Doctors often hear complaints from patients about pain in their legs. They occur not only during sports, but also during periods of complete rest. In most cases, this may be simple fatigue, but sometimes such signs are the first “bells” of a terrible and dangerous disease, known to us as arthrosis of the 3rd degree of the knee joint. Treatment must be competent and professional in order to avoid serious complications and irreversible consequences.
Knee arthrosis, called gonarthrosis in medical circles, occupies a leading position among all lesions and pathologies of this part of the limb known to science. It implies that the patient has dystrophic and degenerative deformities that occur due to constant physical stress on the leg. What’s most interesting is that women suffer from arthrosis much more often than men. The disease is usually diagnosed in patients over 45 years of age.
For many centuries, experienced doctors have been studying the disease in detail: its features, signs, new methods of therapy. One of the researchers is doctor and professor Sergei Bubnovsky. Osteoarthritis of the knee joint, according to his opinion, can be successfully eliminated with the help of special physical therapy. Like his colleagues, he associates the disease with the deposition of salts in the ligamentous apparatus, especially in its soft tissues, as well as at the tendon junctions. Arthrosis is characterized by a slow progression of development, starting with minor disturbances in the blood supply system.
The main risk group, in addition to representatives of the weaker half of humanity who are in adulthood, also includes professional athletes, workers who spend a lot of time on their feet or engage in heavy physical labor. At first, their healthy joints begin to ache unpleasantly. These minor pain sensations are observed during vigorous activity, for example, when a person climbs stairs. In addition, when the leg is bent, it begins to emit a barely audible crunch, which, if the disease is not treated, becomes loud and audible to others.
Among the main symptoms of arthrosis, there is also aching in the limbs, which clearly manifests itself during hypothermia. Then swelling appears, which may indicate arthritis. Osteoarthritis of the knee joint is different in that swelling in the leg appears only during periods of sharp exacerbations. It is always accompanied by a nagging pain that causes discomfort. Late stages are characterized by difficulty bending the limb, changes in gait, unsteadiness while standing, and joint deformity.
This is one of the varieties of the disease. If a patient is diagnosed with grade 3 arthrosis of the knee joint, treatment is prescribed depending on the reasons causing the progression of the disease. In the primary form of the disease, these may be hereditary disorders: congenital pathologies of the musculoskeletal system, for example, flat feet, dysplasia or increased flexibility of the knee. Various genetic deformations also lead to the development of the disease: they occur in the cartilage tissue during the period of organ formation and the formation of the basic systems of the embryo in the womb.
Primary arthrosis is a consequence of degeneration of the cartilage tissue of the knee without any other abnormalities in the body. It can also be a “product” of a violation of recovery processes. It is difficult to establish the exact cause of arthrosis, especially when it comes to elderly patients in whom the line between the primary and secondary types of the disease is blurred and unclear.
Other factors also cause this disease. Secondary arthrosis of the knee joint is often the result of external influences. For example, it can be caused by mechanical damage: fractures or injuries, after which the entire organ system is disrupted. Regular microtrauma in professional athletes is another cause of the disease. It is often diagnosed against the background of constant physical activity, dynamic or static movements. By the way, obesity also leads to arthrosis, accompanied by strong pressure of excess weight on the lower extremities.
The secondary form of the disease also develops against the background of cardiovascular and autoimmune diseases. Often its appearance is provoked by atherosclerosis, varicose veins, gout, psoriasis, arthritis, and so on. In some cases, the cause is various joint diseases, hormonal imbalances, metabolic disorders, endocrine system problems, and a lack of important substances in the body - calcium, phosphorus and the “sunshine” vitamin.
The cause of permanent disability is often grade 3 arthrosis of the knee joint, the treatment of which is no longer able to completely relieve a person from the negative consequences of the disease. The main symptoms of this stage of the disease are:
If you take an x-ray, it will be noticeable that the intra-articular structures - menisci and ligaments - are destroyed. In this case, complete erasure of cartilage tissue, the appearance of sclerosis and fusion of connective bones in the joint space may be observed.
