Bilateral gonarthrosis of 1 degree: causes and treatment
Joint diseases now occupy a huge niche among pathologies of the musculoskeletal system. Among them, an important place is occupied by gonarthrosis.
What is it?
Under gonarthrosis is understood an inflammatory disease of a degenerative nature, affecting the knee joint. This disease is widespread everywhere and develops mainly in middle-aged and elderly women. The incidence of this pathology is higher in rural areas than in cities.
The disease is characterized by depletion of the articular cartilage, changes in congruence of the joint, and the development of bone growths in the joint( osteophytes) region. When gonarthrosis changes the volume of active movements, the configuration of articular surfaces.
The disease has a high risk of disability of patients, a significant deterioration in their quality of life. If the process is not diagnosed in time, the prognosis regarding recovery and complete restoration of the impaired joint function worsens.
Among the reasons provoking the development of gonarthrosis, we can distinguish the following:
- Hereditary predisposition. According to statistics, the risk of developing gonarthrosis in patients whose parents suffered from this disease is high enough.
- Heavy static work. In this case, prolonged stagnation of blood and lymph in the joint region, its overload, which significantly increases the load on the articular cartilage. This factor often serves as a prerequisite for the development of gonarthrosis 1 degree.
- Injury to the joint. They are the most common cause of gonarthrosis development as long-term effects or complications. Causes immediate damage to the cartilage, which subsequently undergoes resorption.
- Overweight and osteochondrosis. They are not the direct causes of gonarthrosis, but worsen the course of the disease itself.
- Congenital malformations of the knee joint. Because of incorrect embryonic tissue filling, the joint can not develop fully, which is why the gonarthrosis of the first degree of the knee joint develops.
Features of the disease course
Gonarthrosis has some specificity, which depends on the underlying cause. If the cause is not clearly understood or there are predisposing factors such as excess weight or spine diseases, then in the given situation the bilateral gonarthrosis of the 1st degree develops most often. If the basis of the disease is trauma or some professional characteristics, then in this situation there will be a one-sided defeat of the knee joint.
Joint damage on one side is more favorable for treatment, but it progresses faster than with a bilateral process. Bilateral gonarthrosis of the 1st degree is more favorable in terms of prognosis, however, treatment takes more time.
Classification of gonarthrosis
The disease can be divided by the amount of damage( bilateral or unilateral).Unilateral, in turn, is divided into right-sided gonarthrosis and gonarthrosis of the left knee joint.
In terms of severity, three stages of the disease are identified:
- Gonarthrosis of 1 degree( or stage) has no clinical manifestations and is only detected during routine examination or is an accidental finding of diagnosticians. Deformation for this stage is not typical.
- The second stage of gonarthrosis already has some clinical signs( pain after a long walk or static load, some stiffness during movements).The volume of active movements is gradually limited by the initial changes and deformations in the joint.
- Gonarthrosis of the third stage is characterized by a constant pain syndrome, visible deformation and almost complete loss of active movements in the joint. Passive movements are difficult. Walking at this stage is impossible.
Gonarthrosis This stage of gonarthrosis is most favorable for patients. The pathological process can stop at this stage and then not progress. Changes in the joint do not make patients uncomfortable and do not limit their social activity. Two-sided gonarthrosis of the 1st degree develops less often than its one-sided form.
The main symptoms that can occur at this stage are the feeling of discomfort in the knee joint after a long physical work, a low-intensity aching pain that quickly passes after a period of rest. Depending on which joint is affected, a left-sided and right-sided shape is identified. Left-sided gonarthrosis of the first degree develops mainly in left-handers and is characterized by pain in the left knee joint.
Right-sided form is much more common. Suffer it usually jockeys, wrestlers, weightlifters, gymnasts. When carrying out preventive arthroscopy, right-sided gonarthrosis of the 1st degree is diagnosed in 40 percent of the population.
Pain usually appears in the morning and passes in a few minutes( for example, when charging).
In some cases, patients may be disturbed by a crunch in the joint, or by the friction experienced during palpation of the joint( it is enough to just put your hand on your knee and bend it several times).
With competent division of labor and rest, gonarthrosis of the first degree of the knee joint stops at this stage. Either flows, but rather slowly. Deterioration of the state is usually observed only after several years( depending on the regime and type of labor).
In rare cases, deforming gonarthrosis of 1 degree may develop. This phenomenon is extremely rare. The development of this form of the disease is prognostically much worse than the classical course.
If there is gonarthrosis 1 degree, treatment may not be required.
2nd stage of gonarthrosis
With progression of the disease, gonarthrosis passes to a new stage. Stage 2( or degree) of gonarthrosis is characterized by a more intense pain syndrome: if at the first stage only the initial pains were noted( in the morning or after a long rest), then unpleasant sensations can appear at any time. Pain is more intense, more difficult to stop with anti-inflammatory drugs.
Because of the intensity of the pain syndrome, atrophy of the muscles of the affected limb can often be observed. This is due to the fact that patients, sparing a sick leg, less and less try to load it.
