One of the common joint diseases is arthrosis, and in cases where degenerative-dystrophic disorders affect the knees, the disease is called gonarthrosis. How is gonarthrosis treated effectively? What are the symptoms of the disease in the early stages? Why does this pathology develop and what can be done to prevent this dangerous disease?
The nature of this disease is non-inflammatory in nature, and it begins due to impaired blood supply to cartilage tissue. Of patients seeking medical help with complaints of knee pain, 53% are diagnosed with one or another stage of gonarthrosis, so it is no coincidence that the disease occupies one of the leading positions in the world among all types of arthrosis.
What is it - gonarthrosis of the knee joint and what happens after a disruption of the blood supply in the small vessels that feed the cartilage? At the molecular level, there is a change in the structure of cartilage tissue, in particular hyaline cartilage. Degenerative changes begin with thinning and separation of the cartilage, which by the end of the second stage is completely destroyed and exposes the joints. They react to the loss of the “assistant” that provides them with support during movement, with compactions, displacement and deformation. This leads to an increase in the size of the joint not only due to deformation, but also as a result of the formation of osteophytes - bone growths with which the joint tries to replenish the missing cartilage tissue.
Often, gonarthrosis is complicated by synovitis - inflammation of the inner surface of the joint and the accumulation of fluid in it. Synovitis may appear from the very beginning, but in the early stages it often goes away on its own. But in the second stage it leads to severe swelling of the joint, and in the third it is constantly present, exacerbating pain.
Symptoms encourage timely treatment of knee gonarthrosis. But the main problem is that the overwhelming majority of patients attribute the discomfort and feeling of tightness under the knee to overwork, prolonged standing, and age.
Joint tightness occurs after long periods of rest, such as after sleeping all night in the morning or when trying to stand up after sitting for many hours. It is not for nothing that patients say that it takes them time to disperse, and after that the pain goes away and joint mobility is restored. But this happens only at an early stage of the development of the disease.
Without proper treatment, gonarthrosis progresses. Pain begins to appear more often, and then becomes a constant companion. When the knee moves, a characteristic crunch appears, the knee begins to bend less and less and over time completely loses mobility. Deforming gonarthrosis manifests itself in swelling of the joint and its complete immobilization, so a person is deprived of the ability to move independently - he has to use a cane, crutches or a wheelchair.
In some cases, the pain may subside in a lying position, in others, on the contrary, it occurs in the middle of the night, forcing the person to suffer and spend sleepless hours trying to relieve pain with the help of medications.
There are three stages of development of gonarthrosis, and each is characterized by a certain condition of the joints and the intensity of symptoms. We can say that the main symptoms at any stage of gonarthrosis are the same - pain and limitation of mobility, only as the pathology develops they intensify many times and are supplemented by new signs.
With the first degree of gonarthrosis, the legs get tired faster. They begin to be pulled, “brought together.” The limitation in the range of motion of the joint is barely noticeable. Visually, the pathology does not manifest itself in any way (there is no swelling, no displacement, no deformation of the joint), but on the x-ray there is already a narrowing of the joint space, albeit insignificant.
At the second stage of gonarthrosis, the characteristic crunch becomes clearly visible. Sharp pain appears when trying to bend or straighten the knee, as well as after a person has walked or stood for a long time. The photographs will show how the bones at the edges have “flattened” and begun to become overgrown with osteophytes, and the joint space has almost completely disappeared.
At the third stage of gonarthrosis, pain also occurs at rest. At this stage, the deformation of the joint is already noticeable not only to doctors, but also to surrounding people. The knee swells, increases significantly in size, the skin over it turns red and “burns.” A feeling of “jamming” appears - acute pain that does not allow you to bend or straighten the knee.
Despite the prevalence of this disease, its causes cannot always be accurately established. So, when it comes to primary gonarthrosis, it develops in old age. Women especially often complain of knee pain. Typically, primary gonarthrosis appears due to impaired metabolism and excess weight (reasons that are often interrelated).
Bilateral gonarthrosis is often primary. In this case, degenerative-dystrophic disorders occur in both knees. However, pathology begins to progress from one joint, gradually involving the second in the negative process.
