

Knee joint gonarthrosis of the third degree - treatment

gonarthrosis of the knee joint 3 degrees of treatment

Pain in the knees pains many women. It is mistakenly believed that almost always the reason for this is in the deposition of salts. In practice, it turns out that discomfort - the symptoms of gonarthrosis of the third degree of the knee joint - a disease that requires serious treatment. It is a degenerative-dystrophic disease, which in the people is commonly called osteoarthritis. If you do not start the fight against the disease in time, it can lead to disability.

Causes and Symptoms of Knee Joint Grade 3

Pain in the knee usually appears due to destruction of the cartilage or dystrophic changes occurring in it. These processes begin against a background of blood flow disturbance, as a result of which an insufficient amount of nutrients enters the knee. Cartilage tissue becomes thinner, it is easily erased while moving, and if it is neglected, it dies away altogether.

The main symptom of bilateral third-degree gonarthrosis is pain. Very often, a feeling of stiffness joins the unpleasant sensations, which initially appears only when walking, and then perspiring even in a state of rest. Many patients with knee osteoarthritis begin to limp and complain about the inability to bend the joint.

The following factors are considered to be infectious:

  • hereditary predisposition;
  • incorrectly cured( or untreated altogether) inflammatory joint diseases;
  • injury;
  • pathology of joints and joint tissues;
  • is overweight;
  • metabolic disorder.

How to treat gonarthrosis of the knee joint of the third degree?

It is impossible to name the only method suitable for the treatment of all patients with knee osteoratrosis. Therapy is usually selected individually. It is important to understand that getting rid of problems once and for all will not succeed - in fact, gonarthrosis is incurable. But you can eliminate unpleasant symptoms of the disease. First of all, they turn to conservative methods of treatment.

To remove inflammation and anesthetize the joint, hormone-corticosteroids help:

  • Diprospan;
  • Hydrocortisone;
  • Kenalog.

Very effective preparations-chondroprotectors. These medicines accelerate the process of restoring cartilage. The best in their category are:

  • Structum;
  • Alflutop;
  • Mucosate;
  • Rumalon.

For the treatment of gonarthrosis of the knee joint of the third degree, anesthetic ointments, creams, gels are also suitable. At the initial stages of the struggle, many experts recommend using:

  • Apisatron;
  • Feloran;
  • Fastum gel;
  • by Nikoflex;
  • Final;
  • Dolobene.

Saccharide medications help to speed up recovery. They normalize the blood flow. When knee osteoarthritis is prescribed:

  • Uppsitis;
  • Cavinton;
  • Ascorutin;
  • Trental.

Physiotherapeutic procedures are useful for deforming gonarthrosis of the third degree:

  • UHF;
  • electrophoresis;
  • microwave therapy;
  • paraffin therapy;
  • hydrogen sulphide bath;
  • massage.

In the most difficult cases, surgical intervention is required. During surgery, excrescences and deformed tissues are removed, sometimes the cartilage is completely replaced.

How does food affect gonarthrosis of the third degree?

A diet that presupposes proper nutrition will not hurt anyone. With knee osteoarthritis, it is vitally important to observe it for people who are overweight. Absence of extra pounds - a pledge to reduce the load on the affected joints.

gonarthrosis of the third degree of the knee joint

The diet should be balanced. It is desirable to add to it:

  • buckwheat;
  • beans;
  • fish;
  • lean meat;
  • lentils.

It is recommended to cook steamed dishes. Fill them best with vegetable fats. If possible, give up alcohol.

Treatment of gonarthrosis of the knee joint - medicines, chondroprotectors, sport and diet

pain in the knee

Knee joint gonarthrosis is a common disease that is a step-by-step drying of the cartilage tissue , causing deformation of the joint with loss of its functions.

This violation is also called osteoarthrosis and deforming gonarthrosis.

Classification of the disease

Types of the disease:

  • primary - it affects older people, although it is impossible to trace the pathogenesis of the disease in this case;
  • ptorichny - appears due to mechanical damage to the knee or its defeat due to inflammation in the body, has no age restrictions.

