Knee joint gonarthrosis of 2nd degree - treatment
Gonarthrosis - arthrosis of the knee, deforming arthrosis - a disease in which progressive destruction of the articular cartilage is observed.Symptoms and stages of gonarthrosis
In the development of the disease, doctors distinguish 3 degrees:
- With gonarthrosis of 1 degree, pain occurs only after prolonged physical exertion. In the region of the knee, there may be a slight swelling, which quickly passes by itself. At this stage, it is possible to cope with the problem of traditional medicine methods.
- With gonarthrosis of the knee joints of the 2nd degree, the pains become frequent or constant, arise even in a state of rest and are intensified after the exercise. When walking, flexing and unbending the leg in the knee, there may be a crunch and clicks. The knee is swollen almost constantly, its apparent deformation is observed. In addition, there is a joint stiffness, which can decrease throughout the day. At night, there may be pain in the calf muscles. Treatment of gonarthosis of the 2d degree requires taking a number of potent drugs, and folk remedies can only be used as auxiliary ones.
- With grade 3 gonarthrosis, visible significant joint deformity, permanent pain, limitation of mobility up to the impossibility of stepping on the aching leg, pronounced lameness. Conservative treatment at this stage is usually ineffective and surgical intervention is required.
How to treat gonarthrosis of the knee joint of the 2nd degree?
At the 2nd degree of knee joint gonarthrosis, treatment with conservative methods is still possible, but it should be performed under strict medical supervision. Treatment of gonarthrosis includes a whole complex of measures:
- Drug intake.
- If possible, reduce the load on the affected joint. With unilateral gonarthrosis of the 2nd degree, the use of the cane is a good way to reduce the load, but in the bilateral form of the disease, when both knees are affected, this method is not available and it is necessary to limit oneself to special knee pads.
- Physiotherapy - laser, magnetotherapy, electrophoresis, low frequency vibration. Helps reduce puffiness, pain and inflammation.
- Massages, manual therapy and therapeutic gymnastics. They help improve blood supply, joint development and restoration of normal mobility.
- The diet for gonarthrosis of the knee joint of the 2nd degree is an obligatory component of the treatment and is designed to normalize the weight( since the fat deposits create additional stress on the joints) and ensure the supply of the necessary vitamins and minerals. The food should be fractional( 4-5 times a day), contain a small amount of fats and as little salt as possible, be rich in plant and animal proteins, B, C and D. Vitamins.
Knee Joints Grade 2
Standard Schemetreatment of gonarthrosis prescribes the use of medicines of such groups:
1. Non-steroidal anti-inflammatory drugs:
They are used primarily to relieve the pain syndrome and to a greater extent eliminate symptoms than have a prolonged therapeutic effect.
- Chondroitin sulfate.
These are medicines containing synthetic analogues of the substances that make up the cartilaginous tissue of the joint. Contribute to the restoration of cartilage, but should be taken regularly, long courses. To the same group include preparations of hyaluronic acid, which is an analogue of articular lubrication.
3. Intra-articular injections of corticosteroids. They are used in short courses for acute symptoms and severe pain.
4. Ointments and compresses - used to relieve swelling and reduce pain. Of the ointments, non-steroidal anti-inflammatory drugs are most effective:
For compresses most often used drugs such as Bischofite and Dimexid.
Gonarthrosis of the knee joint of the 2nd degree: treatment with medications and folk remedies
Degenerative and dystrophic joint disease is called gonarthrosis. Today, this ailment is the leader in the group of various lesions of articulations in humans. The symptomatology of the disease, according to statistics, occurs in 15-20% of the total population. In this case, it is most often in women who are diagnosed with gonarthrosis of the knee joint of the 2nd degree. Treatment of the disease is difficult. Because the disease is incurable.
The main causes of
In gonarthrosis, degenerative processes of cartilage occur that cover the intraarticular surface of each bone. Uncomfortable sensations in this disease arise precisely because of this.
At first, blood circulation in all small vessels is disturbed. The nutrition of the joint worsens. After a fairly long so-called starvation, the cartilage is thinned, and later completely destroyed.