It is better not to start the disease, otherwise the therapy will be lengthy and even aggressive. How to cure arthrosis of the knee joint? Firstly, doctors recommend treating the early stages of the disease using physical rehabilitation methods. This helps with reducing body weight, reducing stress on the lower extremities, strengthening muscles, correcting orthopedic disorders, and so on. Often after the above manipulations, patients feel significant relief, their condition noticeably improves.
Secondly, drug therapy is also indicated. Doctors primarily prescribe non-steroidal anti-inflammatory drugs, which can dull pain and remove swelling in the joint area. For example, Indomethacin, Diclofenac, Ketoprofen and others. Basic treatment also includes chondroprotectors: Arthra, Teraflex, Elbona. Their main substances nourish damaged cartilage and restore its structure.
The course of treatment also includes intra-articular injections. The patient is administered hormonal drugs: Hydrocortisone, Kenalog or Diprospan. These are medications that provide immediate relief for severe pain: they instantly stop the inflammatory process in the joint, limit the production of synovial fluid, thereby bringing relief.
A person who wants to have healthy joints is also given preparations based on hyaluronic acid. They are not as effective, but they are able to nourish cartilage and restore it to its former strength. In young years, the body itself produces a similar substance, but with age its amount gradually decreases - this can become another cause of arthrosis. You can compensate for the lack of hyaluronic acid by injecting it into the joint in the form of a medicine. In addition, complex therapy includes the use of topical medications: creams and ointments. The same products are also suitable for warming compresses.
Unfortunately, grade 3 arthrosis of the knee joint does not go away without the intervention of a surgeon. Surgical treatment can be as follows:
The patient must remember: the more advanced the disease, the more difficult it is for doctors to get him back on his feet.
The procedures included in the complex of such therapy perfectly relieve muscle spasms, improve blood flow in tissues and relieve inflammatory processes. Physiotherapy is always selected individually depending on the form of the disease, its stage, the patient’s condition, and the characteristics of his body. The general rule is sanatorium-resort treatment, which is indicated for almost all patients. In a specialized institution, a person will be prescribed comprehensive rehabilitation, which includes mud baths, sauna procedures, and special exercises. An important role in this is played by changing the usual environment and staying in the fresh air, which eliminates the effects of stress and strengthens the body.
Massage of the knee joint for arthrosis is also very useful. It improves blood circulation in tissues and transmission of nerve impulses. As a result, the patient’s well-being noticeably improves. It is important that the massage is performed by a qualified master who knows all the subtleties and secrets of influencing the knee joint. At the same time, the intensity of manipulation should be minimal: rough and awkward movements can only worsen the situation.
Exercise therapy for arthrosis of the knee joints has a positive effect on strengthening the muscles and improving the mobility of the lower extremities. Muscle weakness is an integral accompaniment of the disease, so with a lack of physical activity, lethargy and inability to move can only increase. A set of necessary exercises can be found in the physical therapy room. It is usually recommended to do them four times a day. The first lesson is best done in the morning - immediately after you wake up. After finishing the lesson, be sure to lie down and rest.
Often, after performing exercise therapy for arthrosis of the knee joints, a person feels discomfort in the leg. This phenomenon is considered normal if it lasts no more than half an hour. When the time period exceeds 30 minutes or the patient experiences pain of varying intensity, we can say that he is doing the exercises incorrectly. In this case, you should consult your doctor for advice. It will help you adjust your activities. By the way, don’t forget about swimming lessons. Water procedures reduce the load on the joint and help restore its mobility.
