The knee joint is formed by a movable "tandem" of the tibia and femur.Their lateral displacement is prevented by the patella, and easy, gliding movement is ensured by an elastic layer of durable cartilage tissue.
The thickness of the "healthy" cartilage covering the articular surfaces of the bones of the knee joint is 5-6 mm.
This is enough to soften the mechanical friction of the bones and absorb the "impact" load.The disease leading to the destruction of the natural cushioning tissue and deformation of the joint - gonarthrosis or arthrosis of the knee joint has unpleasant symptoms and its treatment is often complicated by the initiation of a compensatory mechanism by the bone structures.
What triggers the disease?
There is an opinion that gonarthrosis of the knee is a consequence of "salt deposition".However, calcification or deposition of calcium salts in the ligamentous apparatus of the knee has no independent significance and is more a consequence than a cause.
What is gonarthrosis and how to treat it?
In fact, the "starting point" should be considered a violation of the blood supply of small bone vessels and its consequence - difficulties in the trophism of cartilage tissue and its exhaustion.This is followed by deformation of the hyaline cartilage.The latter exfoliates, covering itself with multidirectional cracks.The synovial fluid becomes more viscous and loses its properties as a natural "moisturizer" of the cartilage tissue.
The complete disappearance of the drying "shock absorber" can be called the end of the pathological process.
However, the underlying bones that have lost their cartilaginous "sheath" compensate for the loss by growing along the periphery and becoming covered with "spikes" - bony outgrowths.In this case, the knee joint is deformed, and the legs take on an X- or O-shape, which is why this pathology is also called deforming osteoarthritis of the knee joint (hereinafter referred to as DOA).
What are the causes of knee osteoarthritis?
- Aging of the body and the accompanying "wear and tear" of the joints;
- Excess body weight;
- Extreme loads on the knee joint (in athletes);
- Knee injury, breaking one of his bones;
- Meniscus removal;
- Untreated arthritis, rheumatism;
- Incorrect location of the bone components of the joint;
- "Failure" in the endocrine system and disharmony of hormones, metabolic imbalance.
Arthritis is often confused with various arthritis.
However, the difference between arthritis and arthrosis of the knee joint is that the former is often the result of various pathogenic agents entering the body, which "results" in inflammatory diseases of the whole body.
Sometimes the signs of arthritis - inflammation and swelling of the joint, swelling, pain that worsens at night - are the result of the immune system "unfolding" an active defense against the body's own cells.
Arthritis, as an exclusively local disease, often becomes a logical continuation of arthritis or a consequence of the gradual "wearing out" of the joint.
Primary and secondary gonarthrosis
In orthopedics and traumatology, the types of arthrosis of the knee joint are usually distinguished depending on the causes that led to degenerative changes in the articular cartilage.
- Age-related or primary gonarthrosisthe knee joint often disrupts the course of relatively painless old age due to the physical "wear and tear" of cartilage tissue.A little more often, compared to men, women who have crossed the 40-year mark are faced with this form of the disease.The earlier development of primary gonarthrosis endangers athletes and those with extra pounds;
- Secondary gonarthrosis- a logical continuation of a previous injury or a consequence of untimely treatment of inflammatory diseases, develops at any age.
Where is the disease hiding?
Gradually developing, gonarthrosis is localized in the inner part of the knee joint.However, the disease can "lurk" between the patella and the surface of the femur.
- Left-sided gonarthrosis often affects athletes and overweight people;
- People whose professional or sports activity is associated with excessive dynamic or static loads on the right leg are more susceptible to degenerative changes in the cartilage layer of the right knee joint;
- Bilateral gonarthrosis is often associated with age.Regardless of the causes, uncontrolled destruction of both knee joints in most cases leads to disability.
Oh, it hurts!
Signs of gonarthrosis of the knee joint are quite vague at the beginning of the disease, and few people will rush to visit a rheumatologist or an arthrologist if they feel pain in the knee after a long walk.
After all, a short rest and relaxation relieves unpleasant symptoms in a slightly "crunchy" knee, which gives a dubious feeling of physical well-being.
In fact, the "vague" symptoms of the first stages of degenerative diseases of the musculoskeletal system make their timely detection and treatment extremely difficult.Deforming gonarthrosis is no exception.
- Stage 1 gonarthrosis, manifested only by mild discomfort caused by fatigue of the limb, is extremely difficult to recognize on your own.The timely impetus to visit a doctor is often given by a dull pain in the knee and "crunching" of rough cartilages adhering to each other;
- Gonarthrosis of the 2nd degree creates conditions for deformation of the knee joint and makes it difficult to move it in the morning, which leads to the need to "diverge".Intense, long-lasting pain occurs after standing for a long time or sitting for a long time.Moderately limited mobility of the knee is accompanied by a crunch;
- The maximum signs of arthrosis of the knee joint appear in the third stage of the disease.A swollen knee, the local temperature of which is elevated, often hurts at rest.
