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 stable cartilage tissue.
The thickness of the "healthy" cartilage that lines 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 "shock" load.A disease that leads to the destruction of the natural shock absorber tissue and the deformation of the joint - gonarthrosis, or arthrosis of the knee joint, has unpleasant symptoms and its treatment is often complicated by the release of a compensatory mechanism from 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 the 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 reality, 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 depletion.This is followed by deformation of the hyaline cartilage.The latter is exfoliated by being covered with multidirectional cracks.Synovial fluid becomes more viscous and loses its properties as a natural "moisturizer" of 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 "cover" compensate for the loss by growing along the periphery and becoming covered with "spines" - bone growth.In this case, the knee joint is deformed and the legs take an X or O shape, therefore this pathology is also called deforming osteoarthritis of the knee joint (hereinafter referred to as DOA).
What are the causes of knee arthrosis?
- Aging of the body and accompanying "wear and tear" of the joints;
- Excess body weight;
- Extreme load on the knee joint (in athletes);
- Knee injury, fracture of one of his bones;
- Removal of the meniscus;
- Untreated arthritis, rheumatism;
- Abnormal location of bone components of the joint;
- "Failure" in the endocrine system and hormone disharmony, metabolic imbalance.
Arthrosis is often confused with different arthritis.
However, the difference between arthritis and arthrosis of the knee joint is that the former is often the result of the invasion of the body by various pathogenic agents, 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 "putting on" an active defense against the body's cells.
Arthrosis, being 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 reasons that caused degenerative changes in the articular cartilage.
- Age-related or primary gonarthrosisthe knee joint often interrupts the course of old age relatively painlessly due to the physical "forgetting" of the cartilage tissue.A little more often, compared to men, women who have crossed the 40-year mark face this form of the disease.Early development of primary gonarthrosis threatens athletes and those with extra pounds;
- Secondary gonarthrosis– a logical continuation of a previous injury or a consequence of premature 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 "eavesdrop" between the patella and the surface of the femur.
- Gonarthrosis of the left side often affects athletes and overweight people;
- People whose professional or sports activities involve 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 age-related.Regardless of the reasons, uncontrolled destruction of both knee joints in most cases leads to disability.
Oh, it hurts!
The signs of gonarthrosis of the knee joint are quite vague at the beginning of the disease, and not many people will rush to visit a rheumatologist or 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 "crooked" knee, giving a dubious feeling of physical well-being.
In fact, the "vague" symptoms of the first stages of degenerative diseases of the musculoskeletal system make it extremely difficult to detect and treat them in time.Deforming gonarthrosis is no exception.
- Stage 1 gonarthrosis, manifested only by mild discomfort caused by fatigue of the limbs, is extremely difficult to recognize on your own.A timely impetus to visit a doctor is often given by a dull pain in the knee and the "chewing" of rough cartilage sticking to each other;
- Second-degree gonarthrosis sets the stage for knee joint deformity and hinders its movements in the morning, causing the need for "divergence."Intense and prolonged pain occurs after standing for a long time or sitting for a long time.Moderate limited knee mobility is accompanied by a cracking sound;
- The maximum signs of arthrosis of the knee joint appear in the third stage of the disease.A swollen knee, whose local temperature has increased, often hurts at rest.
Joint movement is blocked by acute pain caused by "joint rat" - fragments of broken bone growths.
A deformed joint loses stability and is difficult to move.An advanced disease at this stage requires a prosthesis.
Can osteoarthritis of the knee be cured?
The well-known statement "Rest is not an end in itself, but a means to an end" is directly related to those who face the initial manifestations of the disease.Rest ensures maximum unloading of the knee joint during an irritation.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 worsening, will be special orthoses that support the stability of the "loose" knee joint in athletes.
A cane will help seniors "unload" their joints while walking.But the measures listed are more likely to prevent arthrosis of the knee joints.If such a "vaccination" did not help, and aggravated gonarthrosis manifests itself with inflammation and pain, you should hurry to see an orthopedist or arthrologist.
How to treat gonarthrosis?
- Phase 1.Limit inflammation and associated pain.Non-steroidal anti-inflammatory drugs used orally, intramuscularly or intravenously will best cope with the "acute" problem."Locked" NSAIDs in rectal suppositories will have a prolonged 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 ingredient will help increase 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 periarticular blood circulation.
What should be done with arthrosis of the knee joint, for example, for patients suffering from gastrointestinal diseases, for whom taking NSAIDs and sedatives is dangerous?
Oxygen therapy would be a good alternative.
- Phase 2."Feed" the dried cartilage with substances that stimulate collagen synthesis.Chondroprotectors intended for this purpose act slowly, but their long-term use stimulates the synthesis of natural components of the cartilage matrix.The greatest effect is achieved by intra-articular administration of drugs.
- Phase 3.We soften the "roughness" of the cartilage and reduce cartilage friction by injecting hyaluronic acid.
- Phase 4.We improve the blood supply and trophism of the joint using physiotherapy.For this purpose, it is recommended to combine business with pleasure and undergo sanatorium-resort treatment.
- Phase 5.We resort to non-traditional treatment methods: acupuncture and hirudotherapy, apitherapy.An innovation in the treatment of DOA of the knee joint is the intra-articular administration of Orthokine, a serum obtained from the patient's blood proteins.
What are the right exercises to do?
Physical therapy will help slow the progressive destruction of the articular elements.Its main goals:
- improving the blood supply of the joint and activating the trophism of all its components;
- increased mobility of the knee;
- increasing the tone of all the muscles of the human body.
Physical therapy sessions, at least initially, are recommended to be performed under the supervision of a physical therapy instructor.An experienced trainer will choose exercises that correspond to the level of joint mobility, excluding high-amplitude exercises and exercises with excessive axial load - all that can damage the soft tissues of the joint and worsen the patient's condition.
Prescription from the green pharmacy: there are possibilities!
It offers 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 boiled water.After keeping the composition overnight in a warm place, wrapping the jar well, start taking it in the morning, consuming 70 grams of medicine every morning.Gradually increase the intake to 3 times;
- Option 2.Treat the sore joint with a mixture of 1 tbsp.l.honey and 3 tbsp.l.apple cider vinegar.Top with a fresh cabbage leaf (lightly scored with a knife) or burdock (light side towards the knot).Wrap the leg with a cellophane film and a soft scarf.Do it at night, up to 30 procedures.
Inevitable decision
Often severe pain and joint dysfunction threaten disability.
Then middle-aged patients, as well as young people diagnosed with arthrosis of the knee joint, require surgical intervention.
The most common procedure is endoprosthetics.The duration of such an operation is no more than an hour, and its effect is the pain-free functioning of the "restored" limb for at least 20 years.After a while, the "loose" prosthesis will have to be replaced.