The main characteristic feature of the 2nd stage is the development of deformation in the joint. Most often, patients can not completely unbend the bent leg. Palpator can determine the inconsistency of articular surfaces( with unilateral gonarthrosis when compared with a healthy leg) or sensation formation on both sides( bilateral gonarthrosis).
Glandarthrosis This stage is almost terminal during the course of the disease, and patients acquire a disability group( if they can not be operated on).
The pain syndrome acquires a permanent character and is not stopped by usual analgesics. Possible use of narcotic drugs( in the hospital).
Deformations become visible to the naked eye, and the volume of active and passive movements decreases significantly, down to total loss. Perhaps the development of X-shaped and O-shaped deformations.
In the affected joint, development of ankylosis is possible, which is why surgical correction of the pathology is indicated.
The articular cartilage completely disappears from the joint cavity. Friction of the articular surfaces becomes more palpable.
In some cases, the third stage of gonarthrosis is characterized by the development of blockade of the knee joint - a condition in which it is impossible to bend the leg or unbend it.
Such patients need joint replacement.
The diagnosis depends entirely on the patient's complaints, his history( life, work), as well as information obtained by examination and using instrumental methods.
During the general examination it is possible to reveal the expressed mismatch of articular surfaces. With palpation, local soreness can be felt( in the case when gonarthrosis of 1 degree, synovitis and bursitis occur).
During movement in the joints are guided by the noise of crackling or crunching during the movement.
In addition to the examination, it is necessary to determine the amount of movement in the joints. The volume of active movements is those movements that the patient can perform himself, and the passive ones with the help of a doctor.
Radiography of the affected joint and endoscopic examination were disseminated from instrumental methods. Radiography allows you to determine the condition of the joint gap, as well as to identify the developing areas of joint deformation. In order to determine gonarthrosis 1 degree, it is necessary to conduct the radiography in the first place. Intra-articular endoscopy allows to determine visual changes on articular surfaces. It should be remembered that endoscopy is an intervening cavity, and can damage the joint, as well as provoke an aggravation of the process.
Treatment of 1 and 2 degrees of gonarthrosis
Like any disease, gonarthrosis requires a certain approach in treatment. Properly selected therapy should organically combine non-drug methods, drug support and physiotherapy procedures.
If there is gonarthrosis 1, 2 degrees, they can be treated at home or in the hospital - with a significant exacerbation. It all depends on the individual characteristics of the patient and the clinical picture. Usually, folk methods and drug support are used for this.
When the patient complains of grade 1 gonarthrosis, the treatment will be performed on an outpatient basis and include symptomatic therapy - non-steroidal anti-inflammatory drugs( "Nimesulide", "Movalis") drugs and general measures - diet, hardening, vitamin therapy.
In the second stage of the disease, injectable anti-inflammatory drugs and analgesics( medicines "Diclofenac", "Tramadol"), as well as means for restoring the synovial fluid synthesis( "Hyaluronic acid" preparation) are added to the above listed preparations. Do not interfere and the means containing the components of the articular cartilage - drugs "chondroitin sulfate", "Don".
Treatment of 3 severity
With worsening of the condition and diagnosing "gonarthrosis of 3 severity", conservative treatment becomes mostly ineffective( possibly using narcotic analgesics).
To correct joint disorders, surgical treatment should be resorted, usually to joint prosthetics.
This operation allows you to replace both affected articular surfaces( femoral and tibial) bones. Indications for such an operation are persistent disruption of movements in the joint, as well as completely destroyed articular surfaces with loss of ability to walk.
In some cases( if the patient can not tolerate such an operation or if the patient refuses the prosthesis), it is possible to remove the formed bone outgrowths by means of an arthroscope-a device inserted into the joint cavity. This intervention is less traumatic and can be performed under local anesthesia.
Complications of gonarthrosis
In case of untimely diagnosis of the disease, some complications may develop. Among them, one can distinguish those that directly affect the affected limb, and those that will have an effect on the body as a whole.
Gonarthrosis 1 degree does not lead to the development of complications and is the most favorable form.
Local complications include the development of total ankylosis( the formation of a single fusion between the bones), gankrene of the shin and foot( may occur when the vessel falls between the affected bones and their adhesion to the compression of the artery).Possible infringement of passing nerves with development of an intensive painful syndrome and infringement of function of a finiteness.
To total complications include the development of osteochondrosis, scoliosis( due to improper load distribution on the limbs), muscle atrophy of the affected half of the body. Often there is a development of arthritis( due to the redistribution of the load) and herniated intervertebral discs. With the progression of total complications, involvement of internal organs is possible.
In some cases, pain shock may develop.
Prevention of gonarthrosis
Like any disease, gonarthrosis 1 degree is easier to prevent than cure.
The main preventive measures include a healthy lifestyle, proper nutrition( saturated with calcium, glucuronic acid, vitamin D), getting rid of excess weight, rejection of bad habits.
If possible, spend less time on your feet. Uniform distribution of workload and working conditions helps prevent joint overload and delay the development of the disease.
It is also necessary to consult a doctor more often in order to diagnose the disease in time and take early measures.
Treatment of concomitant diseases of the musculoskeletal system and metabolism is also important.