The movement of the joint is blocked by sharp pain caused by "joint mouse" - fragments of broken bone growths.
A deformed joint loses stability and is difficult to move.Advanced disease at this stage requires prosthetics.
Can knee arthrosis be cured?
The well-known statement "Rest is not an end in itself, but a means to an end" is directly related to those facing the initial manifestations of the disease.Rest ensures maximum unloading of the knee joint during an exacerbation.For the same purpose, the use of individual orthopedic insoles is recommended.
The use of individual orthopedic insoles will provide maximum relief of the knee joint.
A kind of insurance against the disease, or rather against its exacerbation, will be special orthoses that maintain the stability of the "loose" knee joint in athletes.
The cane will help the elderly to "unload" their joints while walking.But the listed measures are more likely to prevent arthrosis of the knee joints.If such a "vaccination" did not help, and the aggravated gonarthrosis manifests itself with inflammation and pain, you should hurry to visit an orthopedist or an arthrologist.
How to treat gonarthrosis?
- Stage 1.Limit inflammation and accompanying pain.Nonsteroidal anti-inflammatory drugs used orally, intramuscularly, or intravenously will best deal with the "acute" problem.NSAIDs "sealed" in rectal suppositories will have a long-lasting effect.
The use of corticosteroids is also justified - they are "delivered" directly to the diseased joint.
Local use of ointments or gels with an active anti-inflammatory component will help to enhance the anti-inflammatory effect of NSAIDs used internally.The latter help to quickly relieve swelling.
Drugs that reduce vascular muscle tone are often prescribed together with NSAIDs.This improves peri-articular blood flow.
What to do with arthrosis of the knee joint, for example, for patients suffering from gastrointestinal diseases, for whom taking NSAIDs and painkillers is dangerous?
Oxygen therapy would be a good alternative.
- Stage 2."Feed" the dried cartilage with substances that stimulate the synthesis of collagen.Chondroprotectors intended for this purpose act slowly, but their long-term use promotes the synthesis of the natural components of the cartilage matrix.The greatest effect is achieved by intra-articular administration of drugs.
- Stage 3.We smooth out the "roughness" of the cartilage and reduce cartilage friction by introducing hyaluronic acid.
- Stage 4.We improve the blood supply and trophism of the joint with the help of physiotherapy.For this purpose, it is recommended to combine business with pleasure and undergo sanatorium-resort treatment.
- Stage 5.We turn to non-traditional methods of treatment: acupuncture and hirudotherapy, apitherapy.An innovation in the treatment of DOA of the knee joint is the intra-articular administration of Orthokine, a serum derived from the patient's blood proteins.
What are the right exercises to do?
Physical therapy will help slow the progressive destruction of the joint elements.Its main goals:
- improvement of blood supply to the joint and activation of trophism of all its components;
- increased mobility of the knee;
- increasing the tone of all the muscles of the human body.
Physiotherapy sessions, at least initially, are recommended to take place under the supervision of a physical therapy instructor.An experienced trainer will choose exercises that correspond to the level of mobility of the joints, excluding high-amplitude exercises and exercises with excessive axial load - everything that can damage the soft tissues of the joint and worsen the patient's condition.
Recipes from the green pharmacy: there are options!
Provides gonarthrosis and treatment with traditional methods:
- Option 1.Grind 120 g of garlic, 250 g of celery root and 3 lemons in a meat grinder.Place the mixture in a 3 liter jar and fill it to the top with boiling water.After leaving the composition overnight in a warm place, wrap the jar well, start taking it in the morning, consuming 70 grams of the medicine every morning.Gradually increase the intake up to 3 times;
- Option 2.Treat the affected joint with a mixture of 1 tbsp.l honey and 3 tbsp.l apple cider vinegar.A fresh cabbage leaf is placed on top (lightly tapped with a knife) or burdock (light side towards the joint).Wrap your leg in cellophane wrap and a soft scarf.Do it at night, up to 30 procedures.
An inevitable decision
Often, severe pain and joint dysfunction threaten with disability.
Then middle-aged patients, as well as young people diagnosed with arthrosis of the knee joint, need surgery.
The most common procedure is endoprosthesis.The duration of such an operation is no more than an hour, and its effect is painless functioning of the "restored" limb for at least 20 years.Over time, the "loose" prosthesis will have to be replaced.