Regardless of the type of deviation, three stages are distinguished:

  1. At , the initial stage of , the patient feels a slight knee pain that appears after prolonged exercise or walking. Joints in this period are not subject to deformation.
  2. In the second stage, the pains of begin to increase and become more frequent, and not necessarily because of the loads. The mobility of the joint is worsened, it looks slightly gonarthrosis of the knee swollen and deformed.
  3. At the last stage of , the process is characterized by an acute pain syndrome. The patient may have meteosensitivity, and the pain then becomes unbearable. The deformity of the joint can be seen with a normal look, and the knee has a bloated and cyanotic appearance.

More details about gonarthrosis of 2nd degree:

gonarthrosis of 2nd degree

What is the peculiarity of

2 nd degree of knee joint Gonarthrosis is understood as gonarthrosis and cartilage damage arising on the joint, xytosis of the articular tissue. Knee arthrosis - deg. ..


Details about gonarthrosis of 3rd degree:
prick in the knee

Is it possible to treat gonarthrosis of the knee joint of the third degree and why does the disability come

Gonarthrosis of the third degree of the knee joint is the heaviest. The disease significantly complicates the life of patients, severely limits work capacity....

Goals and objectives of treatment

The goals of treatment of deforming gonarthrosis of the knee joint:

  • to neutralize pain;
  • , if possible, restore the affected cartilage and ligaments;
  • to increase the mobility of the joint.

How to cure the disease

Modern medicine offers several techniques.

Medical treatment

All medicamental treatment of gonarthrosis can be divided into 2 types: for internal and external application. Among other things, solutions for injections are also used.

In cases of arthrosis, non-steroidal anti-inflammatory drugs are usually used to neutralize pain and inflammation.against a background of severe pain, one can not begin treatment.

Only by eliminating the acute pain, you can subsequently go to massage, gymnastics and those physiotherapy activities that, because of the pain, would be unbearable.

In addition, using these tools, it must be borne in mind that all of them have serious contraindications and with long consumption can give tangible side effects.

Therefore, for long-term use it is better to use selective drugs( movalis).

Application of chondroprotectors

knee joint treatment Chondroprotectors - glucosamine and chondroitin sulfate - substances that feed cartilaginous tissue and restore the structure of the affected cartilage, the most useful type of treatment for violations.

They influence the cause of the disease: it favors the restoration of cartilage, the improvement of the production of joint fluid and the normalization of its properties.

This effect of the drugs makes them irreplaceable in the treatment of the initial stage of arthrosis.

Chondroprotectors are not very effective at stage 3 of the disorder, when the cartilage is almost destroyed. After all, it is impossible to grow a new cartilage or to return the form to bones by means of glucosamine and chondroitin sulfate.

Treatment with these substances requires competent and long-term administration in combination with other methods of exposure.

Of all the drugs used in the treatment of arthrosis, this group is the most beneficial. In addition, they have almost no side effects.

To achieve a powerful therapeutic effect, chondroprotectors should be applied by courses, regularly, for a long period. It makes no sense to take glucosamine and chondroitin sulfate from case to case.

Ointments

Ointments and creams can not cure arthrosis of the knees. But they can alleviate the condition and reduce pain in the affected area. To this end, ointments are extremely useful.

So, with arthrosis flowing without synovitis, warming ointments improve the blood flow in the joint. For this use of menovazine, gevkamen, etc. These ointments usually cause the patient a feeling of pleasant warmth. They rarely give side effects.

Ointments based on non-steroid substances( indomethacin, butadione, dolgite) are applied when the course of the disorder is combined with synovitis.

Compressors for compresses are more effective than ointments. Of the topical agents used today, the most common dimexide, bischofite, medical bile.

Sport and gymnastics

Many people think that physical activity is forbidden in case of illness. For the normal operation of the joint, he needs strong developed muscles, which is why

foot exercises moderate sports activities in the disorder bring only good.

