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 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 fever, tuberculosis, syphilis, sore throat, and a number of others), injuries, functional overload 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 disturbed, as a result of which the cartilage is thinned and destroyed, sometimes to the point of complete disappearance.
Who is at risk?First of all, women over forty are at risk of developing osteoarthritis of the knee joint;in them it occurs 2 times more often than in the strong half of humanity.In addition, the risk increases in those women who tend to be overweight or obese.
But in general, gonarthrosis is a disease of the elderly.And there is a simple explanation for that.As you know, cartilage tissue consists of approximately 70-80% water, thanks to which it absorbs well.In addition, at a young age, the "regenerating" cells, the chondrocytes, are actively working.With age, the amount of moisture begins to decrease, and therefore the ability to soften the joint deteriorates, the cartilage becomes dry, brittle and cracks, and the 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 include obesity, lack of physical activity, chronic joint damage or systemic microtraumatization of the joint, alcohol abuse, chronic stress, previous or existing diseases of the knee joint, such as:
- knee arthritis,
- dislocation, 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 specific reason that caused gonarthrosis of the knee joint;in this case, they talk about a combined cause, that is, gonarthrosis is the result of several diseases at once.
Also, the disease, according to the causes of its occurrence, is usually divided into two forms: primary and secondary.
The cause of primary arthrosis is age and the presence of related factors, such as:
- Professional predisposition,
- Overweight
- obesity,
- Varicose veins of the lower extremities.
The cause of secondary gonarthrosis can be a previous injury to the knee (fracture, tear of the ligament apparatus), called post-traumatic arthrosis of the knee joint.The cause can also be a previous infectious disease or inflammation of the knee joint.
Symptoms
The signs of osteoarthritis of the knee joint do not appear overnight;the development of the disease is gradual and often takes several months or even years.The pain that comes to the fore is constant and gets worse with physical activity – walking, running, going up or down stairs, etc.Another characteristic symptom of this disease is the presence of crepitus in the joint, it can be a popping or crunching sound in the knee.
Also very common manifestations of gonarthrosis are:
- an increase in local temperature (the joint is hot to the touch) or general,
- the presence of joint swelling,
- increasing its volume,
- difficulty moving,
- deformation of the joint with subsequent distortion of the limb.
As the disease progresses, when the cartilage tissue is completely destroyed, the body has no choice but to start defending 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 1 degree.Patients feel stiffness and slight pain in the joint in the morning or when sitting or standing for a long time.At this stage, there is no deformation of the joint, mobility is completely preserved.X-ray reveals a small osteophyte.
- Gonarthrosis 2 degree.Painful sensations appear not only in the morning, but also after prolonged physical exertion;the joint is deformed, the joint surfaces expand, as a result of which the volume of the joint increases, folding is difficult, a crunch is felt when performing movements.On the X-ray, a pronounced osteophyte is visible, the joint space is not changed.
- Gonarthrosis 3 degrees.The manifestations are the same as in the second degree, only the symptoms become more pronounced.The pain is constant and does not subside even during 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.He has a severe deformity of the knee joint.An X-ray shows a slight narrowing of the joint space.
- There is also a fourth stage, in which there is complete immobilization in the affected joint with subsequent deformation.Radiography revealed sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of arthrosis of the knee joint
To achieve good treatment results, you should seek help from a qualified rheumatologist, and if he is not there, then from a therapist, since they are the ones who know how to treat knee arthrosis.In no case should you try to treat it yourself, it can only make an already bad situation worse.Before starting treatment, it is extremely important to make a correct diagnosis, because the correct diagnosis is the key to successful treatment.
Treatment of gonarthrosis is a rather long process and depends on a number of factors (type of arthrosis, cause of arthrosis, degree of the disease).The treatment is complex and includes drug and non-drug therapy, and in some cases surgical treatment is indicated.
Medical treatment of arthrosis of the knee joint is mainly aimed at alleviating the main manifestations of the disease, such as:
- pain;
- Inflammation of joint and periarticular tissues.
In addition to relieving the symptoms of the disease, drugs are used to:
- restoration of joint tissues,
- improvement of its trophic and blood circulation,
- strengthening the body's defenses,
- elimination of allergic reactions.
Various non-narcotic analgesics are used to relieve pain symptoms;in rare cases, narcotic pain relievers are prescribed for a short time.The most commonly used drugs are from the group of nonsteroidal anti-inflammatory drugs.They have a combined anti-inflammatory, analgesic and antipyretic effect.
Chondroprotectors are used to restore cartilage tissue and improve joint mobility.Medicines stimulate the activity of cartilage cells - chondrocytes and help them restore the tissue.Intra-articular application of hodoprotectors gives a good effect.In recent years, a new, effective product based on hyaluronic acid has appeared.Due to its effect, this medicine is called "liquid prosthesis".After injection into a diseased joint, this drug forms a protective film on the damaged cartilage and gradually restores the 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-medicinal methods for the treatment of gonarthrosis, manual and physical therapy are widely used.Of great importance are magnetotherapy, acupuncture, electrophoresis and massage, apparatus traction (joint traction), etc.Recently, the practice of treating arthrosis includes methods such as laser therapy and cryotherapy (exposure to liquid nitrogen).Along with physiotherapy, therapeutic gymnastics also has a good effect in knee arthrosis.Exercise therapy is the use of various physical exercises for therapeutic purposes.
Gymnastics for arthrosis of the knee joint
At the beginning of the disease, physical stress on the affected joint should be minimized.You should not run, jump, lift weights, walk fast or squat.Exercises for arthrosis of the knee joint can be performed only after completing a course of treatment under the supervision of the 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, the exercises should be of 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 carefully without making any effort.
When performing any gymnastic exercises, it is important to follow some rules:
- Do not exercise while you overcome the pain,
- If an exercise causes pain, it should be replaced by another, more gentle one.
Massage for arthrosis of the knee joint has a beneficial effect on the restoration of the functions of the knee joint.At the site of impact, blood vessels expand, blood circulation improves and metabolism accelerates.Massage treatments improve lymph flow, which 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 arthrosis of the knee joint
Recently, medical experts have established that there is no direct relationship between the incidence of gonarthrosis and nutrition.However, it is an indisputable fact that the development of arthrosis is strongly influenced by the presence of excess weight in a person.If the cause of the disease is 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 with a high fat content 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 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 as not to overload the joints.Swimming provides the best effect and minimal load on the joints.If you play professional sports, you should use joint protection.It is useful to alternate physical activity with rest;you should not remain still for a long time.
Observance of all these simple rules, along with a healthy lifestyle and proper nutrition, will not allow arthrosis of the knee joint to ruin the life of any person.