In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint ranks first.
Gonarthrosis or osteoarthritis of the knee joint is a disease accompanied by a slow destruction of the cartilage tissue of the joint with the involvement of the entire joint in the pathological process, including ligaments, synovium, subchondral bone and other elements of the joint.
Under the influence of various factors, such as infectious diseases (colds, flu, typhus, tuberculosis, syphilis, tonsillitis and others), injuries, functional congestion of the joint (for example, in athletes, forced laborers, dancers)there is a violation of the trophism (nutrition) of the cartilaginous tissue of the knee joint, as a result, the cartilage becomes thinner and destroyed, sometimes until its complete disappearance.
Who is at risk? Firstly, knee arthrosis risks "winning" women over forty, twice as many as in the strong half of humanity. In addition, the risk increases in women who tend to be overweight or are obese.
But in general, gonarthrosis is a disease of the elderly. And there is a simple explanation for this. As you know, cartilage tissue is approximately 70-80% water, due to which it is well absorbed. In addition, at a young age, the cell's "restorative" chondrocytes are actively working. With age, the amount of moisture begins to decrease and, therefore, the ability to cushion the joint worsens, the cartilage becomes dry, fragile and cracks, and existing chondrocytes do not have time to repair the damage. In many ways, this explains the occurrence of gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors are overweight, physical inactivity, chronic joint injury or systematic joint microtrauma, alcohol abuse, chronic stress, previous or existing diseases in the knee joints, such as:
- knee arthritis,
- sprain, partial or complete rupture of ligaments,
- intra-articular fracture of the femur or tibia,
- metabolic disorders, such as gout and a number of other pathological conditions.
Often, it is not possible to establish a specific cause for gonarthrosis of the knee joint, in this case, it is a combined cause, that is, gonarthrosis was due to several diseases at the same time.
In addition, the disease, for reasons of occurrence, is generally divided into two forms: primary and secondary.
Primary arthrosis is caused by age and associated factors, such as:
- Professional predisposition,
- Excess,
- Obesity,
- Varicose veins of the lower limbs.
The cause of secondary gonarthrosis can be a previous injury to the knee (fracture, rupture of the ligamentous apparatus), called post-traumatic arthrosis of the knee joint. The same reason can be a previous infectious disease or inflammation of the knee joint.
Symptoms
Signs of arthrosis of the knee joint do not appear overnight, the development of the disease occurs gradually and usually takes several months or even years. The pains that are permanent and that increase with physical activity - walking, running, going down or climbing stairs and so on - come up. Another characteristic symptom of this disease is the presence of crackling in the joint, which can be clicked or clicked on the knee.
Also very common manifestations of gonarthrosis are:
- an increase in the local temperature (the joint is hot to the touch) or general,
- presence of joint edema,
- increasing its volume,
- difficulty in movement,
- joint deformity followed by limb curvature.
As the disease progresses, when cartilage tissue is completely destroyed, the body has no choice but to start defending itself. This is manifested by the proliferation of bone tissue over the bones that form the joint in the form of "spines" (osteophytes), a deforming arthrosis of the knee joint occurs. Exudate appears in the joint cavities.
Depending on the size of the osteophytes and the degree of deformation, various degrees of gonarthrosis are distinguished:
- Gonarthrosis grade 1.Patients experience stiffness and mild joint pain in the morning or when they sit or stand for a long time. There is no deformity of the joint at this stage, mobility is maintained completely. An X-ray reveals a small osteophyte.
- Gonarthrosis grade 2.Painful sensations appear, not only in the morning, but also after a prolonged effort, the joint is deformed, the joint surfaces are enlarged, as a result of which the joint volumeit is also increased, the flexion is difficult, a crack is felt when performing the movements. The X-ray shows a pronounced osteophyte, the joint space is not altered.
- Gonarthrosis grade 3.The manifestations are the same as in the second degree, only the symptoms become more pronounced. The pain is permanent, it does not stop even at rest and sleep. The function of the joint is almost completely lost, patients are unable to bend the leg or stretch it. As a result, lameness occurs, movement is only possible with crutches or outside help. There is a pronounced deformation of the knee joint. On radiography, a slight narrowing of the joint space is determined.
- There is also a fourth stage, in which there is complete immobility in the affected joint with additional deformation. On radiography, the phenomenon of sclerosis of the subchondral bone and a significant narrowing of the joint space are determined.