Partial exposure of bones creates a kind of friction between them when walking. This causes very severe pain. A person can no longer fully bend or unbend the joint. In the most severe cases, thorns appear. Because of this, the bone deforms, which, in turn, leads to the curvature of the leg.
When gonarthrosis is sometimes observed rapid deposition of calcium salts. As a result, calcification of the soft tissues of the knee occurs. However, this manifestation does not stand out in a separate clinical situation. Usually it does not extend directly to the joint itself.
The main types of the disease
This disease is divided into primary and secondary.
Primary gonarthrosis of the knee joint of the 2nd degree, the treatment of which is directed mainly at the elimination of unpleasant symptoms, can occur even in an absolutely healthy person. Many doctors believe that such a disease is provoked by a violation of metabolism, the presence of excessive weight, as well as age-related changes in the joints. There are situations in which primary gonarthrosis has developed as a result of taking some contraceptive hormonal medications. Also, the cause may be poor heredity.
Most often the primary gonarthrosis affects both knees, but it can begin to develop in any of them. Pathological changes over time cover the entire joint and pass to the other leg. One-sided malaise can occur with an uneven load on the legs.
Secondary gonarthrosis of the knee joint of the 2nd degree, the treatment of which must begin in time, almost always one-sided. He has a clear reason.
The most common source is joint trauma. This can be as a hemorrhage in the joint, and a severe bruise or dislocation. The disease sometimes develops after some surgical interventions, with various inflammatory processes and neoplasms in the knee.
The situation can only get worse if you do not go to the doctor on time. Also, one should not engage in self-medication, as often it is fundamentally wrong. And this will only lead to even greater complications.
The main symptoms of
The disease begins with the appearance of pain in the joints after walking, as well as physical activity. But many people do not attach importance to this symptom, because discomfort passes if you rest a little. Sometimes there are mild pains in any one hip.
Characterized by knee joint gonarthrosis symptoms:
- increased pain in the knee joint;
- does not go through unpleasant sensations even after rest or sleep;
- severe discomfort when loaded to the knees;
- joint pain after a long walk;
- there is a significant underdevelopment of muscle tissue in the lower extremity of the corresponding side;
- appears a certain crunch in the knee;
- violation of the main function of the joint;
- appearance of the first signs of joint deformation.
By the time when the second degree of gonarthrosis is already determined, the disease covers both joints. One-sided malaise occurs when excessive load on any one leg. In this situation, a person unconsciously begins to shift all his weight to the other side. As a result, the degeneration of the cartilaginous tissue of the articulation develops.
Degrees of the disease
There are several degrees of the disease in terms of the intensity of their development:
- 1 degree( initial).Quite insignificant swelling and pain in the knee after physical exertion. The shape of the joints does not change.
- 2 degree. There is a slight crunch in the joints, the pain becomes stronger. There is a certain stiffness in the joint. The outlines of the knees begin to change outwardly.
- 3 degree. All symptoms manifest themselves in full. Gonarthrosis of the third degree of the knee joint is characterized by pain, which is permanent. The joint is strongly deformed and increases in size. It becomes difficult for a person to walk.
- 4 degree. On X-rays, a strong deformation of the joint is clearly visible. Practically complete absence of joint space. The pain does not stop, the knee is limited in movements.
Diagnosis of the disease
The diagnosis of the specific difficulties is not caused and is carried out on the basis of symptoms indicative of the rapid development of the disease:
- deformation of the knee joint;
- appearance of crunch;
- pain enhancement;
- limitation of joint mobility.
The most clear picture can be seen on the radiographic images. Deforming gonarthrosis of the knee joint of the second degree is characterized by specific marginal growths and strong narrowing of the gap.
Treatment of altered joints
It is rather difficult to fight this disease. Before examining how to treat gonarthrosis of the knee joint, it should be understood that the disease is considered incurable. After all, no one is able to return the joints to their joint mobility. The most that will be possible to do at all is to reduce the pain sensations only slightly and try to suspend the process for a while.
Only timely diagnostics of the disease will achieve these goals. However, any intervention will be ineffective if you do not learn to unload the affected joints.