Unilateral gonarthrosis is often caused by professional sports activities or excessive physical activity, as well as regular carrying of heavy bags, when their weight is transferred to only one leg.
There is a set of reasons for the development of secondary gonarthrosis:
In addition, the list of negative factors that increase the risk of developing knee gonarthrosis includes:
For effective treatment of gonarthrosis, it is important to correctly diagnose the degree of development of the disease, as well as establish the cause of its occurrence, in order to eliminate the “root of evil” if possible.
When diagnosing gonarthrosis, an integrated approach is used, including:
Unfortunately, it is impossible to effectively treat a chronic disease such as gonarthrosis without a course of medications prescribed by a doctor.
The first thing you almost always have to struggle with is eliminating pain symptoms. For this, various painkillers, anti-inflammatory drugs, and sometimes hormones are used.
An important element of the drug effect is chondroprotectors. These are drugs that help restore cartilage tissue at the cellular level. Only they cope with this task most effectively. Unfortunately, neither diet nor folk remedies can restore cartilage, especially if the cause of its destruction has not been eliminated.
An important point in the treatment and prevention of gonarthrosis, as well as many other diseases of the musculoskeletal system, is physical therapy. Exercises for gonarthrosis are selected individually for each patient, taking into account the degree of development of the pathology, general health, age and other factors.
Practicing a complex that is praised by Internet users can only be done as a preventive measure. If your knees are affected by arthrosis, then it is unacceptable to carry out additional experiments on them, because you can load the joints so much that you will only accelerate their destruction.
It is impossible to say unequivocally that “grandmother’s recipes” are nonsense and a whim, and all the “miraculous deliverances from gonarthrosis with the help of a magic tincture” described on the Internet are lies. The thing is that home remedies have a certain effect (improve blood circulation, strengthen the overall tone of the body, relieve swelling, etc.), but these results, unfortunately, are short-lived.
In addition, herbal tinctures or compresses from burdock leaves cannot penetrate deep into the cartilage tissue and restore their structure, so in no case should you rely on “treatment without side effects.” There will be an effect, and it will be negative - precious time is lost, the disease progresses, the pain intensifies, and it becomes more and more difficult to bend the knee every day.
Additional methods of treating gonarthrosis, which are also prescribed by a doctor, include:
Each method is aimed at eliminating certain symptoms - pain, swelling, inflammation, etc.
If the results that can be obtained using traditional treatment methods do not satisfy the attending physician, then the patient is offered alternative options. These include:
In cases where the affected joint needs help, various orthopedics are used. These can be all kinds of orthoses - special knee pads of a rigid design that limit the mobility of the injured joint.
Orthopedic treatment also includes special insoles (in the early stages and for prevention), as well as canes and crutches (in the final stages of the disease).
In advanced forms of gonarthrosis, as well as in situations where other treatment methods are powerless and the pathology continues to progress, almost completely destroying the joint, the patient is offered surgery - endoprosthetics. During it, the diseased joint is replaced with an artificial analogue.
This operation is very common and is successfully performed by Russian surgeons not only in capital clinics. True, you need to pay for it either out of your own pocket, or stand in line to receive a federal quota, and spend the entire waiting time in excruciating pain.
Gonarthrosis, like most other chronic diseases, is better to prevent than to then spend a lifetime on treatment, so simple recommendations will be useful for those who do not want to get destroyed joints by the age of 40.
It will not be possible to cure chronic gonarthrosis, but with timely treatment it can be stopped. Be more attentive to your body! Don't ignore the warning signs from your knees! And at the first suspicion, do not hesitate to visit the clinic.
Osteoarthritis of the knee joint is characterized by the process of destruction of the cartilage of the joint. Due to metabolic disorders, cartilage tissue does not receive the necessary nutrients and fluids, resulting in its degeneration.
Elderly people usually suffer from this disease. But, due to poor lifestyle, every year there is a tendency to diagnose the disease at an earlier age. The earlier arthrosis is detected, the more effectively it will be possible to cope with it at home, without resorting to drug or surgical treatment.
The main reasons that can trigger the pathological process are:
Deforming arthrosis of the knee joints develops gradually as the functioning of the intra-articular cartilages lining the surface of the condyles of the femur and the articular surfaces of the patella and tibia is disrupted. This condition is a consequence of circulatory failure in the knee joint.