Two-sided gonarthrosis of the knee joint can and should be treated with leisurely exercises. It should be borne in mind that the patient joints can not be subjected to sudden movements and heavy loads.

Except gymnastics, long walks in the fresh air are useful.

Diet

The diet for gonarthrosis is a powerful way to influence the course of the disease.

The food should be balanced, but too high-calorie food needs to be removed, tk.they can lead to excess weight, which is one of the main causes of gonarthrosis.

The peculiarity of nutrition is that it must be saturated with animal proteins, because they are involved in the structure of muscles. But to feed the cartilage is necessary to use jelly, broth, brewed from the bones.

There is also a list of products not recommended for arthrosis of the knees. This alcohol, fatty meat, cabbage, tomatoes, pepper, milk, sour fruit.

Manual therapy

Manual therapy for violations of I and II stages gives a remarkable result. Sometimes several sessions are enough to make the patient feel better.

manual therapy This method of treatment is especially effective in combination with joint extension, chondroprotective consumption and intra-articular administration of ostenil.

Osteoarthritis of knee joints is a deviation occurring in 3 stages of development.

And if at first you can cure by means of drugs from arthrosis, gymnastics and massages, then if there are already changes in the joint, the way out is the operation.

Surgical intervention

Today, there are several types of interventions that can eliminate pain and discomfort due to a violation. Some of them, for example, artodes, give a certain immobility to the joint, rather than neutralize the pain.

More modern techniques involve the use of prostheses, which can replace the joint or improve its work through a special plate.

hand polyarthritis How and how to treat polyarthritis of the hands with traditional and traditional medicine.

What sections of the population are at risk of getting trochantitis and what should be known about the prevention and treatment of this unpleasant disease.

Traditional treatment of knee joint gonarthrosis

In many situations, folk remedies are extremely effective. Tinctures and ointments on herbs give a good effect. So, you can rub a sore spot with camphor oil or make a compress with apple cider vinegar and honey.

Many recipes for the treatment of violations are used as the basis of the leaves of burdock. It is necessary to attach the sheet to the joint, wrap with a film and a warm scarf overnight.

By the same principle, you can use white cabbage leaves. To enhance the effect it is necessary to grease the cabbage leaf with honey.

Conclusions

It is necessary to understand the danger of diseases of knee joints. Means for treatment should be selected carefully, given all the nuances.

At the first manifestations of pain in the knees of , it is worth to find an experienced doctor , which will give effective guidance on preventing this problem.

In the initial stages of gonarthrosis is better treated than late. If you want to live without pain and unnecessary complications, take care of your health and the health of your joints.

Video: Exercises for gonarthrosis

What if the knee has a pain and there are suspicions of gonarthrosis? You need to visit a doctor to make a correct diagnosis, and also to study these exercises.

osteocure.ru

Genuine scourge of the twenty-first century is gonarthrosis of the knee joint. If several years ago only elderly people were at risk, now the disease does not spare the youth.

In most cases, gonarthrosis develops on the background of injuries sustained by athletes in training and competition.

Reasons for

The destruction of the knee joint is gradual: first against a background of mechanical damage there is microtraction of the cartilage, then the process of its degeneration begins.

This disease is characterized by a change in the tissue of the cartilage of metabolism, the essence of which is that the saturation of the cartilage with chondroitin sulfate is markedly reduced.

The causes of progression of gonarthrosis are:

  • arthrosis, formed against the background of Paget's disease;
  • bone tumors of benign or malignant nature;
  • fractures of the knee bones;
  • ankylosing spondylitis( arthritis affecting the joints of the sacrum and spine);
  • rheumatoid arthritis.

Modern physicians distinguish 3 degrees( or stages) of gonarthrosis.

First-degree gonarthrosis

Unfortunately, this stage of gonarthrosis is often ignored by most people. Pain syndrome occurs only after a load, and the deformation of the knee joint to notice with the naked eye is almost impossible.

