The inflammatory-degenerative process in the knee joint, gonarthrosis, occurs for various reasons. It has an extremely negative impact on a person's quality of life and sometimes leads to disability. How to treat arthrosis of the knee joint and prevent complications?
What is osteoarthritis?
About 22% of the world's population suffers from gonarthrosis, with women being affected more often. This insidious disease is characterized by rapid progression.
If treatment is not started in a timely manner, complete collapse of the knee joint may occur. This leads to impaired musculoskeletal function. Movement is only possible with the help of crutches or the person becomes hostage to a wheelchair.
The knee joint is the second largest after the hip and the most complex in structure. It allows you to bend and straighten your leg in different directions, promotes correct posture and coordination in space. This is a strong and stable joint that can withstand the weight of a person. Consists of 3 bones: the femur, the tibia and fibula, and the patella or kneecap. Includes osteochondral structures, muscles, ligaments and nerve fibers.
The disease begins with a violation of blood circulation and nutrition of the joint tissues. First of all, the cartilage suffers. The quality and quantity of synovial fluid, which is located in the joint capsule and contributes to the smooth functioning of the knee, decreases. Friction occurs between the joint parts. Gradually the cartilage tears and collapses. Unprotected bones begin to rub against each other. Pain occurs and a grinding noise is heard.
Causes of the disease
Older people, especially overweight women, are particularly affected. Hormonal changes cause severe wear and tear of the cartilage in the knee. Gonarthrosis of varying degrees occurs in more than 80% of people after 60 years.
There are other reasons for the occurrence of knee osteoarthritis:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part of it;
- Arthritis;
- Diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people who repeatedly perform physical work. This group also includes athletes, people with a sedentary lifestyle and people with unfavorable environmental conditions. Patients are often people who are addicted to toxic substances (drugs, alcohol, smoking).
The cause of joint deformation can be work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological diseases (fibroadenoma, endometriosis, uterine fibroids). Due to a lack of minerals and vitamins in the body, diet can be the trigger.
Stages and symptoms
Gonarthrosis can occur on one or both sides. Depending on the nature of the manifestations, the disease is divided into degrees:
- There are no obvious clinical signs at this time. After prolonged exercise, you may experience mild discomfort and pain that disappears after rest. The pain is noticeable in the morning, but with movement it disappears after a while. Grade 1 osteoarthritis is rarely diagnosed accidentally during a routine examination.
- Pain and stiffness in the knee increases. A person protects his leg and tries to put less strain on it. As a result, the muscles atrophy, the joint is deformed, a formation is noticeable, and the leg at the knee does not fully straighten.
- The pain is constant. The leg cannot be straightened or bent and the person finds it difficult to walk. There is a partial or complete loss of mobility. The cartilage is completely destroyed, the friction between the joint bones increases and osteophytes form.
In addition to the pain in the 2nd and 3rd degrees, a crunching noise can be heard in the knee. Fluid and pieces of cartilage tissue can accumulate in the joint capsule, causing swelling. At a late stage, the inflammatory process is pronounced, the knee joint becomes deformed.
diagnosis
If you have knee pain, you can contact your family doctor, who will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist if necessary.
To find out the causes and treatment of gonarthrosis, a comprehensive diagnosis is required:
- general and biochemical blood test;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- Arthroscopy.
An x-ray makes it possible to detect the condition of the cartilage and changes in the bones in stages 2 and 3. This involves a narrowing of the joint space, osteophytes on the edges of the patella, changes in the periosteum. Arthroscopy provides more detailed information about the meniscus, synovial membrane and the presence of fluid. This method is also used in the treatment of the knee to remove pieces of cartilage or meniscus.
Treatment of knee osteoarthritis
Therapy is lengthy and sometimes painful. Once occurred, the disease remembers you for the rest of your life. The main drugs used for treatment are non-steroidal anti-inflammatory drugs. Most often these are drugs based on non-steroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. Medicines are relatively inexpensive, but lead to the formation of ulcers and erosions in the stomach and duodenum. Modern medications cause fewer side effects, but are expensive.
Treatment measures in stage 1 include exercise-related preventative measures. Daily exercise, the use of a contrast shower, a swimming pool twice a week and combating increased body weight are required.
Stage 2 requires fixation of the joint - the use of an elastic bandage, bandage or orthosis. To relieve pain, NSAIDs are used in the form of creams and ointments. To reduce the degree of cartilage destruction, the patient is prescribed drugs from the group of chondroprotectors.
Severe severity requires oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. In addition, painkillers are prescribed.
A solution of hyaluronic acid is injected into the joint. It replaces the intra-articular fluid and nourishes the cartilage. When moving, it acts as a shock absorber for the joint. The manipulation is painful and is carried out by a doctor after the acute phase has subsided. If conservative treatment is unsuccessful, endoprosthetics is performed.
In addition to drug therapy, exercises using special simulators and devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered through subcutaneous or intramuscular injections, ozone-based ointments and creams. Manipulation stimulates blood circulation and enhances the effects of chondroprotectors and glucocorticosteroids.
Modern nutritional supplements are in demand as an alternative to drugs for joint restoration. Exercise therapy and massage are indicated. A set of special exercises improves blood circulation and nutrition of cartilage cells and increases the elasticity of the ligaments.
Complications and prevention
Destroyed cartilage tissue and deformed bones cannot be treated. In this situation, only surgery can help. No ointments or medications can restore cartilage. Medicines can only stop the process of destruction of cartilage tissue.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without appropriate treatment, the patient's condition quickly deteriorates. The knee cannot work, serious complications arise:
- joint deformity;
- cosmetic defect – curvature of a limb;
- Infection involving blood or lymph flow from another source in the body;
- due to the weakness of the ligaments, dislocations and fractures are observed even during normal walking;
- Bone fusion (ankylosis) occurs in the joint area, making movement impossible.
Complications arise if the patient does not seek medical attention in a timely manner and the disease has progressed. Regular preventive examinations and timely treatment of general diseases of the body will help prevent worsening of the condition and maintain the motor function of the limb.