With all of the above measures, the likelihood of knee arthrosis is extremely low. A high risk, however, remains with a family history of a family history( if there were cases of development of the disease in close relatives).
Symptoms, treatment, features of arthrosis of the knee joint of the 1st degree
Osteoarthritis of the knee joint( gonarthrosis) is a chronic disease in which progressive destruction of the cartilage and deformation of the articular surfaces occur. According to the severity of symptoms, three degrees of ailment are distinguished. Minimal pathological changes and the most favorable prognosis are characterized by arthrosis of the knee joint of the 1st degree: timely start of the treatment at this stage not only stops the further destruction of the joint, but also allows to restore the already disturbed functions, to completely remove the pain sensations and return working capacity.
Unfortunately, at the time when full effective effective treatment of gonarthrosis is possible, patients turn to the doctor extremely rarely. As a result, the disease passes to the subsequent stages, where it is already impossible to achieve such a pronounced positive result, even with the use of the latest techniques and preparations. Delays in referring to a doctor are due to the following factors:
Patients associate symptoms they have with age-related changes. Indeed, in the aging process, physiological "wear" of the cartilage is noted, but such damage is insignificant, develop very very slowly and subjectively is almost invisible, that is, people should not feel them. After all, even in a very old age, the function of the joints is normally maintained at a level that is quite sufficient for normal movement. And if you have obvious painful signs - they need to be treated, otherwise after several years there is a risk of losing the ability not only to walking without a cane and crutches, but also to elementary self-service.
Symptoms of 1 degree of gonarthrosis are weakly expressed, present not constantly, then arising, or even disappearing. Patients do not pay attention to them, they forget. Nevertheless, they are quite distinct, and they can be seen when you care about your health.
Among other reasons for late treatment, there is a shortage of time for working patients to visit a doctor, difficulties with medical care( there are no specialized specialists in a number of polyclinics, or they can be accessed only by appointment, etc.).In this regard, you can say only one thing: you are responsible for your health first of all yourself. Find time, opportunity, address( at least for the first, preliminary reception) in private clinics or achieve free-of-charge reception. Believe that when it comes to 2-3 degrees, you will be forced to do the same, but the situation will be much more difficult.
Three degrees of arthrosis of the knee joint. Click on photo to enlarge
Causes of the disease
The initial degree of arthrosis of the knee joint develops due to the following factors:
Mechanical wear of the cartilage: with obesity, intensive physical exertion, incorrect weight distribution in case of deformities of the musculoskeletal system( scoliosis, flat feet).
Deformation of cartilage due to infection( arthritis, bursitis, after operations and injuries on the joint).
In case of metabolic disorders( for example, when salts are deposited with gout).
Symptoms of 1 degree of gonarthrosis
At 1 degree of ailment the same symptoms are noted, as in others - pain, dysfunction, knee deformity - but they are all insignificant.
Pain sensations at 1 degree are very weak. In contrast to the 2-3 degree of the disease, when the pain in the knee becomes unbearably excruciating, in the early stages, there are often transient weak aching pains or just discomfort in the knee. Pain and discomfort arise after excessive physical exertion( at the end of the working day, after sports, running, climbing the stairs), but at rest completely. Sometimes a sick knee whines in wet, windy weather.
. Disruption of
function. Minimal changes in cartilage, noted at 1 degree of gonarthrosis, are usually not accompanied by obvious violations of the knee joint function: the patient can walk, lean on the leg, bend and unbend the leg in the knee without experiencing pain. However, some stiffness in the joint is still there, and most of all it is noticeable in the mornings: after lifting from the bed it is difficult to move, squatting or bending the leg in the knee is accompanied by a crunch. During the day the joint is gradually being developed, and by the evening no one remembers the past difficulties.
There is no deformation of the joint at the initial stage of gonarthrosis, and it can be noticed only with a careful medical examination( measuring the circumference of the joints with a centimeter tape).A small puffiness around the knee and some smoothing of the relief of the knee joint appear in the evening, especially against the background of physical overwork.
A distinctive feature of the treatment of gonarthrosis 1 degree is the predominance of non-drug methods over medicamentous. Only chondroprotectors and topical agents with a warming effect are used. But quite toxic non-steroidal anti-inflammatory drugs( NSAIDs) are practically not prescribed, or they only resort to their local forms( ointments, creams, gels).The main emphasis in the treatment is on gymnastics, correction of physical activity, therapeutic diet.
Physical activity and gymnastics
Correction of physical activity - the need to limit the load on the joint. With degeneration and cartilage dystrophy, any loads accelerate the wear of the cartilage and injure the surface of the joint. Therefore, if possible, you should avoid long walking, carrying heavy loads, climbing uphill and on the stairs, squats.
In the course of medical gymnastics exercises are performed, not loading, but developing joints. These are all exercises with a foot "on weight": from positions sitting on a chair, lying, standing on a healthy leg. Movements in the leg should not be sharp. Pendulum-like flexion-extension, pivoting to the right and left, circular rotation in the knee are recommended.