Treatment of gonarthrosis should be carried out according to strict rules. To do this, stock up with a lot of patience. It is recommended to completely abandon all bad habits, observe a special diet, as far as possible, completely eliminate all heavy loads.
When gonarthrosis is applied:
- Non-steroidal anti-inflammatory drugs for pain relief( Nimesulide, Movalis, Diclofenac, etc.).
- Preparations in which there are components of articular cartilage( "Chondroitin-sulfate", "Glucosamine", etc.).
- Drug injections in the joint of hyaluronic acid preparations( Synvisc, Fermatron, Duralan).This acid is an analogue of an articular lubricant, which covers the cartilage, thereby reducing friction when moving in the joint.
Special support devices are used that can reduce the load on the joint. It can be like an ordinary cane, and hard knee pads, as well as special orthopedic insoles. Such a device is chosen by the doctor individually for each patient, relying on the degree and severity of his illness.
If the patient does not already have a chance to save the joint, surgery is recommended. Gonarthrosis of the knee joint is often treated with complex therapy, resorting to surgical intervention only in extreme cases.
There is such an operation option as endoprosthetics. It consists in the fact that the prosthesis is replaced by the whole joint or some of its parts. The operation is most often done when a unilateral gonarthrosis is post-traumatic in nature. This includes the rupture of ligaments, fractures of the knee joint.
Surgical treatment is performed only if the disease is not accompanied by osteoporosis. Another taboo to the operation is the increased fragility of bones.
Additional methods of
Comprehensive treatment is supplemented by some fairly effective methods:
- special massage;
- physiotherapy with thermal action and laser;
- exercise therapy;
- UHF, electrophoresis.
Special therapeutic exercises
With gonarthrosis of the knee joint, it is impossible to completely exclude physical activity. The individual curative gymnastics program will help to strengthen the weak muscles surrounding the joint, and improve blood circulation.
Because the joints need movement, then physical exercise should be practiced constantly. During such exercises, not only the affected muscles are trained, but the entire musculoskeletal system is trained.
Gymnastics in gonarthrosis of the knee joint can be performed by patients at home. But it is always worth remembering that physical exertion on sick joints is allowed only during the remission of the disease. The presence of edema and pain will simply make any movement unrealistic. Ignoring this nuance can exacerbate the condition to some extent.
When gonarthrosis is strictly prohibited squats, long walking, running, stress knee joints. They will always cause acute pain.
For each degree of the disease, its individual treatment is applied
1 degree - massage, easy medical gymnastics, physiotherapy. To reduce the load on the joints, it is recommended to reduce weight.
At the 2nd degree, the load on the joint should be minimized. Physiotherapy, physiotherapy exercises are prescribed. Anesthetics, anti-inflammatory drugs and some chondroprotectors are used.
Gonarthrosis of the third degree of the knee joint requires therapeutic symptomatic treatment. The patient may be referred for surgical treatment. At the same time, all bone growths are removed, osteoplasty of the cartilage is done. On the last - the fourth - the stage the arthroplasty of the joint is increasingly performed.
We use folk remedies
Various decoctions and sprays made from medicinal plants are used in case if 1 or 2 degree of such a disease as gonarthrosis of the knee joint is diagnosed. Folk remedies with a serious degree of disease, unfortunately, will not have absolutely no effect.
This is one of the most common methods of combating the disease, widely used by patients who are diagnosed with gonarthrosis of the knee joint of the 2nd degree. Treatment involves the use of blue or red clay. It should be applied only with a plastic or wooden spatula. No contact with metal is allowed.
Clay is diluted with water to a consistency of liquid sour cream. The mixture is spread on a cloth. They put it on a sore knee and wrap it with cellophane or with a warm woolen shawl. This compress is held for a couple of hours, after which the clay is washed off.
A special tincture from gonarthrosis is prepared from the most common domestic ficus. His leaves are passed through a meat grinder and add a little vodka. Insist for 3 weeks in a dark place. The dishes should be very tightly closed.
