In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint occupies a leading place.
Gonarthrosis or arthrosis of the knee joint is a disease accompanied by the slow destruction of the cartilage tissue of the joint, involving the entire joint in the pathological process, including ligaments, synovial membrane, subchondral bone and other elements of the joint.
Under the influence of various factors, such as infectious diseases (colds, flu, typhoid, tuberculosis, syphilis, sore throat and a number of others), injuries, functional congestion of the joint (for example, athletes, workers engaged in heavy physical labor, ballet dancers), the trophism (nutrition) of the cartilage tissue of the knee joint is disrupted, as a result of which the cartilage becomes thinner and destroyed, sometimes to the point of complete disappearance.
Who is at risk?First of all, women over forty are at risk of developing arthrosis of the knee joint; it occurs in them 2 times more often than in the stronger half of humanity.Moreover, the risk increases in those women who are prone to being overweight or obese.
But by and large, gonarthrosis is a disease of the elderly.And there is a simple explanation for this.As you know, cartilage tissue consists of approximately 70-80% water, thanks to which it absorbs well.In addition, at a young age, “regenerating” cells, chondrocytes, actively work.With age, the amount of moisture begins to decrease, and, consequently, the ability to cushion the joint deteriorates, the cartilage becomes dry, brittle and cracks, and the existing chondrocytes do not have time to repair damage.In many ways, this explains the occurrence of gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors include excess weight, physical inactivity, chronic joint injury or systematic microtraumatization of the joint, alcohol abuse, chronic stress, previous or existing diseases of the knee joint, such as:
- knee arthritis,
- sprain, partial or complete rupture of ligaments,
- intra-articular fracture of the femur or tibia,
- metabolic disorders, for example, gout, and a number of other pathological conditions.
Quite often, it is not possible to establish any one specific cause that caused gonarthrosis of the knee joint; in this case, they talk about a combined cause, that is, gonarthrosis was the result of several diseases at once.
Also, the disease, according to the reasons for its occurrence, is usually divided into two forms: primary and secondary.
The cause of primary arthrosis is age and the presence of associated factors, such as:
- Professional predisposition,
- Excess weight
- Obesity,
- Varicose veins of the lower extremities.
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 cause may also 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 often takes several months, or even years.The pain that comes to the fore is constant and aggravated by physical activity - walking, running, going up or down stairs, and so on.Another characteristic symptom of this disease is the presence of crepitus in the joint, this can be a cracking or crunching sound in the knee.
Also very common manifestations of gonarthrosis are:
- increase in local temperature (the joint is hot to the touch) or general,
- the presence of swelling of the joint,
- increasing its volume,
- difficulty moving,
- deformation of the joint with subsequent curvature of the limb.
As the disease progresses, when the cartilage tissue is completely destroyed, the body has no choice but to begin to defend itself.This is manifested by the growth of bone tissue on the bones that form the joint in the form of “spikes” (osteophytes), and 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, several degrees of gonarthrosis are distinguished:
- Gonarthrosis 1st degree.Patients feel stiffness and mild pain in the joint in the morning or during prolonged sitting or standing.There is no deformation of the joint at this stage, mobility is fully preserved.An x-ray reveals a small osteophyte.
- Gonarthrosis 2nd degree.Painful sensations appear not only in the morning, but also after prolonged exercise; the joint is deformed, the articular surfaces are enlarged, as a result of which the volume of the joint is also increased, bending is difficult, and a crunching sensation is felt when performing movements.The x-ray shows a pronounced osteophyte, the joint space is not changed.
- Gonarthrosis 3 degrees.The manifestations are the same as in the second degree, only the symptoms become more vivid.The pain is constant and does not subside even at rest and sleep.The function of the joint is almost completely lost; patients can neither bend nor straighten their leg.As a result, lameness occurs, and movement becomes possible only with crutches or assistance.There is severe deformation of the knee joint.An x-ray reveals a slight narrowing of the joint space.
- There is also a fourth stage, in which there is complete immobilization in the affected joint with further deformation.X-rays reveal sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of arthrosis of the knee joint
To achieve good results from treatment, you should seek help from a qualified rheumatologist, and if he is not there, then to a therapist, since they are the ones who know how to cure arthrosis of the knee joint.Under no circumstances should you try to treat it yourself, this can only worsen an already bad situation.Before starting treatment, it is extremely important to make a correct diagnosis, since correct diagnosis is the key to successful treatment.