In the diet of patients should not be fatty, fried, very sweet dishes, but it should contain enough foods rich in protein, vitamins and minerals. To feed the cartilage and strengthen its structure, it is recommended to take a cold or pour 1-2 times a week. The diet should contain fresh fruits and vegetables, herbs, and dairy products. High-calorie foods and meals are limited: flour, especially fancy foods, sweets, fatty foods( butter, lard).To prevent excessive deposition of salts in the joint and even greater deformation of the joint surfaces, it is desirable to abandon salted, marinated products and smoked products.
At any stage of development of gonarthrosis, drugs from the group of chondroprotectors( don, arteparone, mukartrin, teraflex, inoltra) are widely used. But it is at 1 degree that their effectiveness is proven: course taking( application to the skin, ingestion) of chondroprotectors stops the destruction of the cartilaginous tissue and prevents its further damage. Only a doctor should choose a chondroprotector.
In addition to chondroprotectors, with 1 degree of gonarthrosis, superposition of warming compresses, wraps and the use of waxes with a warming effect give a very good result. They stimulate blood circulation in the knee joint area, thereby improving cartilage nutrition. In addition, warming preparations for topical application produce an easy analgesic effect, which is quite sufficient for the relief of transient weak pains at grade 1 arthrosis.
As warming agents, alcoholic tinctures of hot pepper are used, home remedies based on mustard, honey, turpentine, camphor alcohol. Of the ready-made "pharmacy" drugs are popular means for snake venom( viprosal), finalgon, gevkamen, etc.
In conclusion, I want to remind once again that is delayed with treatment of gonarthrosis even at the initial degree in no case it is impossible! If you find yourself showing any signs of joint damage, contact the doctor immediately and, if necessary, begin treatment immediately, otherwise the disease will continue to progress.
Effective treatment of knee joint gonarthrosis
The structure of the knee joint of a person
Problems with joints are familiar to almost every second person on Earth. Modern methods of treating the disease help the body to mobilize its own resources, open new resources and be healed of such a disease as gonarthrosis of the knee joint. There are indications and contraindications for any kind of medication, as well as nuances, non-observance of which causes harm to health.
How to treat gonarthrosis of the knee joint and what effect does this or that medical preparation give? The pain can be successfully eliminated if the doctor has sufficient knowledge and can make a specific plan of treatment for the patient. Self-medication of joint ailments is unacceptable and entails dangerous consequences for the diseased organ.
Knee joint gonarthrosis is accompanied by numerous symptoms, characteristic of other diseases, so the specialist should always monitor the progress of treatment and the performance of prescribed procedures. The doctor who is treating the gonarthrosis of the knee joint 1 degree, assigns a complex of medical procedures to the patient, which contribute to the following important tasks:
- improvement of the cartilage nutrition process;
- elimination of pain symptoms;
- adjustment of pressure on the joint area;
- preservation of mobility of the cartilaginous joint.
Ointments and creams for the treatment of gonarthrosis
By setting a specific goal, a person seeks to cure the ailment with the help of ointments and anesthetic gels or creams. It is important to remember that anesthesia with ointments is a symptomatic treatment that can not eliminate the cause of the ailment, but which brings relief in an uncomplicated process.
Cartilage gradually deteriorates, resulting in destruction of the joint bones
Knee joint gonarthrosis is treated with warming ointments that improve blood circulation in the affected organ. When they are applied, the mechanism for reconstructing the blood filling of the cartilage tissues is triggered. For treatment use such preparations:
- "Fast Relief".
Therapeutic ointments have a therapeutic effect, penetrating through the skin. They pleasantly warm, soothe the skin. When using local anesthetics, the overall psychological mood of the patient is important. With the development of clinical manifestations of synovitis, the physician recommends that gonarthrosis of the knee joint be treated with ointments containing non-steroidal components.
- Indomethacin and turpentine ointments.
Treatment of gonarthrosis of the knee with non-steroid ointments is less effective because of insignificant penetration of the active substance to the diseased organ.
Application of chondroprotectors
Chondroprotector - drug that is injected directly into the joint
Quite often the doctor recommends that patients begin treatment with chondroprotectors, which restore the cartilage base and supply it with the necessary nutrients. The state of cartilage is well influenced by glucosamine and chondroitin sulfate. When the diagnosis of "knee joint gonarthrosis" is required not only to eliminate the symptoms of arthrosis, but also to work on the cause of the disease.
Glucosamine heals the cartilage surface, and also promotes:
- to improve the formation of synovial fluid;
- change and normalization of its qualitative composition.
Gonarthrosis 1 degree is treated very quickly and successfully if the doctor uses chondroitin sulfate and glucosamine. In more advanced cases, treatment with chondroprotectors is less effective due to the complete destruction of the cartilaginous tissue. In the second and third stages of knee joint gonarthrosis, chondroprotectors stop the development of the disease very slowly.
The course of therapy lasts 3 months, during which glucosamine or chondroitin sulfate is taken. To achieve a stable result, you need to undergo 2-3 courses of treatment. The funds prescribed by the doctor after the examination and diagnosis, help the patient to effectively combat the disease, especially with the disease of the knee joint 1 degree.