First of all you need to take a salt bath. Prepared infusion slightly warmed, and then applied to the affected joint and wrapped in a warm kerchief. Do this for 10 days in a row.
Two-sided gonarthrosis of the knee joint, treatment of any degree, diagnosis and prevention of the disease.
Gonarthrosis is a degenerative-type disease. This is the most common type of arthrosis. It is characterized by progressive destruction of the knee cartilage, accompanied by deformation and dysfunction of the entire joint. This disease is observed, as a rule, in people in old age. Most often they suffer from women.
The development of the disease leads to a narrowing of the joint cracks, which causes the rapid deterioration of the cartilage. The process is accompanied by the restructuring and deformation of bone tissue. As a result, there are osteophytes, called spines. Increasing, they cause pain. If the treatment of the knee gonarthrosis does not begin on time, then the most unfavorable consequences can be expected in the form of destruction of the cartilage and exposure of the bones under it. The result is a complete deformation of the joint.
This disease has a common name - "salt deposition".And for this there are grounds. Indeed, arthrosis of the knee joints can be accompanied by the deposition of calcium salt in soft tissues, but this process is of an organic nature and does not have clinical significance.
Causes of the disease
Depending on the origin, gonarthrosis is of two kinds:
Primary or idiopathic
Scientists have not yet been able to identify its cause. As a rule, this is a bilateral gonarthrosis that occurs in elderly people with excess weight.
It is the result of an earlier knee pathology: trauma, infection, chondromatosis. As a rule, this is a one-sided affliction that appears in people outside of any dependence on age.
The main symptoms of
The insidiousness of the disease lies in the absence of pain at an early stage. Therefore, it may take years before the patient seeks help from a specialist. At first, people feel barely noticeable pain that occurs after long walks or in other situations when their legs experience increased loads, for example, when walking on a ladder.
This disease has 3 degrees of
At first, there is a dull ache. It occurs only after exercise and may be accompanied by swelling of the knees. At this stage, the knee does not yet have a pronounced deformation.
Gonarthrosis of the 2nd degree has already more pronounced symptoms. The pain intensifies and becomes longer in time. Patients complain of stiffness in the morning, they use analgesics. There is a crunch when walking, and the joint increases in size, its flexion or extension is very limited.
GG 2 nd degree has already more pronounced symptoms. The pain intensifies and becomes longer in time. Patients complain of stiffness in the morning, they use analgesics. There is a crunch when walking, and the joint increases in size, its flexion or extension is very limited.
In the third stage of the disease, patients experience almost unceasing painful sensations, which intensify with weather changes. Their gait is disturbed. The knee acquires a larger volume and changes shape. There are valgus - X-shaped deformations and varus - O-shaped.
Therapy This diagnosis is diagnosed by X-ray examination, which allows you to put a fairly accurate diagnosis to find out the stage of the disease, and also to track the dynamics of its development. With a disease such as gonarthrosis of the knee, treatment requires a mandatory change in the lifestyle of the patient. It is important to start eating right, and also get rid of bad habits.
For people with a diagnosis of gonarthrosis, gymnastics helps stop pathological processes and increase muscle tone. There are special sets of exercises, which you need to learn from a specialist, and then do them several times a day. It is necessary to rest lying down after work for at least 40 minutes.
You can reduce pain, and also relieve inflammation with anti-inflammatory non-steroid drugs. For this, medicines from a number of chondroprotectors are used, they replace the synovial fluid. For warming, apply half-alcohol compresses, as well as warm baths with pine needles or sea salt.
Physiotherapy techniques are also effective in fighting at the initial stage. Patients are treated with phonophoresis with hydrocortisone, diadynamic currents, ultraviolet irradiation, electrophoresis with novocaine, laser and magnetic therapy, UHF, foot massage.
Patients are assigned to wear individual insoles. They use when walking the cane to unload their joints. Sometimes special orthoses are used to relieve pressure on certain bone areas.
When conservative therapy has no effect, one of three operations is performed: arthroplasty, arthrodesis or corrective osteotomy.
- Arthroplasty can restore the lost motor function of the knee. During the operation, a new joint surface is modeled and special pads are placed in it, which replace the affected parts. They are produced from the patient's own tissue or artificial material.