Second-degree gonarthrosis

Symptoms of the disease become more specific. Thus, the duration and intensity of painful sensations localized in the joint increases, and often a characteristic crunch is formed during flexion.

Gonarthrosis of the third degree

Gonarthrosis, developed up to 3 degrees, is characterized by quite strong painful sensations, arising both during movement and when a person is standing or sitting. In addition, the affected joint "reacts" to the weather change. Mobility of the knee joint is limited, there are changes in the gait( lameness).

Types of

Medicine is known for two types of disease: primary( idiopathic) and secondary.

Primary

The disease occurs and develops due to intensive loads of the knee joint. The risk group includes middle-aged and elderly women, as well as athletes and people suffering from obesity.

The pathological process is distributed as one joint, and both. When there is a simultaneous destruction of both joints, doctors diagnose bilateral gonarthrosis.

Secondary

The provoking factors of gonarthrosis secondary are:

bolit-sustav.ru

Medical treatment

Schematic comparison of a healthy knee joint and affected with arthrosis.

Most doctors prefer tablets, injections, ointments. But we need to understand that drugs only muffle the symptoms of the affected joint, but do not lead a real fight with the causes of arthrosis. In addition, they have a very negative effect on other organs and systems of the patient. The most famous drugs for the removal of inflammation and pain symptoms are recognized - non-steroidal anti-inflammatory drugs. These include Ketoprofen, Diclofenac, Naproxen, Indomecin, Ibuprofen and other medications. With exacerbation of arthrosis of the knee joint, steroid( hormonal) agents are used. These medications are treated as a course of injections( from 5 to 10), as the volume of the drug administered is strictly dosed.

Most often for intraarticular injections, glucocorticosteroids and corticosteroids are used.

With 3 degrees of knee arthrosis, chondroprotectors are rarely prescribed. Benefits from them will be no, since the hyaline layer of cartilage has already undergone considerable destruction. There is often nothing to restore. Expensive tablets at this stage will be ineffective.

To reduce pain in the knee, therapeutic ointments and creams are prescribed. Arthrosis and coxarthrosis they will not heal, but the patient's well-being will improve. If there are no edema from synovitis, then you can use warming ointments: Menovazine, Gevkamen, Espol and other similar drugs. Treatment of the inflamed knee joint is carried out with the help of Fastum-gel, Voltaren-gel, Dolgit and other non-steroid ointments.

IMPORTANT TO KNOW!Doctors are dumbfounded! The pain in the joints is FOREVER!Just before bedtime. .. Read on - & gt;

Traditional medicine

For many centuries our ancestors used folk remedies to treat various joint diseases. All of them are tested by time and practice. Here are a few recipes.

  • Raspirka from turpentine and apple cider vinegar. Composition and proportions: one yolk of a chicken egg, a tablespoon of apple cider vinegar and a teaspoon of turpentine. Mix all ingredients thoroughly.

Application. Rub into a sore knee before going to bed. Be sure to warm a shawl or woolen scarf. Leave it overnight. In the morning rinse with warm water and soap.

  • Mumiyo. Composition and proportions: in half a cup of honey add 3 grams of mummy and thoroughly mix.

Application. Hand grease any vegetable oil( so that honey does not stick to them) and gently rub the mixture into the diseased knee. This procedure should be followed several times during the day and at bedtime.

  • Ointment from vegetable oil and turpentine. Composition and proportions: mix a glass of vodka, vegetable oil and turpentine. Pour the mixture into a dark glass bottle, first throwing a small piece of camphor into it. Seal the bottle, shake it and put it in a dark place.

Application: smear the drug area of ​​the patient knee joint at night. Be sure to wrap the treated area with a woolen cloth. In the morning, rinse with oily water and soap. Repeat every night for several days.

Summing up

Symptoms of arthrosis of the knee joint of the third degree are very painful, and the treatment is long, painful, expensive. Sometimes surgical intervention may be required. Often the patient is registered as a disability. You can not start the disease so much. Treatment should be started on time.