For therapy use monopreparations and combined means:
- "Chondroitin AKOS";
Popular Medication for Arthra Joints
Chondroprotectors do not have contraindications and only in case of individual intolerance cause side effects. Among them, most often there is an allergic reaction. There are also such symptoms:
Caution should be taken with biologically active additives containing glucosamine and chondroitin sulfate. They are not medical devices and can harm a person's health.
Treatment of joint damage 1 degree
If there are signs of gonarthrosis, treatment of joint fatigue and restriction of movements should be started as early as possible in order to obtain a quick effect. Medicinal products should fulfill the main therapeutic task - reducing the burden on the affected joint. Treatment of gonarthrosis of the knee joint involves diet food, exercise therapy.
To achieve maximum effect, the doctor suggests the patient:
- sanatorium treatment;
The medicamentous effect consists in the use of anti-inflammatory drugs, hormonal and anesthetic drugs, chondroprotectors. Anti-inflammatory drugs eliminate pain in the joint, reduce inflammation and promote faster recovery. The result of treatment depends on how the disease proceeds. Before prescribing NSAIDs, the doctor examines the patient's state of health, since these drugs are contraindicated for people with liver, kidney, stomach ulcer.
It should be remembered that anti-inflammatory drugs do not treat gonarthrosis, but only eliminate pain in the joint. Long-term therapy with drugs leads to a disruption in the supply of cartilage to water, exacerbation of the inflammatory process and destruction of the cartilage of the diseased joint.
Doctors recommend the use of drugs that have a selective effect, for example, "Movalis."This medicine has no dangerous side effects and does not destroy articular cartilage. It can be taken for a long time, but only under medical supervision, until the patient feels better.
Folk treatment for patients with joints
Phytotherapy of joint ailments can effectively remove inflammation of the hip and knee joints, eliminate pain attacks. Treatment of sawdust from pine, fir, spruce has a calming effect. These substances are used as an integral part of compresses that do not cause any harm, if there are no abrasions on the skin.
Nature is a universal healer, and preparations from laurel leaf relieve inflammation and treat sick joints no worse than medications. Collected herbs, carefully selected, used for articular ailments, using as infusions and broths. Treatment with folk remedies involves the use of sunflower. From his baskets, a medicinal ointment is made for rubbing into the patient's skin several times a day. Tincture of dried chestnut flowers on turpentine eliminates pain and deformity in the joint. She warms up the affected tissues well, relieves pain. During treatment, drafts must be avoided.
An effective remedy is the Caucasian hellebore and a drug based on it. After its use in patients, pain disappears, inflammation passes, joints are freed from salt deposits. Oil based on a resin, with the addition of ginger, juniper, propolis, relieves inflammation, removes puffiness and pain.
In case of joint diseases, it is useful to take medicinal sage preparations or to make triturate from turpentine turpentine, pork fat, iodine and aloe juice. Turpentine baths are used at 1 degree of arthrosis. They greatly facilitate the patient's condition. Before their application it is necessary to consult a doctor, as they are contraindicated in case of increased blood pressure, heart disease, after a stroke. In the period of exacerbations of the disease, the patient is also helped by coniferous baths, which relieve pain and muscle spasms. The fee for gonarthrosis includes:
- birch leaf;
- flowers of violets;
- nettle leaf.
Treatment of phytopreparations alleviates the condition of the patient 1.5 months after the start of treatment. Metabolic processes improve the collection of clover, linen and grass sabelnik. Patients should not wait for the full stiffness of the joint. They need to include a day of exercise for the joints, which are gentle. Do not exercise when exacerbated. The result is Nordic walking, which has a healthy character. Use a pedometer for lessons, gradually increasing the path to 10,000 steps per day.
For many years, the condition of patients helps to ease the saber. It suppresses the formation of salts in the joints, cleans the cells of accumulated toxins. From the grass, the plants are made to infuse, for 10 days, an ointment is used from the rhizomes and stems of the saber. Ointment is rubbed into sore spots and covered with a warm cloth. When the disease worsens, the treatment continues: a more vivid manifestation of the symptoms indicates an effective effect of the plant on the affected joint.
Treatment of gonarthrosis is long, symptomatic. To date, there are no highly effective drugs that affect the mechanism of the disease. Physiotherapy and medicines are the basis of complex treatment of joint diseases.
Gonarthrosis. Causes and degrees of gonarthrosis. Treatment of gonarthrosis
What is gonarthrosis
Gonarthrosis( arthrosis of the knee joint, osteoarthritis of the knee joint, deforming arthrosis of the knee joint) is a degenerative-dystrophic disease of the knee joint, characterized by progressive destruction of the cartilaginous tissue, deformation of the joint and a violation of its function. Gonarthrosis is widespread among elderly patients of , more often they suffer from women.
Reasons for gonarthrosis
Two main types of gonarthrosis are distinguished by pathogenesis. Primary or idiopathic gonarthrosis - the cause of the development of such an arthrosis is not known. Primary gonarthrosis is more common in elderly patients, mainly a bilateral process.
Secondary gonarthrosis - arthrosis of the knee, which arises as a result of the previous( or against the background) pathology of the knee joint ( knee joint injury , developmental disability, against infectious or systemic knee joint diseases, etc.).Secondary gonarthrosis occurs depending on the cause of its occurrence at almost any age, it is more often unilateral.