As a result, the lack of necessary nutrients for the cartilage leads to its drying out, delamination and destruction. With thinning or complete disappearance of hyaline cartilage, bone tissue becomes denser, forming compensatory growths along the periphery.
Clinical manifestations of gonarthrosis are very diverse and, depending on the degree of damage to the joint, can be more or less pronounced. The following symptoms can confirm that there is arthrosis of the knee joint:
A person must clearly understand that the later he begins treatment, the more difficult it will be and the higher the risk that joint replacement surgery will be required.
In this case, the disease is characterized by minor pain when performing active movements. Synovial fluid may accumulate in the joint cavity, leading to the formation of a Baker's cyst. Pain occurs during movement, but immediately goes away at rest. The cartilage tissue is damaged, but externally the deformation of the joint is not noticeable.
It is difficult to make a diagnosis using radiography at this stage of arthrosis development; additional examination methods are required.
The joint space narrows and the cartilage tissue is damaged to a significant extent. In the X-ray image, bone growths can be seen. Acute pain is accompanied by any movement in which the knee joint takes part. At rest, the unpleasant sensations disappear, but then appear again. The pain is accompanied by a characteristic crunching sound when performing flexion-extension movements.
Gradually, the function of the joint becomes impossible. The knee stops bending and straightening. Externally, the doctor can determine bone deformation.
In some places, the cartilage tissue becomes completely thinner, and exposed areas of bone are formed. The X-ray image clearly shows a large number of osteophytes - salt deposits in the joint cavity. In addition, loose bodies may be found there.
External changes are becoming more and more noticeable. It is no longer possible to cope with the pain by stopping movements. It persists both during physical activity on the joint and at rest.
The diagnosis of gonarthrosis is based on a patient interview, examination and radiography of the affected joint. Sometimes the doctor prescribes an ultrasound of the joint to the patient; less often, a tomography or computed tomography scan of the affected knee is performed. In doubtful cases, the doctor can use a puncture to take a sample of the synovial fluid located in the joint cavity for examination, however, as a rule, this is not necessary.
Many joint diseases have very similar manifestations and symptoms to a layman. Therefore, only a specialist can understand the situation and make the correct diagnosis of arthrosis of the knee joint. Accordingly, if any signs of a knee joint disease appear, there is no need to engage in self-diagnosis and self-medication; you should consult a doctor as soon as possible. Diagnosis and treatment of arthrosis of the knee joint (gonarthrosis) is carried out by a rheumatologist or arthrologist.
There is no single treatment regimen for gonarthrosis, just as there is no one medicine that would help all people equally. When planning treatment tactics, the doctor takes into account the age and condition of the patient, the stage of the disease, the severity of the pain syndrome and the degree of joint deformation.
Combination therapy is very important in conservative drug treatment, so it is necessary to combine treatment so as to solve several problems at once:
Therefore, the main methods of treating arthrosis are:
The author's methods of treating gonarthrosis include:
They have different principles of action, but without exception, they have all proven themselves to be effective ways to support knee joints affected by gonarthrosis. Unfortunately, we are not talking about a complete recovery.
In recent years, modern methods of treating arthrosis of the knee joint have become increasingly popular, which can be used in combination with drug therapy and as independent therapy. In some cases, they can replace or be combined with medication.
New methods of treating arthrosis of the knee joint:
Kinesitherapy can significantly prolong the activity of damaged tissues and stop the progression of the disease. This technique is based on individual selection for each patient of a set of so-called “correct” movements, which can be performed by the patient independently or using special multifunctional simulators and devices. Performing these exercises involves not only the muscles, but also helps to normalize the functions of ligaments, tendons, nerve endings, cardiovascular, respiratory, digestive and endocrine systems.
Kinesitherapy promotes the production of substances in the body such as endorphins, which can have an analgesic effect and have a beneficial effect on the patient’s psycho-emotional state. Individual exercises, affecting the muscles, allow you to:
Ozone therapy, which is gaining increasing popularity in the treatment of arthrosis of the knee joint, is characterized by ease of use, high efficiency, minimal side effects and good tolerability.