Recommendations of the expert

People who are overweight are at risk for arthrosis of the knee joint. And many other chronic diseases can be caused by this problem.

dlyaspiny.ru

The change in the supply of cartilage tissue in the knee joint, which occurs for a long time, causes the development of processes of formation of gonarthrosis. This disease, which causes a gradual destruction of the structure of the compound and its surfaces.

1. Process development mechanism

Knee joint ganglion

The change in the basic properties of the cartilage leads to a decrease in the natural slip of bones relative to each other due to a weakening of the ability to retain moisture in the intercellular space of the cartilage. The next stage is the deterioration in the mobility of education, which means that the supply of nutrients to the joint surfaces will be less, since the delivery of necessary elements is achieved only with motor activity. The general universal mechanism of interaction of elements in a connective tissue is broken. There is a loss of strength of the hyaline coating and the cartilaginous base becomes less dense. The functional response of the cartilage during the load on the joints of the squeezing and unclenching is interrupted. And cartilage can not give water at the time of applying the acting force and back absorb. As a result, fractures of this solid material appear.

2. Forms of the development of the disease, causing its causes and the degree of change in the state of the structures of the knee joint

. Depending on the cause, the forms of the disease resulting from:

  • are congenital anomalies in the development of the human bone system;
  • disturbed processes of delivery of food elements caused by mechanical action on the limb and a general decrease in the work of the exchange system.

When the development of the disease begins, the first changes in the properties of the synovial fluid appear, the composition of which influences the state of the cartilage layers. The first degree is characterized by pain after loading in the knee area. Manifestation of pain is considered by a mechanical type, i.e. occurs after loads( walking, jumping, long standing) and calms down in peace. It is the beginning of a change in the state of the cartilage, which will subsequently result from a decrease in the mobility of the joint ends, the outcome of which will be deformation of the bones. In the second stage, the movements are limited, the pain does not pass after rest and can last for a long time. In these two stages, the recovery process will go well, and will not have any residual effects. When gonarthrosis of the third degree begins, the main substance of the hyaline coating undergoes complex changes in its chemical properties. In this case, the deep layers of cartilage are also affected.

3. What is gonarthrosis of 3 degrees?

3 degrees of gonarthrosis

This disease is a condition in which there are strong and continuous pain in the affected limbs. Externally, the joint changes, there is a swelling in the joint.

All signs of the first two degrees of disease are manifested most in the critical third stage of pathology development.

Characteristic symptoms of grade 3 gonarthrosis:

  • significant decrease in the functionality of the connecting formation;
  • a crunch is heard while the limbs are moving;
  • a visual increase in the volume of the joint surface;

Precedence of initial disorders in gonarthrosis of the third degree of the knee joint in the structure of its formation is considered a violation of trophic delivery of food to it. The process of cartilage damage also begins as a result of local disturbance of blood circulation, the appearance of the inflammatory process, traumatic injuries, in conditions of depletion of the cartilaginous tissue.

During the already formed changes with gonarthrosis of the third degree of the knee joint, the third degree is characterized by the fact that the joints of the sick person will be difficult to cope with even the minimal load that falls on them. In the pathological process, other structures of the osseous system( the foot, the spine) will already be involved.

4. Management of therapeutic measures

Gonarthrosis of 3 degree

When there is a deformation in the joint of bones during a disease such as gonarthrosis of grade 3, treatment that will be planned can be prompt. The determination of the choice of therapy at this stage is based on the narrowing of the joint gap. This is the main diagnostic sign when gonarthrosis of the knee joint of the third degree is established according to roentgenological symptoms, which in the pictures will be revealed in the form of growths on bone tissues.

How the treatment of gonarthrosis of the third degree is carried out

The clinical data of the examination of the patient, his functional capabilities in the affected limb, blood tests, arthroscopy, synovial sheath biopsy and radiography are the main and complete diagnostic definition. According to the management of therapeutic measures, treatment of gonarthrosis of the knee joint of the third degree is conducted conservative therapy.