Stages of gonarthrosis
Clinically, there are 3 stages of gonarthrosis. The essence of the stages is reduced to describing the clinical manifestations of the disease and the degree of disruption of the knee joint function.
First stage gonarthrosis is characterized by initial manifestations of the disease. Patients at this stage are periodically disturbed by dull pain, at the back of the knee joint that appears after a long walk or other load on the joints. Sometimes the knee joints swell, after which the symptoms themselves disappear. Knee joints are not deformed at this stage.
Gonarthrosis of the second stage of is characterized by an increase in the symptoms that appeared in the first stage. The pain syndrome becomes more prolonged and intense. Patients mark the appearance of a crunch in the joint with motion of the knee. Many complain of stiffness in the joints in the mornings, which passes after a short walk. At this stage, patients periodically use analgesics. There is an insignificant limitation of flexion and extension in the knee joint. The joint is enlarged in volume.
Third stage gonarthrosis, is characterized by the greatest development of all the symptoms inherent in this disease. The pain syndrome acquires a practically constant character when walking and at rest. Often joint pain occurs when weather changes. Gait at this stage of the disease is severely impaired. Restrictions of movements in the joint are sharply outfitted. Visually the knee joint is enlarged in volume, deformed. There are X-shaped deformation of the knee joint - valgus and O-shaped deformation - varus.
Knee joint gonarthrosis 1, 2 and 3 degrees: treatment, causes, symptomsWhat is this - gonarthrosis is a non-inflammatory disease of the knee that disrupts the blood supply of cartilage covering the joint surfaces of the femoral and / or tibialbones. As a result, the cartilage is destroyed, the parts of the bones begin to rub against each other, as a result of which they become denser and expand. This is often accompanied by inflammatory phenomena. Symptoms of the disease are due only to the above processes;calcium salts, if they are deposited in the joints, the cause of the pathology is not. Pathology most often develops in individuals 40 years and older, mainly women and people who are engaged in professional sports or having knee injuries. Articular cartilage does not regenerate, so the disease must be detected and treated early in the early stages.
Causes of gonarthrosisThe disease develops with a combination of several causes:
- fractures of the bones of the lower leg involving the knee joint;
- trauma of the cartilaginous joints of the joint - meniscus;
- knee ligament tears;
- increased load on the joint - running, squatting, lifting weights from the vertical position of the body - after 40 years of age, especially if a person does not exercise regularly;
- joint inflammation( arthritis), which has a different - psoriatic, gouty, rheumatoid or reactive - etiology;
- genetically conditioned weakness of the ligamentous-capsular apparatus of the joint, because of which its looseness occurs;
- pathology of joint innervation, characteristic for craniocerebral and spinal cord injuries;
- metabolic disease.
- 1) Primary. It occurs against the background of full joint health( without pre-injury or inflammation).It is based on metabolic diseases, long reception of hormonal means, genetic predisposition of articular cartilage. The process is usually two-sided( although it can begin as one-sided).It develops more often in the elderly.
- 2) Secondary. Develops due to injuries, inflammations, tumors transferred to the joint operations. Can develop at any age. The process is usually one-sided.
Symptoms of gonarthrosis of the knee jointHow the disease manifests itself will depend on how far the degenerative process has progressed. Depending on this, three stages of the disease are distinguished, each of which has its own symptomatology. As a rule, the first degree of gonarthrosis of the knee joint is manifested by certain symptoms, which should be noted:
- feeling of tightening under the knee;
- stiffness in the knee, which manifests itself after sleep, prolonged sitting or prolonged immobility of the joint;
- joint pain:
- arising from prolonged walking, squats, walking on stairs;
- intensifying after standing or physical exertion
- joint swelling may occur for a short time, passes by itself.
- joint pain becomes more intense, lasts longer. It disappears after rest.
- pain is felt inside the joint or on the inside of the knee.
- there is a crunch in the knee when walking.
- in the morning it is impossible to unbend the knee.
- closer to night and at night there are pains in calves. The
- does not fully extend its leg.
- joint swells, acquires signs of initial deformation.
- 1) Pain in the joint worries constantly, regardless of the physical activity of the person.
- 2) Pain syndrome increases with changing weather.
- 3) The mobility of the joint is limited, due to which the person limps.
- 4) The knee is enlarged in size and deformed. When the process progresses, the joint becomes an X-shaped or O-shaped.
Diagnosis of gonarthrosisThe presence of gonarthrosis of the knee in a patient can be suspected even on the basis of his complaints and objective examination data. The diagnosis is confirmed with the help of such instrumental studies:
- 1) Radiography. This method may be uninformative at the first stage of the disease, but subsequently it visualizes the narrowing of the joint gap, the compaction of the bone zone below the articular cartilage, and the sharpening of the edges of the condyles.
- 2) Computed tomography of the joint. This is more expensive, but more informative( even at stage I) method based on x-ray radiation. Visualizes the joint itself and surrounding tissues in more detail and layer by layer.