Ozone therapy can be used:
A set of ozone therapy measures is selected individually for each patient. Parenteral administration of ozone has a more pronounced effect and has a number of therapeutic effects:
Glucocorticosteroid drugs and chondroprotectors can be used in parallel with ozone. This combination enhances the healing properties of these drugs and reduces their negative effects on cartilage.
To relieve pain, gas is injected into the area around the pathological focus or directly into the pain points, as well as inside the joint. The number of points for subcutaneous ozone injection may vary depending on the condition of the knee joint; From 2 to 12 ml of ozone is injected into one point.
In parallel with the intra-articular administration of ozone, patients are prescribed intravenous infusions of ozonized 0.9% sodium chloride solution (about 400 ml daily). As a rule, a course of ozone therapy consists of 10-12 intravenous injections and 5-7 intra-articular injections. After just 3-4 procedures, the patient’s mobility of the affected joint improves and pain is significantly reduced. The clinical effect of ozone therapy can last for 4-9 months.
When the functioning of the joint is clearly impaired and conservative treatment does not help, surgical intervention is used. But it comes to this extremely rarely. The affected joint can be replaced with an artificial one (endoprosthetics). But more often it is used at stage III.
The axis of the limb is restored or bone changes are removed (osteotomy). Arthroscopic intervention is performed through skin punctures. Through punctures in the knee, destroyed cartilage is removed from the joints. Then medications are administered.
Any treatment option for arthrosis of the knee joint should only be carried out as prescribed by a doctor. Therapeutic gymnastics involves slow, measured exercises that exclude squats, twisting of the joint, and jumping. It is best to do gymnastics in the morning, sitting or lying down, for 20 minutes, repeating each exercise 10 times.
The main objectives of therapeutic exercises are to relax muscle spasms that cause pain, increase blood supply to the joint, slow down the progression of the disease, and prevent further destruction of cartilage. During the period of exacerbation of the disease, physical exercise is prohibited.
Using the method of blows (through the palm, fingers, slaps) at home, you can work on a sore knee joint. It is important to know how certain movements affect the deforming joint:
Complex treatment of this disease includes, in addition to the methods described above, also a strict diet. It requires an adequate approach. There is no need to go to extremes. But there are a number of restrictions that will have to be taken into account:
A dietitian will help you balance your diet. For example, here are a number of foods that you can eat, and this is even welcome with such a diagnosis. First of all, these are products containing chondoprotectors and collagen; they are the building blocks for bones, cartilage, and ligaments. Your diet should include broth made from beef, especially bones. The presence of jelly, aspic, and jellied meat in the menu is welcome.
Many people have felt pain in the knee joint. But if it passes quickly, then this fact does not cause much concern. But this may be the first signal about the beginning of a terrible disease - deforming arthrosis of the knee joint.
If such painful symptoms begin to become frequent and noticeably worse, this should be a signal for a visit to an orthopedist. With this disease, pain occurs spontaneously, without any reason. There is no way to neglect the disease, as it is quite difficult and time-consuming to treat. If you miss the moment and do not see a doctor in time, you can wait for disability. Arthrosis in an advanced state is quite difficult to treat.
The disease is more common in older people; women during menopause are most susceptible to it. But recently, doctors from all over the world have been sounding the alarm that the disease has become significantly younger. And at an appointment with orthopedists, you can meet young people aged 30-35 years who show similar signs.
Deforming arthrosis of the knee joint in its initial stage does not have specific symptoms. It can be:
The latest signs indicate that the disease is already progressing and urgent medical attention is required. The disease itself does not tend to develop rapidly. At first there is slight pain or even swelling, which is most often attributed to fatigue. This is easily explained by the fact that there are no nerve endings in the knee cartilage. The disease manifests itself at a later stage, when the signs are already pronounced or even visible to the naked eye. Usually this is the third stage of the disease and a person, unable to endure the pain, is forced to consult a doctor.
The disease has three stages, which are characterized by the described signs.
Only a professional doctor can accurately diagnose the stage of the disease.
There is no point in trying to cope with the disease on your own. Self-medication will lead to dire consequences and can simply put a person in a wheelchair.