Pain sensations that result from changes in cartilage properties in the knee are the main symptomatic indicator when choosing a pharmaceutical effect for Gonarthrosis disease of grade 3, how to treat a damaged cartilage will depend on the degree of its destruction or the present bare exposure of the emerging end portion of the bone.

The conservative effect of the therapy measures for gonarthrosis of the third degree of the knee joint in the treatment is carried out according to the basic principles:

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Gonarthrosis - arthrosis of the knee joint |Dr. Yolkin

Osteoarthritis of the knee joint

Gonarthrosis, aka arthrosis of the knee joint, is considered to date one of the most common types of this disease. According to statistics, almost 20% of the world's population suffers from it, that is, almost every fifth inhabitant of the Earth.

Most often, gonarthrosis is detected in people after 40 years. The disease is susceptible to both men and women, but among women, arthrosis of the knee joint is twice as common.

The knee joint is one of the largest joints in our body and is characterized by a very high level of mobility - it not only provides leg movement, but also helps to keep the weight of our body. The knee joint connects the femoral, tibia and tibia and is supported by various groups of ligaments and tendons.

The knee-forming bones are "joined" by special cartilaginous pads( menisci), which play an important role - they absorb static and dynamic loads and stabilize the knee joint, preventing excessive movements.

The articular surfaces of the bones are covered with hyaline cartilage, the function of which is to reduce the friction that occurs during any motor activity. The healthy cartilage is very tight and smooth, which allows the ends of the bones to slide easily and noiselessly relative to each other.

With gonarthrosis, blood circulation is disturbed in small bone vessels and a degenerative-dystrophic process begins in the cartilage covering of the joint and surrounding tissues. Under the influence of age factors or other negative causes, the cartilage loses its density and elasticity, is covered with various defects - depressions, cracks, and patterns.

At first, deforming arthrosis of the knee joint develops only at the molecular level. Only then noticeable changes appear in the hyaline cartilage: it becomes turbid, stratifies and splits. The consequence of this pathological process is the complete or partial disappearance of the cartilage and exposure of the underlying bone. Motor activity becomes difficult, since any load on the knee joint causes painful sensations.

With further development of the disease, the inflammation of the synovial membrane of the knee joint begins, the functionality of the synovial fluid decreases, and the joint capsule thickens. Osteophytes( bone spines) begin to appear on the surfaces deprived of cartilaginous bones, which, clinging to each other, further complicate the process of movement.

Damage to the joint is not limited to bone and cartilage components - the capsular-ligamentous apparatus also begins the pathological process. The further the disease develops, the more the muscle around the joint becomes atrophied. All this leads to the appearance of contracture of the knee joint, in which motor activity becomes almost impossible. In complex cases of arthrosis, due to such immobility, there is a risk of complete fusion of bones.

CausesSymptoms StagesDiagnosticsLeaching Prevention

Reasons for

One of the main causes of the disease is the natural aging process of the body, therefore the main group of people suffering from this disease are the elderly.

But besides this, there are additional negative factors affecting the development of arthrosis of the knee joint. First of all, these are diseases that have caused cartilage destruction( chondromatosis, arthritis) and traumas of any origin( meniscus damage, ligament rupture, fracture of the thigh or tibia), which cause posttraumatic arthrosis of the knee joint.

The disease can also be caused by a genetic predisposition, an increased body weight or a prolonged intake of a certain group of drugs.

Symptoms of

Knee joint gonarthrosis has the following symptoms: feeling stiff and tight in the joint, knee pain after a long walk. With the development of the disease, the pains are becoming stronger, the movements of the knee joint are accompanied by a crunch.

Without timely and adequate treatment, the curvature of the legs( O-shaped or X-shaped) is gradually formed. This is due to the fact that the condyles are being destroyed( bone protrusions serving to attach muscles) and the joints begin to sag.