- 3) Magnetic Resonance Tomography - a method based on a non-radiological, considered harmless radiation, which can be used for contraindications to CT.Also layer-by-layer displays the picture in the joint, but is more informative regarding the surrounding soft tissues.
- 4) Arthroscopy is an invasive technique for joint research when a fiber optic device is inserted into a hole made under local anesthesia, allowing a specialist to examine the joint from the inside.
- 5) Knee ultrasound is informative for the diagnosis of such complication of gonarthrosis as synovitis.
Treatment of gonarthrosis of the knee jointThe doctor involved in the treatment of this disease is an orthopedist. Drug therapy of the disease includes the following groups of drugs:
- 1) Non-steroidal anti-inflammatory and pain medications: Voltaren, Celebrex, Rofika, Nimesil, Movalis.
- 2) Chondroprotectors: "Artra", "Artron", "Dona", "Teraflex", "Chondroitin complex".These drugs are taken for at least six months in the dosage prescribed by the doctor.
- 3) Inside the joint with pronounced inflammatory phenomena, enter "Hydrocortisone" or "Kenalog" no more than 3 times.
- 4) The preparations of hyaluronic acid are shown, which must be injected into the joint when the inflammatory phenomena are abated in it: "Hyalurum", "Ostenil", "Sinocrom".These medications show a very good effect, they are administered only a few times, while having a fairly high cost.
- 5) Heating compresses with "Dimexid", "Bischofite", medical bile to improve the blood supply of the joint, increase the production of "lubricating" liquid in it.
- 6) The preparation on the basis of drawing from soya and avocado plants - "Piascladin" - has also established itself as an effective tool in the treatment of gonarthrosis of the knee joint. At the same time, the treatment course is not less than six months.
Physiotherapy for gonarthrosisIn an acute period a person needs to provide complete rest for a diseased knee. Then proceed to the gradual introduction into his regime of the day of physical exertion. Exercises are carried out in the position of the patient lying on his back, they consist mainly in lifting the straightened legs, keeping them in the raised position. It is important to perform exercises smoothly, carefully, so that they do not cause pain. Begin with 10 minutes, gradually, 2 minutes a day, increasing the duration of classes. Increase and the amplitude of movements, which should be selected by specialists individually for each.
Knee joint gonarthrosis - the development of the disease and its treatment
In the company of degenerative-dystrophic diseases of the musculoskeletal system, the gonarthrosis of the knee joint is one of the first places. For the first time gonarthrosis manifests itself after forty years, and women suffer this pathology somewhat more often than representatives of the stronger sex. Among predisposing factors, it is necessary to allocate excess weight, insufficient motor activity and knee arthritis in the anamnesis( arthritis of the knee joint, intraarticular fracture of the tibia or femur, rupture or sprain of the ligaments, menisci, hemarthrosis).
How the development of the disease occurs
The key role in the development of gonarthrosis is played not by the deposition of salts, as most of our audience mistakenly believe, but the dystrophic changes in the hyaline cartilage that covers the condyles of the femur and tibia.
Changes at the molecular level remain behind the scenes for a long time, but the cartilage gradually collapses, exposing the subchondral surfaces of the bones that form the knee joint. At some point, the hyaline cartilage becomes so thin that it ceases to perform its damping function, and soon it disappears altogether. As a consequence - the condyles of the bones are exposed, and this leads to their destruction.
Further, the body includes protective mechanisms, which leads to the appearance of tibia and the femur on the surface of bone growth, spines or osteophytes are formed. These deformations can already be determined with the help of palpation, they are clearly visible even during X-ray examination. Gonarthrosis passes into the stage of deforming arthrosis. The synovial membrane of the joint also suffers, an aseptic synovitis is attached, an exudate is formed in the cavity of the knee joint.
Depending on which stage of destruction and deformation the process has achieved, three degrees of gonarthrosis are identified. The clinical picture and complaints of the patient directly depend on the stage of the disease.
Degrees of gonarthrosis
Knee joint gonarthrosis of 1 degree is manifested by morning stiffness and minor pain in the affected joint. The patient notes that the pain occurs after a prolonged stay in a sitting or lying position, more often in the morning. It is worth it - and the pain subsides. The joint is not deformed at this stage, there are no external changes, mobility is not violated.
grade 2 knee arthroplasty requires more attention. The pains occur not only after sleep, but also due to prolonged exercise, the knee is already deformed, enlarged in volume, and an experienced specialist can determine an unnatural increase in the size of the joint surfaces. Often the patient complains of the inability to bend the leg in the knee "to the end", feels a crunch in the joint during movement.
X-ray, we can already see a vivid picture, in which the central place will be allocated to deformations of the subchondral bone sections and narrowing of the joint gap.
Knee joint gynarthrosis of the third degree shows the same symptoms, but only their severity increases many times. Pain becomes an integral part of the life of such a patient, it tortures him both during walking, and at rest, and even at night, preventing sleep. The function of the joint is severely impaired - the patient is unable to bend the leg in the knee even by 90 degrees, moreover, often he can not fully unbend it. Appears lameness, a person falls on the affected leg, or can not move at all without help. The deformation of the joint is visible to the naked eye, and on the x-ray we see a gross change in the structure of the knee joint.