Treatment of gonarthrosis is a rather lengthy process and depends on a number of factors (type of arthrosis, cause of arthrosis, degree of the disease).Treatment is complex and includes drug and non-drug therapy, and in some cases surgical treatment is indicated.
Drug treatment of arthrosis of the knee joint is aimed primarily at relieving the main manifestations of the disease, such as:
- Pain;
- Inflammation of the joint and periarticular tissues.
In addition to relieving symptoms of the disease, medications are used to:
- restoration of joint tissues,
- improving its trophism and blood circulation,
- strengthening the body's defenses,
- eliminating allergic reactions.
To relieve pain symptoms, various non-narcotic analgesics are used; in rare cases, narcotic painkillers are prescribed for a short time.The most commonly used drugs are from the group of non-steroidal anti-inflammatory drugs.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 restore tissue.Intra-articular administration of chodroprotectors gives a good effect.In recent years, a new, effective product based on hyaluronic acid has appeared.Because of its effect, this drug is called a “liquid prosthesis”.After injection into a sore joint, this drug forms a protective film on the damaged cartilage and gradually restores normal lubrication characteristics of the joint.
Muscle relaxants are used to relieve muscle spasms; in addition to their relaxing effect, they have a positive effect on blood circulation in the affected joint.
Among the non-drug methods of treating gonarthrosis, manual and physical therapy are widely used.Magnetic therapy, acupuncture, electrophoresis and massage, hardware traction (joint traction) and others are of greatest importance.Recently, the practice of treating arthrosis has included methods such as laser therapy and cryotherapy (exposure to liquid nitrogen).Along with physiotherapy, exercise therapy for arthrosis of the knee joint also gives a good effect.Exercise therapy is the use of various physical exercises for therapeutic purposes.
Gymnastics for arthrosis of the knee joint
At the onset of the disease, physical stress on the affected joint should be kept to a minimum.You should not run, jump, lift weights, fast walk, or squat.Exercises for arthrosis of the knee joint can be performed only after completing a course of treatment, under the supervision of your attending physician.
It is necessary to choose exercises that help strengthen the muscles and ligaments of the affected knee joint, but do not lead to excessive mobility of the joint.That is, exercises should be with minimal dynamic activity.It is useful to perform exercises to stretch the ligaments and joint capsules.The rules here are the same, perform the exercises gently, without using any effort.
When performing any gymnastic exercises, it is important to follow some rules:
- Do not perform exercises while overcoming pain,
- If an exercise causes pain, then it should be replaced with another more gentle one.
Massage for arthrosis of the knee joint has a beneficial effect on restoring the functions of the knee joint.At the site of exposure, blood vessels dilate, blood circulation improves and metabolism accelerates.Massage procedures improve lymph flow, and this, in turn, helps eliminate residual inflammation.Massage strengthens the muscular system, increases the flow of oxygen into them, improves gas exchange, normalizes their tone, and increases plasticity.
Diet for arthrosis of the knee joint
Recently, medical experts have found that there is no direct relationship between the incidence of gonarthrosis and nutrition.However, an indisputable fact is that the development of arthrosis is greatly influenced by the presence of excess weight in a person.If the cause of the disease was precisely excess weight, then it is obvious that nutrition for arthrosis of the knee joint should be aimed at gradually reducing body weight.This will require a change in diet and a change in diet.Food should be lower in calories, fried foods and foods high in fat should be excluded from the diet.Eat more vegetables, fruits and fluids.
Prevention of arthrosis of the knee joint
In order for the joints to remain healthy for as long as possible, it is necessary to regularly engage in physical education and gymnastics, but you should not get too carried away with this, so that this does not lead to overload of the joints.Swimming provides the best effect and minimal stress on the joints.If you are involved in professional sports, you must use joint protection.It is useful to alternate physical activity with rest; you should not remain motionless for a long time.
Compliance with all these simple rules, together with a healthy lifestyle and proper nutrition, will not allow arthrosis of the knee joint to ruin the life of any person.