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 associated with 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 overload of the joint (for example, athletes, workers engaged in heavy physical work, ballet dancers), trophism (nutrition) of cartilage, as a result of the breakdown of cartilage tissue of the joint.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 happens in them 2 times more often than in the stronger half of humanity.Moreover, 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 this.As you know, cartilage tissue consists of approximately 70-80% water, thanks to which it is well absorbed.In addition, at a young age, "regenerative" cells, chondrocytes, work actively.With age, the amount of moisture begins to decrease and, therefore, the ability to soothe the joint deteriorates, the cartilage becomes dry, brittle and cracked, 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 excess weight, physical inactivity, 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,
- 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.
Very often, it is not possible to determine any 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 accompanying 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 can 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 lasts several months, or even years.The pain that comes to the fore is constant and aggravated by physical activity – walking, running, climbing or descending stairs, etc.Another characteristic symptom of this disease is the presence of salt in the joints, this can be a crack or crack in the knee.
Also very common manifestations of gonarthrosis are:
- increased local temperature (the joint is hot to the touch) or general,
- the presence of joint swelling,
- increasing its volume,
- difficulty moving,
- deformity of the joint with subsequent bending 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 in the bones that form the joint in the form of "grey bones" (osteophytes) and deforming arthrosis of the knee joint appears.Exudate appears in joint cavities.
Depending on the size of the osteophytes and the degree of deformation, several degrees of gonarthrosis are distinguished:
- Gonarthrosis of the first degree.Patients feel stiffness and mild pain in the joints in the morning or when sitting or standing for a long time.There is no joint deformation at this stage, mobility is completely preserved.An x-ray reveals a small osteophyte.
- Gonarthrosis of the second 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 increases, bending is difficult and a cracking sensation is felt when performing movements.X-ray shows a pronounced osteophyte, the key 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 during rest and sleep.The joint function is almost completely lost;patients can neither bend nor straighten the leg.As a result, lameness appears and movement becomes possible only with crutches or assistance.There is severe deformity 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 the treatment, you should seek help from a qualified rheumatologist and if he is not there, then from a therapist, as they are the ones who know how to cure knee arthrosis.Under no circumstances should you try to treat it yourself, this can only make an already bad situation worse.Before starting treatment, it is extremely important to make an accurate diagnosis, as accurate 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).Treatment is complex and includes drug and non-drug therapy, and in some cases surgical treatment is indicated.
Drug treatment of knee arthrosis is mainly aimed at relieving the main manifestations of the disease, such as:
- Pain;
- Inflammation of joints and periarticular tissues.
In addition to relieving the symptoms of the disease, medications are used to:
- joint tissue restoration,
- improving its trophism and blood circulation,
- strengthening the body's defenses,
- elimination of allergic reactions.
To relieve pain symptoms, various non-narcotic analgesics are used;in rare cases, narcotic sedatives are prescribed for a short time.The most 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.Medicines stimulate the activity of cartilage cells - chondrocytes and help them restore tissues.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 medicine is called "liquid prosthesis".After injection into an injured 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 the relaxing effect, they positively affect 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 the 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 knee arthrosis 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 beginning of the disease, physical stress on the affected joint should be kept to a minimum.You should not run, jump, lift weights, walk fast or sit down.Exercises for arthrosis of the knee joint can be performed only after completing a course of treatment, under the supervision of your doctor.
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 stretching exercises for ligaments and joint capsules.The rules here are the same, perform the exercises gently, without using any effort.
When performing any gymnastic exercise, it is important to follow some rules:
- Do not exercise during pain relief,
- If an exercise causes pain, then it should be replaced with another, gentler 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 expand, blood circulation improves and metabolism accelerates.Massage procedures improve lymphatic flow, and this, in turn, helps 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 experts have discovered 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 clear that the diet for arthrosis of the knee joint should be aimed at the gradual reduction of body weight.This will require a change in diet and a change in diet.Food should be lower in calories, fried foods and foods rich in fat should be excluded from the diet.Eat more vegetables, fruits and juices.
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 that this does not lead to overloading of the joints.Swimming offers the best effect and minimal stress on the joints.If you are involved in professional sports, you should use joint protection.It is useful to alternate physical activity with rest;you should not stand still 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 destroy the life of any person.