Treatment of gonarthrosis of the knee joint is a long and complex process that requires the consolidated efforts of the doctor and patient. Because there is no inflammation in the joint, anti-inflammatory drugs will not give anything. A key role is given to the regime measures, such as physical therapy, massage, sanatorium treatment.
The patient, if, of course, he is trying to keep the joint, should perform a daily exercise complex in the morning, in the course of the day, take care of the joint as much as possible, and in the evening apply warming compresses to it. In the physiotherapy room, the patient can undergo a course of electrophoresis with medications that will calm the pain.
In case of severe deformity, surgical treatment is indicated, which consists in joint endoprosthetics.
Two-way gonarthrosis: diagnosis of the disease and its treatment
Most of us rarely pay attention to discomfort, periodic pain in the knee, writing off this for an old bruise. And in vain, this may well be the beginning of a very serious disease - gonarthrosis. This is called arthrosis of the knee joint, when the cartilage tissue undergoes changes and eventually loses mobility.
We used to think that such diseases are the destiny of the elderly. In fact, now the disease occurs at any age, although people more than 40 years old are more inclined to it. The reason is simple - changes in the cartilaginous tissue begin after knee injuries, which is very often the case with lovers of an active lifestyle. The cause may be an infection, a violation of blood supply in the presence of varicose veins, especially if there is excess weight.
Types of the disease
The disease manifests itself in different ways. For example, one leg may be affected - right-sided or left-sided, or two - then it is called bilateral gonarthrosis.
In its origin, gonarthrosis can be of two kinds:
- Primary - its victim is any healthy person. Too large, regular physical activity, age-related changes in cartilage, diseases with metabolic disorders, overweight. .. All this directly or indirectly leads to deformities. Primary gonarthrosis can be bilateral.
- Secondary gonarthrosis appears after an injury or other disease, for example - arthritis. Bad, incomplete treatment of one disease over time leads to its manifestation.
Both primary and secondary gonarthrosis eventually leads to pathological deformation of the cartilaginous, bone tissue of the knee joints, which greatly reduces their mobility, and without adequate treatment may eventually lead to disability.
The course of the disease
This disease does not begin immediately, it has certain clearly defined periods. They are divided into 3 degrees:
- 1 degree - knee joints can hurt sometimes after a long walk or running. Sometimes the knee can swell a little, but after rest everything passes. Although this is only the very beginning of the disease, but there is also a bilateral gonarthrosis of the 1st degree, with the defeat of both legs.
- 2 degree - even with a small load a person begins to feel a strong pain. Passing a small distance or raising a small weight for him becomes torture. It becomes heard a crunch when bending the knee, extension. The diseased knee becomes more healthy, the stiffness of movements appears. Two-way gonarthrosis of the 2nd degree is able to severely limit the life of a sick person.
- 3 degree - pain in the knee is almost all the time, regardless of whether a person is sitting or walking. Constant pain can prevent a person from sleeping. It is well noticeable that the joint is greatly enlarged compared to the healthy one. The deformation of the diseased knee causes a noticeable curvature of the legs. The joints at this stage are very limited in movement.
As a rule, the disease of 1 degree goes unnoticed - it does not bother the person, but to go to the reception because of a slight pain in the knee. .. Many people think this is just not serious, and are very mistaken - because to cure the disease at this stage can almost completely quickly.
To see a doctor usually get with gonarthrosis 2 degrees, as a rule - bilateral. The disease goes too far, causing irreversible changes in the joints, so you can not completely get rid of it - you can only move the offensive of the 3rd degree for a long time.
Diagnosis of the disease
Of course, in neglected form, you can visually determine the increase, deformation of the knee. But much more reliable methods of research work - radiography, ultrasound, computed tomography, MRI - magnetic resonance imaging. Any of these methods can show changes in the cartilaginous tissue, and even more so - bone growths around the joint heads.
For a complete diagnosis, the doctor will prescribe a blood test. Particularly help him analyze the rheumatoid factor. Other diagnostic methods are assigned more to clarify the individual characteristics.
Diseases of the joints - not one that can be treated independently. It is possible to be treated only under the control and on prescription of the doctor. Especially self-treatment is fraught with consequences in bilateral gonarthrosis, and even 2 degrees - you can aggravate the situation and become a complete disabled person.
The doctor will correctly assess the course of the disease, prescribe appropriate physiotherapy, treatment. Therapy is aimed at improving the blood supply to the sick leg, increasing its mobility. In addition, they can prescribe injections or tablets from a group of non-steroidal anti-inflammatory drugs - to reduce the inflammatory process, anesthesia. All this is quite effective when the disease is not started.
In severe cases, when the knee function is completely broken, it is severely deformed, causes permanent pain, the doctor can decide that surgery is necessary. Methods of surgical treatment are different - from the superposition of metal structures, to the replacement of its parts with artificial ones. In particularly difficult cases, the surgeon will replace the entire joint.
As you can see, the path from an untreated knee injury to such a serious illness as gonarthrosis is very small. So do not treat such "little things" scornfully. Any sore should be cured completely, then it will not have to receive such "surprises".