- In arthrodesis, bone fixation is performed with the help of various devices( screws, plates, transplants).After that they fuse. But the restrictions in the movement will still remain. An arthrodesis allows to forget about a pain at an arthrosis.
- An osteotomy is called dissection of bones and their subsequent fixation in a functionally correct position. Due to this operation, the distribution of loads on the joint bones will be more even, with normalization of intraosseous pressure, and pain disappears.
Osteotomy is the dissection of bones and their subsequent fixation in a functionally correct position. Due to this, the distribution of the load on the joint bones becomes more uniform and, as a consequence, intraosseous pressure normalizes, and the pain disappears.
In arthrodesis, the bone is fixed with special devices( grafts, plates, screws).After that, they grow together. Although the motor limitations still remain, but this allows you to get rid of the pain with deforming arthrosis.
Arthroplasty will restore the lost motor functions of the knee. During the operation, new articular surfaces are modeled and special spacers are placed between them, which will replace the affected areas. The gasket is made of an artificial material or the patient's own tissue.
Second-degree knee joint gonarthrosis: how to treat bilateral, right-sided and left-sided gonarthrosis
Progressive gonarthrosis of the knee joint of the 2nd degree often leads to the fact that a person loses the ability to move independently without assistance or an auxiliary cane. Any movement causes pain and does not allow you to ignore the pathology of cartilage and bone tissue. It is necessary to contact the doctor as soon as possible to diagnose and prescribe the appropriate treatment. But first, you should consider the most probable causes and typical symptoms of this ailment.
The risk factors include, in the first place, excess body weight with a sedentary lifestyle and the lack of sufficient muscle mass development in the gastrocnemius and femoral area. Recently, orthopedic doctors are discussing the risk of destruction of the cartilaginous tissue of the knee joints on the background of venous insufficiency. Thus, varicose veins of the lower limbs, which is accompanied by severe congestion, may well become a risk factor for the appearance of problems with large joints. This is due to the violation of microcirculation and diffuse nutrition of cartilage with the help of muscle fibers surrounding it.
Women aged 40-45 years are more likely to suffer. Primary pathological changes in them begin during pregnancy, against a background of pre-eclampsia and the associated edematous syndrome. In the future, in the absence of rehabilitation, the cartilage tissue changes and gonarthrosis of the second degree develops, which prevents certain movements during walking.
Two-sided gonarthrosis of the 2nd degree and its treatment
Depending on the causes of the disease, the disease can be unilateral or affect the knee joints symmetrically with almost equal expression of symptoms and destructive changes. Double-sided gonarthrosis of the second degree is more common, since the systemic pathological changes in the patient's body remain the leading causes. Usually the disease at an early stage is detected only in a random way, as patients prefer not to pay attention to sudden pain in the knees, a feeling of increased fatigue of the calf muscles and convulsive syndrome that accompanies the disease at the initial stage of its development.
Symptoms, which gives a bilateral gonarthrosis of the 2nd degree, leave no chance to ignore them, as they greatly impede movement, cause sharp soreness. Symptoms can be expressed as follows:
- soft tissue swelling around the affected joint;
- tenderness in palpation;
- slight degree of deformation of bone tissue, which is visible through the skin;
- pain enhancement during movement, especially often pain patients complain when climbing the stairs;
- crunch, creak, clicks in the joint area, which arise due to the friction of bone tissue in conditions of a thinned cartilaginous lining.
Treatment of bilateral gonarthrosis of the 2nd degree does not guarantee a quick positive result, as there are already serious destructive changes not only in the cartilaginous, but also in the bone tissue of the femoral and tibia bones of the joints joining the joint. For therapy, intraarticular blockades can be used, including hormonal drugs( hydrocortisone, dexamethasone, prednisolone).All of them contribute to the rapid elimination of the inflammatory process, which leads to a sharp reduction in the intensity of pain. The edema subsides, hyperemia is eliminated - the patient has the impression that there is an obvious process of recovery. However, after a few days the effect disappears and pain returns with redoubled force. This happens because hormonal drugs increase the process of destruction of bone tissue due to the washing out of calcium.