After diagnosis, the attending physician prescribes treatment, the outcome depends only on the desire and conscientiousness of the patient. The disease can progress on one leg. But, when treating the right joint, it is necessary to take care of the left leg. This disease can affect paired parts of the body. The first and second stages are treated with various drugs, the third stage requires surgery.
The first thing the patient needs to do is take care of proper nutrition and slightly increase physical activity on the legs. This is neither working out in the gym or on the treadmill. Walking, quiet walks are quite acceptable both during treatment and for the prevention of both left and right joint arthrosis.
Drug treatment provides pain relief. Improving blood circulation, restoring cartilage tissue, improving metabolism. Doctors prescribe the following drugs as treatment:
Treatment is accompanied by a complex of physical therapy to avoid muscle atrophy and help improve blood supply. Massage and physiotherapeutic procedures play an invaluable role in complex treatment.
The disease may recur after some time, so most orthopedists recommend annual wellness trips to specialized sanatoriums.
Traditional medicine knows many recipes for the prevention and treatment of arthrosis. But, do not forget that the prescription and introduction of traditional medicine drugs into the treatment complex can only be done by the attending physician. Compresses, herbal baths, and mud wraps will have the completely opposite effect if you do not follow the recommendations of your doctor. For these purposes you can use:
Each experienced orthopedist has in his arsenal many recipes that are designed for a specific case and degree of disease. Therefore, when prescribing treatment, he himself can advise which folk recipes will help in this particular case.
Gonarthrosis is a progressive disease in which the cartilage tissue of the knee joint, which protects the bone structures from damage, is destroyed.
Gonarthrosis of the knee joint is among the five most common diseases of the musculoskeletal system. Symptoms of gonarthrosis are observed in 20% of the population over 40 years of age, with grade 2 gonarthrosis of the knee joint being the most common. The fact is that at stage 1 the symptoms of the disease are almost not expressed: the mobility of the knee is not limited, and few people pay attention to mild pain. Destruction of the joint to the 2nd degree causes severe discomfort in a person, which forces him to seek help from a rheumatologist.
With grade 2 gonarthrosis, a person is bothered by frequent and constant pain that occurs both after minor physical exertion and after a long rest. While with grade 1, pain appears only after prolonged physical activity, and manifests itself quite weakly. Another characteristic sign of stage 2 joint damage is an audible crunch and clicking sound when walking, bending a leg or other movements that occur due to depletion of cartilage tissue. In general, the symptoms of the pathology cause the patient significant discomfort and significantly reduce his quality of life.
It is impossible to completely cure grade 2 gonarthrosis. But there are available therapy methods that can relieve unpleasant symptoms and give a person the opportunity to lead a full life. What kind of treatment is this - read further in the article.
Stages of gonarthrosis and destruction of the knee joint: above - a schematic image, below - an x-ray. Click on photo to enlarge
Normally, our joints work smoothly and silently during various movements - due to the fact that they have elastic cartilage, which is constantly washed by a special “lubricant” (synovial fluid).
With gonarthrosis, cartilage tissue is destroyed and cannot fully perform its shock-absorbing function. The pathology progresses very slowly and does not bother a person for a long time, so the curable first degree of the disease often goes unnoticed.
The main cause of grade 2 gonarthrosis is ignoring the first symptoms of the disease and late contacting a doctor (rheumatologist) already at the stage of serious joint destruction, which causes severe pain and interferes with normal movement.
Gonarthrosis of the 2nd degree (bypassing the first) can occur immediately after a serious injury.
Also, if the patient ignores the causes of the 1st degree, they are also the causes of the 2nd degree of the disease:
Arthritis is one of the causes of gonarthrosis
At stage 2 of the disease, the vessels in the affected area are already so worn out that the cartilage tissue receives a minimal amount of nutrition and oxygen. This is why the following symptoms appear:
The characteristic distinctive symptoms of exactly 2 degrees of gonarthrosis are: the first signs of deformation of the knees, damage to both knee joints is possible.
Knee deformity due to gonarthrosis
Treatment of grade 2 gonarthrosis is carried out exclusively by conservative methods. According to reviews from doctors and patients, a well-designed course of therapy and strict adherence to prescriptions give positive results in 50% of cases: pain completely disappears, swelling subsides, and normal joint movement becomes possible.