The consequence of this is a change in the axis of the shin, which leads to lameness. The motor function of the joint is seriously limited and there is an atrophy of the muscular apparatus. With gonarthrosis in an advanced stage of development, it becomes difficult to move independently. Deformation and contracture of the knee joint develops - impossibility of its bending and extension.

At the first symptoms of deforming arthrosis, the patient should immediately contact the hospital. If the doctor does find out for him an arthrosis of the knee joint, the treatment should begin immediately. At the initial stages, the development of the disease is always easier to suspend.

Stages of gonarthrosis

The development of gonarthrosis is characterized by three stages of development.

Osteoarthritis of the knee joint 1 degree

This is the initial stage of the disease, in which, as a rule, there are primary symptoms - discomfort, minor pain that appears after prolonged exposure to the legs or physical exertion. In some cases, a small swelling in the region of the knee joints, which disappears after rest, can be seen.

Arthrosis of the knee joint of the 2nd degree

The painful manifestations at this stage become brighter and more lasting, in the joint when you move, you can hear "crunching", "creaking".As a rule, in the second stage of the disease there is a "starting pain", which appears after a long stay at rest and disappears after a while. Also there is a slight restriction in movement - stiffness in the knee joint.

In addition, the joint itself begins to increase in volume. If you do not start the immediate treatment of gonarthrosis at this stage, the deformity of the joint will progress. The gait will change, you need additional support - crutches or walking stick.

Osteoarthritis of the knee joint of the third degree

At the third stage of the disease development, painful sensations are present not only during movement, but also in resting. The contracture of the knee joint is pronounced, the gait is broken, X-shaped or O-shaped curvature of the legs arises, the joint acquires a deformed shape.

Primary and secondary gonarthrosis

Primary gonarthrosis can occur in quite healthy people. At risk, usually elderly people( especially women), as well as those who are obese, because in this case there is a serious strain on the knee joints. Also, primary gonarthrosis occurs with a genetic predisposition( to metabolic disorders or circulatory disorders) and due to inadequate physical exertion.

Secondary gonarthrosis of the knee joint may occur as a result of a traumatic injury or knee joint disease( arthritis, chondromatosis).In the presence of any of the diseases that can affect the destruction of cartilage, it is necessary to deal with its treatment, as it will prevent the emergence and development of gonarthrosis.

Most pathology develops after 40 years, but young people are also immune from it. It is not uncommon for bilateral gonarthrosis, when both knees are immediately affected. In the case of timely treatment, there is always the possibility to suspend both primary and secondary and posttraumatic arthrosis of the knee joint.

Diagnosis

Before starting to treat deforming arthrosis, doctors determine the degree of its development.

Diagnostic examinations, in addition to visual examination and anamnesis, include mandatory radiography or magnetic resonance imaging. This will clearly see the narrowing of the joint gap, changes in the shin of the axis, the presence of bone growths( osteophytes).

To exclude other diseases, differential diagnosis is performed and additional clinical studies are carried out - blood analysis and analysis for rheumatoid factor.

How to treat arthrosis of the knee joint?

Conservative treatment of

In the early stages of a disease such as knee arthrosis deforming, treatment is begun with conservative methods.

Conservative treatment of deforming arthrosis of the knee joint primarily involves taking medications of various groups - painkillers and anti-inflammatory( non-hormonal) drugs, as well as drugs aimed at improving cartilage tissue nutrition and strengthening bone tissue.

In addition, a large role in the treatment play a variety of physiotherapy procedures - electrophoresis, phonophoresis with hydrocortisone, ultraviolet irradiation, laser and magnetic therapy.

Application of a full set of these procedures will allow to normalize the metabolic processes in the joint and improve the nutrition of the cartilage, which will help reduce pain, improve the motor function of the joint, prevent the development of contracture of the knee joint and slow the further development of the disease.

An important part of conservative therapy is the conduct of a massage course and exercise therapy, which are designed to strengthen the knee muscles and restore normal blood circulation in the joint region.