The second trend in conservative therapy is the use of treatment regimens with non-steroidal anti-inflammatory drugs, vitamins and chondroprotectors. These measures do not give an expressed positive effect. The patient is offered a wait-and-see tactic using symptomatic means to reduce pain. At the 3rd and 4th stage, a surgical operation is proposed with the aim of prosthetics of the knee joint.
You can prevent the development of pathology to this state. Perhaps successful conservative treatment. How to do this is written on this page.
Right-sided and left-sided gonarthrosis of the 2nd degree
A one-sided pathological process often develops as a result of trauma. This can be a bruise, rupture of the ligamentous and tendon apparatus, dislocations, fractures of the femoral and tibia bones. In a number of cases, right-sided gonarthrosis of the second degree is a consequence of a violation of posture in the form of scoliosis and kyphosis. When the center of gravity is shifted, the distribution of the damping load falls on the large joints of the lower extremities. Left-sided gonarthrosis of the second degree can become a complication in injuries of the lower leg and ankle joint. Do not exclude from the number of possible causes coxarthrosis of the hip joint, which is accompanied by a shortening of the femur and a violation of the position of the heads in the cavity of the knee joint of the bones.
Both for left-sided and right-sided gonarthrosis of the 2nd degree, diagnostics most often does not present special difficulties. There is an asymmetric deformity of the joint, swelling and redness of the soft tissues, soreness when trying to palpate. During the movement, a crunch or a creak can be heard. An x-ray photograph shows narrowing of the joint gap and bony growths of irregular shape. When carrying out tomography, thinning of the cartilaginous tissue and a decrease in the volume of the synovial fluid are observed.
Associated disease may be bursitis of aseptic etiology. When treating it, one should take into account the deformation of the joint and the deficit of muscle mass in the gastrocnemius.
How to treat gonarthrosis 2 degrees by methods of manual therapy?
And now we offer to learn how to treat gonatrosis of 2nd degree by methods of manual therapy: is it possible to recover and what are the chances of success? First of all, it is worth noting that the most likely pathological cause of destruction of any cartilaginous tissue in the human body is the disturbance of diffuse nutrition from adjacent muscle fibers. Own cartilage network does not have cartilaginous tissue and receives all the nutrients from the muscle tissue. Therefore, with muscle dystrophy in conditions of insufficient volume of physical activity and stagnant phenomena against the background of venous insufficiency, destruction of cartilage and decomposition of hyaluronic fibers occur. This leads to bare bone tissue, which loses its natural protection against friction. In the process of contact of bone surfaces, microscopic trauma and cracks occur. They become the centers of future bone growths.
What do you need to do to stop this process and possibly turn it back? It is necessary to restore normal blood supply to cartilaginous tissue. It can help to do manual therapy.
The methods of osteopathy, fractional traction are used to cut off the physiological position of the head of bones in the joint cavity, therapeutic massage and physical training in the form of complexes of gymnastic exercises. To reduce the pain syndrome and activate the process of self-restoring tissues, acupuncture and reflexotherapy can be used.
Every patient has chances for successful treatment! The most important thing is to start treatment on time and carefully follow all the recommendations of the manual therapist. He, among other things, will advise a special diet and drinking regimen, help to develop a sparing schedule of the day and will give very important advice.
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Degrees of progression of pathology
Gonarthrosis of 1st degree
Early signs of gonarthrosis characterized by dull pain due to heavy loads on the joint. Often minor pain sensations appear after awakening, but after a while the joint enters the habitual rhythm of work, and the pain recedes.
Pain can also appear after a long sitting or lying down, after a long walk up the stairs. Sometimes a temporary mild swelling of the joint is formed, but there is no deformation.For gonarthrosis of the first degree is characterized by the development of pain during movements and their retreat after the cessation of actions, manifested several times a day.
The initial sign of the disease becomes a crunch in the joint .Simultaneously, there is a disturbance of blood flow in the small intraosteel joints responsible for saturation of the cartilage, in connection with which its surface dries up, it loses its smoothness, and cracks form on it. Microtraumas provoke worsening of depreciation characteristics.
