The inflammatory-degenerative process in the knee joint, or gonarthrosis, occurs for various reasons. It has an extremely negative impact on a person's quality of life, sometimes leading to disability. How to treat arthrosis of the knee joint and prevent complications?
What is arthrosis
About 22% of the world's population suffers from gonarthrosis, and women suffer more often. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint can completely collapse. This leads to disorders of the musculoskeletal system. Movement is possible only with the help of crutches, or a person becomes a hostage of a wheelchair.
The knee joint is the second largest after the hip and structurally the most complex. It allows you to bend and straighten the leg in different directions, promotes correct body position and coordination in space. This is a strong and stable joint that can support the weight of a person. Consists of 3 bones: femur, tibia and tibia, as well as the patella or knee bone. Includes osteochondral structures, muscles, ligaments, and nerve fibers.
The disease begins with violations of blood circulation and nutrition of joint tissues. First, the cartilage suffers. The quality and quantity of synovial fluid, which is present in the joint capsule and contributes to the smooth functioning of the knee, decreases. Friction occurs between the connecting parts. Gradually, the cartilage cracks and collapses. Unprotected bones begin to rub against each other. Pain occurs and a crunching sound is heard.
Causes of the disease
It mainly affects older people, especially overweight women. As a result of hormonal changes, the cartilage in the kneecap wears down a lot. Gonarthrosis in varying degrees occurs in more than 80% of people after the age of 60.
There are also other causes of arthrosis of the knee joint:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of a meniscus or part thereof;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases for people who engage in repetitive physical work. This group also includes athletes, people who lead a sedentary lifestyle, and people with adverse environmental conditions. Often patients are people addicted to toxic substances (drugs, alcohol, smoking).
The cause of joint deformation can be work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine myoma). Because the body lacks minerals and vitamins, diet can be the cause.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. Depending on the nature of the manifestations, the disease is divided into degrees:
- There are no obvious clinical signs at this stage. After prolonged exercise, there may be slight discomfort and pain, which disappears after rest. Pain is felt in the morning when moving, after some time it passes. Grade 1 arthrosis is rarely diagnosed accidentally during a routine examination.
- Pain and stiffness in the knee increases. A person takes care of his leg and tries to put less stress on it. As a result, the muscles atrophy, the joint is deformed, a formation is felt, the leg does not fully extend at the knee.
- The pain is constant. The leg does not straighten or bend, and it is difficult for a person to walk. Partial or complete loss of mobility develops. Cartilage is completely destroyed, friction between the bones of the joint increases with the formation of osteophytes.
In addition to the pain, there is a crunching sound in the knee in grades 2 and 3. Fluid and pieces of cartilage tissue can accumulate in the joint capsule, causing swelling. In the late stage, the inflammatory process is pronounced, the knee joint is deformed.
Diagnostics
If you have knee pain, you can contact your local doctor, who will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist if necessary.
To find out the causes and treatment of gonarthrosis, a comprehensive diagnosis is required:
- general and biochemical blood analysis;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
X-rays allow you to see the condition of the cartilage and changes in the bones in stages 2 and 3. This is a narrowing of the joint gap, osteophytes along the edges of the patella, changes in the periosteum. Arthroscopy provides more detailed information on the presence of meniscus, synovial membrane and fluid. This method is also used in the treatment of the knee joint to remove pieces of cartilage or meniscus.
Treatment of arthrosis of the knee joint
Therapy is long and sometimes painful. Having appeared once, the disease reminds of itself for the rest of one's life. The main drugs used for treatment are non-steroidal anti-inflammatory drugs. Most often, they are drugs based on non-steroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They prevent inflammation and pain. The drug is relatively cheap, but causes ulcers and erosion of the stomach and duodenum. Modern drugs have fewer side effects but are expensive.
Treatment measures for stage 1 include exercise-related prevention measures. It requires daily exercise, contrast showers, use of the swimming pool 2 times a week and struggle with increased body weight.
In the 2nd stage, fixation of the joint is required - use of an elastic bandage, bandage or orthosis. NSAIDs are used in the form of creams and ointments to relieve pain. To reduce the degree of cartilage destruction, the patient is prescribed drugs from the group of chondroprotectors.
In severe cases, NSAIDs should be administered orally. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. In addition, painkillers are prescribed.
Hyaluronic acid solution is injected into the joint. It is a substitute for intra-articular fluid and nourishes the cartilage. When moving, it acts as a shock absorber for the joint. The manipulation is painful, it is performed by a doctor after the acute period subsides. If conservative treatment is unsuccessful, endoprosthesis is performed.
Together with drug therapy, exercises are prescribed using special simulators and devices (kinesitherapy). Ozone therapy has a positive effect on the condition of the road. The substance is used externally, administered by subcutaneous or intramuscular injection, ozone-based ointments, creams. Manipulations stimulate blood circulation, enhance the effect of chondroprotectors and glucocorticosteroids.
Modern nutritional supplements are in demand as an alternative to medication for joint restoration. Exercise therapy and massage are indicated. A complex of special exercises improves blood circulation and nutrition of cartilage cells, increases the flexibility of ligaments.
Complications and prevention
Destroyed cartilage tissue and deformed bones cannot be treated. Only surgery will help in this situation. No ointment or drug can restore cartilage. Drugs can only stop the process of cartilage tissue destruction.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without appropriate treatment, the patient's condition rapidly deteriorates. The knee cannot work, serious complications appear:
- joint deformation;
- cosmetic defect - limb curvature;
- infection with blood or lymph flow from another body source;
- due to the weakness of the ligaments, dislocations and fractures are observed, even during normal walking;
- fusion of bones (ankylosis) occurs in the joint area, making movement impossible.
Complications develop if the patient does not come to the doctor on time and the disease has progressed. Regular preventive examinations and timely treatment of general body diseases will help to prevent the deterioration of the condition and preserve the motor function of the limb.