Unfortunately, conservative treatment of knee joint gonarthrosis can be effective only at the earliest stages of the development of the disease and to a greater extent plays the role of preventive treatment.

Surgical treatment of

If there is a neglected gonarthrosis of the knee joint, the treatment is already performed surgically.

The basic operations carried out to get rid of the problem of arthrosis are arthrodesis, correcting osteotomy and arthroplasty.

An arthrodesis is indicated to patients who are not allowed to perform other types of surgical intervention and its main purpose is to restore the limb's limb and reduce the painful manifestations. During the operation, bones are fixed by means of special devices( screws, plates, transplants).After such fastening, the bones coalesce, the leg sustainability is restored and this, despite the fact that the motor limitations remain, allows to solve the pain problem with deforming arthrosis of the knee joint.

Osteotomy is an effective method of treating gonarthrosis, which allows not only to regain the lost motor functions, but also to slow the pathological process developing in the joint. The essence of the operation is to cut bone( or artificial fracture) and then fix it in a functionally correct position. This surgical intervention aims at a uniform and more accurate distribution of the load on the joint and, as a consequence, the normalization of intraosseous pressure, which will lead to a decrease, and in some cases, a complete disappearance of the painful sensations.

Supportive conservative therapy, conducted after the operation, will speed up the fusion of bones, restore the work of the musculoskeletal system and finally get rid of the problem of arthrosis.

Osteotomy is divided into closed and open. As a rule, closed osteotomy is more correct, which is carried out through small incisions - this reduces the traumatic nature of the operation and allows you to recover faster. In addition, after such intervention there are no ugly scars left.

In the early stages of arthrosis, when the joint is not yet completely destroyed, the effect of the performed osteotomy may persist for a long time.

Arthroplasty can completely solve the problem of lost or limited motor functions of the knee joint. During the operation, new joint surfaces are modeled and a special spacer is placed between them, which will replace the affected joint. This gasket can be made from artificial materials or from the patient's own tissues.

If you have a knee arthrosis deforming in an advanced stage of development, only total arthroplasty or endoprosthetics can help.

Endoprosthetics today is the most effective method of surgical treatment of arthrosis, because during the operation a complete replacement of the affected joint with an artificial one takes place. In some cases, this is the only way to save a person from pain and give him the opportunity to walk.

Special endoprostheses used to replace the affected joint are made of strong and advanced materials that can serve for decades. In addition, there are special designs and special types of endoprostheses, which are established, for example, with dysplastic coxarthrosis of the hip joint. And special implants with short legs can reduce the risk of a second operation.

The operation itself is performed using special techniques, in which muscles and tissues are not cut, but are "pushed".If the patient's condition requires more serious intervention, the muscles cut off during the operation are attached to their original position with high accuracy. This approach not only reduces the operational trauma, but also allows you to recover after surgical treatment for a short time. Gentle machines do not injure the muscles - the muscle-ligament apparatus subsequently works in full.

The timing of recovery depends on the size of the operation, as well as the patient's age and other factors. But, as a rule, a week later a person can walk and even independently climb the stairs( of course, using crutches).After the endoprosthesis of the knee joint, there will be no pain associated with gonarthrosis.

Important point - after total arthroplasty, you must undergo a full rehabilitation course, which is aimed at restoring the muscles. One of the world recognized methods of rehabilitation after such surgical interventions is myostimulation of muscles, which will return the normal biomechanics of gait and motor functions in full.

It happens that in addition to arthrosis, the patient is diagnosed with other knee joint lesions( for example, meniscopathy).In such cases, to remove all causes of pain and movement restrictions, surgery for the underlying disease is combined with other surgical interventions.

Prevention

To prevent the development of arthrosis, it is important to adhere to simple rules, compliance with which will not allow the disease to worsen the quality of your life.

Regular and moderate physical activities are very important - they strengthen muscles and joints, allow to maintain normal blood circulation and maintain the function of the joint in good condition. And, of course, it is necessary to treat any diseases and injuries in a timely manner.

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