Grade 2 The severity of the disease is characterized by a long and more intense pain developing during walking or with a long standing in one place. The pain recedes only after a long rest and rest.
Any movement is accompanied by a joint crunch, which becomes even stronger and more pronounced as gonarthrosis progresses. The disease is characterized by moderate limitation of mobility even with the slightest deformation of .Also there are compensatory changes in the structures of the bones - this also changes the articulation area to accommodate the load.
Part of the bone under the cartilage is compacted. In this case, the edges of the articular surfaces are covered with outgrowths - thus, the synovial membrane and the joint capsule are degenerated, the viscosity of the joint fluid increases, worsening the characteristics. Because of this, the degeneration of the cartilage itself is accelerated, it is strongly thinned to complete extinction, in connection with which, the friction between the surfaces of the joints increases.
Further one-sided or bilateral gonarthrosis of the 3rd degree develops.
Grade 3 hyperthyroidism can lead to disability.
Gonarthrosis of 3rd degree
The third degree of pathology in the knee joint is characterized by a clear manifestation of symptoms. The pain is not passing, it can chained the patient to bed, forcing a long time to choose a comfortable pose for calming down the pain.
There is also a pronounced violation of gait, restriction of motor activity and deformation in the joint, interfering with normal vital activity, worsening working capacity.
Deformations severely limit limb mobility - it becomes difficult to bend the leg even at a right angle, blockage in the knee joint can begin - that is, it is impossible to flex and unbend the leg painlessly.
Bilateral gonarthrosis of the third degree significantly changes the structure of the joint in the knee, the surface of its bones is heavily compacted, the joint slit narrows, the cartilaginous tissue practically completely disappears and the number of osteophytes simultaneously increases.
Methods of treatment and preservation of knee joint health
Gonarthrosis in medicine is considered to be an incurable disease, that is, the affected joint can not be returned to its original state. But to carry out treatment is necessary for the relief of intolerable pain and slowing the progression of pathology. These tasks are easier to implement with the timely start of the treatment process.For the treatment of disease it is important to get acquainted with the full range of therapeutic procedures, to abandon bad habits, to normalize nutrition and the very way of life.
The following drugs are used for medicines that are used for symptoms of grade 2 and 3 gonarthrosis:
- Various analgesics, including corticosteroids.
- Chondroprotectors and anti-inflammatory agents.
The listed medicines are usually applied in the form of tablets, injections for joints and muscles, and also in the form of creams, ointments and gels. They allow you to get rid of pain in a short time.
Orthopedic therapy of pathology
Such treatment involves the use of a variety of support devices that reduce the load on the damaged joint. This can be hard knee pads, canes, orthopedic insoles for shoes. They should be selected in accordance with the recommendations of the doctor individually, taking into account the degree and lifestyle of a person.
The operation for treatment is realized only when the disease starts, when the chances of recovery are minimized .Instead of surgery, endoprosthetics are often prescribed, when the whole joint or part of it changes to an artificial joint.
An operation is required when a unilateral or bilateral gonarthrosis of 2 degrees or 3 degrees is characterized by a post traumatic nature, for example, occurs after ligament rupture, after fracture inside the knee joint.
Additional treatments for the disease
The following therapeutic procedures also apply:
Gonarthrosis - arthrosis of the knee |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 found 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.
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
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 in addition, 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, increased body weight or a prolonged intake of a certain group of drugs.
Knee joint gonarthrosis has the following symptoms: a feeling of stiffness and tightness 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, small pain that appears after a long stay on 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.
Osteoarthritis of the knee joint of 2nd degree
Painful manifestations at this stage become brighter and longer, in the joint when you move, you can hear "crunching", "scratching".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
In 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 may 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.
Before starting to treat deforming arthrosis, doctors determine the degree of its development.
Diagnostic examinations, in addition to visual examination and collection of 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).
For the exclusion of other diseases, differential diagnosis is performed and additional clinical studies are carried out - blood test 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 deformans, 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 complex 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 implementation 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, corrective 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.
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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