Treatment for knee arthrosis
To obtain good results with treatment, one should seek the help of a qualified rheumatologist, and if he is not, a therapist, as he knows how to cure arthrosis of the knee joint. In no case should you try to treat it yourself; this can only aggravate a situation that is no longer better. Before starting treatment, it is extremely important to make the correct diagnosis, as the correct diagnosis is the key to successful treatment.
The treatment of gonarthrosis is a very lengthy process and depends on several factors (type of arthrosis, cause of the arthrosis, degree of the disease). Treatment is complex and includes drug and non-drug therapy, and in some cases, surgical treatment is indicated.
The drug treatment of knee joint arthrosis has as its main objective the relief of the main manifestations of the disease, such as:
- Pain;
- Inflammation of articular and periarticular tissues.
In addition to relieving the symptoms of the disease, medications are used to:
- repair of articular tissue,
- improving your trophism and blood circulation,
- strengthening the body's defenses,
- elimination of allergic reactions.
Various non-narcotic pain relievers are used to relieve pain symptoms; in rare cases, narcotic pain relievers are prescribed for a short period of time. Most of the time, drugs from the group of non-steroidal anti-inflammatory drugs are used. They have a combined anti-inflammatory, analgesic and antipyretic effect.
Chondroprotectors are used to restore cartilage tissue and improve joint mobility. The drugs stimulate the activity of cartilage cells - chondrocytes, and help them to repair tissue. The intra-articular insertion of head protectors provides a good effect. In recent years, a new effective product based on hyaluronic acid has appeared. Due to its action, this medication is called "liquid prosthesis". Once injected into a diseased joint, this drug forms a protective film on the damaged cartilage and gradually restores the joint's normal lubrication characteristics.
Muscle relaxants are used to relieve muscle spasms, in addition to a relaxing effect, they have a positive effect on blood circulation in the affected joint.
Manual and physical therapy is widely used based on non-medicated methods of treating gonarthrosis. The most important are magnetotherapy, acupuncture, electrophoresis and massage, traction device (joint extension) and others. Recently, methods such as laser therapy and cryotherapy (exposure to liquid nitrogen) have entered the practice of treating arthrosis. Along with physical therapy, exercise therapy for osteoarthritis of the knee joint also has a good effect. Lfk is the use of various physical exercises for therapeutic purposes.
Gymnastics for arthrosis of the knee joint
At the onset of the disease, physical activity in the diseased joint should be minimized. You shouldn't run, jump, lift weights, walk fast, squat. Arthrosis exercises for the knee joint can only be performed after a course of treatment, under the supervision of your doctor.
It is necessary to choose exercises that help to strengthen the muscles and ligaments of the affected knee joint, but at the same time do not lead the joint to excessive mobility. That is, the exercises must be with minimal dynamic activity. It is useful to do exercises to stretch the ligaments and joint capsules. The rules are the same, the exercises are performed delicately, without using any effort.
When performing any gymnastics exercise, it is important to follow some rules:
- Don't exercise on pain
- If exercise causes pain, it should be replaced with a milder one.
The knee osteoarthritis massage has a beneficial effect on restoring the functions of the knee joint. At the site of exposure, blood vessels expand, blood circulation improves and metabolism is accelerated. Massage procedures improve lymphatic flow and this, in turn, helps to eliminate residual inflammation. Massage strengthens the muscular system, increases the flow of oxygen in them, improves gas exchange, normalizes their tone and increases plasticity.
Diet for knee arthrosis
Recently, medical specialists have discovered that there is no direct relationship between the incidence of gonarthrosis and nutrition. However, an indisputable fact is that the development of osteoarthritis is greatly influenced by the presence of excess weight in the individual. If the cause of the disease was overweight, then it is obvious that nutrition for osteoarthritis of the knee joint should aim at a gradual decrease in body weight. This will require a change in diet and a change in diet. Foods should be less caloric, fried foods and foods high in fat should be excluded from the diet. Eat more vegetables, fruits and fluids.
Prevention of knee joint arthrosis
For joints to stay healthy as much as possible, it is necessary to regularly practice physical culture and gymnastics, but not get too excited, so that there is no overload of the joints. Swimming provides the best effect and minimum stress on the joints. If professional sports are involved, joint protection should be used. It is useful to alternate physical activity with rest, you should not be stopped for long.
Compliance with all these simple rules, together with a healthy lifestyle and adequate nutrition, will not allow arthrosis of the knee joint to destroy anyone's life.