Therapy includes five methods:
(if the table is not completely visible, scroll to the right)
1. Treatment with non-steroidal anti-inflammatory drugs. Examples of drugs:
Effectively relieves pain, allows a person to move normally and eliminates tissue inflammation.
2. Treatment with chondroprotectors: glucosamine and chondroitin sulfate.
Restores cartilage tissue.
3. Physiotherapeutic procedures: electrophoresis, magnetic therapy, laser.
Physiotherapy delivers medicinal substances directly to the affected area, and the drugs act quickly and effectively.
4. Physical therapy.
Restores blood circulation, improves joint mobility. Goes very well with physiotherapeutic procedures.
Arthritis deformans belongs to a group of dystrophic diseases that develop as a result of a violation of the principles of cellular nutrition of the joints.
Anatomical changes can be found in the knee joint in the cartilage, which changes its structure, it becomes thinner and may even disappear completely, thus exposing the bone.
The changes affect the peripheral parts of the joint, and with deforming arthritis they always go in parallel with regenerative processes in the cartilage and joints.
However, the deformation of the knee joint still develops upward, that is, it increases and increases. Thus, secondary deformations quickly begin to join the primary deformations.
Here you can also observe the beginning of the appearance of stretching of the joint capsules, as well as dislocation of the knee joint or subluxation.
In principle, the majority of patients diagnosed with arthritis deformans are elderly, but the disease can occur in some cases in young patients.
When considering the problem, it is necessary to take into account that the deforming type of arthritis has several types:
Most often, monoarthritis affects large joints, such as the hip, or damage to the knee or shoulder joint.
As for polyarthritis, as we have already said, several joints are damaged, but mainly small ones, for example, the joints of the fingers and toes, and the wrists.
Until now, scientists and doctors have not been able to fully study the issue of the occurrence of deforming arthritis, and its origin remains a mystery.
There are several prerequisites:
A correct diagnosis of deforming arthritis in the knee joint can be made with great accuracy using radiography or CT scanning.
Hardware diagnostic methods show a complete picture of all processes in the joint.
Timely identification of the problem is extremely important for the patient, since this type of arthritis is disabling and seriously reduces a person's quality of life, so treatment must be timely.
Unfortunately, at an early stage of the development of the disease it is almost impossible to detect it, since arthritis has a hidden course.
As a rule, the patient complains of immobility and pain in the joint. Stiffness in the knee joint is often noted, and this condition is observed not only in the morning, but also after simple short-term rest.
Further symptoms with the development of the disease can be displayed as follows:
If you do not start timely treatment, the disease will only progress, and the speed of deforming processes will also increase. Most changes in the knee joint will be irreversible.
At the same time, the development of this type of arthritis does not lead to an increase in body temperature, and when conducting a biochemical blood test, only small changes can be noted, for example, the ESR level increases.
Arthritis deformans has three degrees of damage. In the first stage, there is only a slight limitation of mobility, so often such occurrences are ignored by patients, which leads to the development of the second degree.
In the second degree, pain may begin to appear in the area of the knee joint after physical activity. It is here that it is necessary to begin urgent treatment, as the first deformation processes in the knee begin.
At the third degree, all manifestations are already bright. The pain is severe, movements are constrained, and the deformity is visible to the naked eye.
It is the third degree that leads to disability if treatment is not started, since many processes in the deformation of the knee joint will be completely irreversible.
It must be said right away that even modern treatment is not able to completely cure the patient, however, treatment that begins in a timely manner significantly slows down all destructive processes of the knee joint.
Basically, the treatment is complex, which is based on the correct mode of physical activity and alternating rest with adequate loads on the joint.
Great importance is attached to weight normalization, so overweight patients will have to start a diet to reduce their levels.
At the first and second stages of the disease you can use:
The third degree of damage necessarily includes medications in treatment. And first of all, these are non-steroidal anti-inflammatory drugs and glucocorticosteroids.
Corticosteroids are also used for therapy, however, in cases where conventional NSAIDs cannot produce a positive effect.
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