Knee arthrosis can also be treated with herbal medicine. For these purposes, a collection of herbs is used, which includes juniper fruits, calendula and elderberry flowers, cinquefoil and birch leaves, willow and buckthorn bark, as well as St. John's wort, nettle, horsetail and sweet clover. They are brewed and taken in the form of tinctures; in addition, healing lotions and compresses are made from the beneficial liquid. After starting the course, improvement occurs within three weeks. In addition, various oils are effective in the fight against the disease: sea buckthorn, lavender, eucalyptus and others. But before you start using traditional medicine, you need to consult with an experienced doctor.
As for prevention, it is aimed primarily at increasing physical activity. A person should play sports, walk a lot, and spend more time in the fresh air. Proper and healthier nutrition is another guarantee that you will not get arthrosis. To the above recommendations should be added timely treatment of diseases of the musculoskeletal system, as well as high-quality correction of congenital defects of the bone structure.
The most common question that rheumatologist patients have is whether grade 3 arthrosis of the knee joint can be cured without surgery. Stage 3 gonarthrosis is an advanced form, which is characterized by irreversible changes in the joint. There are no therapeutic methods that would eliminate bone deformities. At a late stage, conservative treatment is aimed only at minimizing manifestations. Even the pain can be relieved only for a short time. Restoring joint function and getting rid of constant pain is possible only through endoprosthetics, but the patient’s health or financial condition does not always allow such an operation. What non-surgical treatment methods are available at this stage?
An alternative to endoprosthetics is arthrodesis, that is, the formation of ankylosis artificially. Complete immobilization of the joint (ankylosis) is sometimes considered grade 4 arthrosis of the knee joint. But if the bones themselves grow together as a result of complete destruction of the cartilage, ankylosis usually forms in a vicious position, that is, the leg is bent and twisted. With arthrodesis, the leg is given a functionally advantageous position. After such an operation, the knee will not hurt, but any movement in it will become impossible, so arthrodesis cannot be considered a solution to the problem.
The only effective treatment for grade 3 arthrosis of the knee joint is surgery to replace the joint with a prosthesis. Young people of working age are often embarrassed by the fact that in 15 years they will need to replace their prosthesis. It can last longer, but only those who have undergone endoprosthetics in old age have a chance to avoid repeat surgery (revision). Financial considerations are another good reason why many people refuse surgery. But the most important factor is the presence of medical contraindications. The decision to undergo endoprosthetics is made only after a comprehensive examination of the patient.
Contraindications to knee arthroplasty are:
Some conditions are temporary and can be eliminated, while others cannot be corrected. The reason for concern is the characteristics of the immune system, which can lead to rejection of the endoprosthesis, although they are made from hypoallergenic materials.
If absolute medical contraindications to endoprosthetics are identified, or the patient refuses surgery for other reasons, the question arises whether grade 3 arthrosis of the knee joint can be cured without surgery. It is impossible to cure advanced arthrosis using conservative methods; even at an early stage, such an outcome is extremely unlikely. But it can and should be treated. Joint traction (separating the articular ends of bones) using manual or traction therapy methods is rarely used at stage 3. Stretching muscles and ligaments (postoisometric relaxation) is also effective at stages 1–2. Doctors usually prescribe:
It is not difficult to completely restore JOINTS! The most important thing is to rub this on the sore spot 2-3 times a day...
The latter includes the use of a cane when walking; it can reduce the load on the joint by 20–40%. In the early stages, this measure slows down the destruction of cartilage; in the later stages, it allows the patient to move without assistance and relieves pain. The cane must be selected correctly according to height (its length should be equal to the distance from the wrist of the lowered hand to the floor), preferably having a rubber attachment. You need to hold it in your hand on the side of the healthy limb. With decompensated gonarthrosis, especially bilateral, a cane is not enough; crutches are needed. The diet at the late stage of gonarthrosis should be more strict. A person with severe damage to the knee joints cannot actively move, so they burn fewer calories. To avoid obesity, you need to reduce the calorie content of your food.
If for stage 2 arthrosis of the knee joint, treatment with chondroprotectors is quite effective, then at stage 3 these expensive drugs are prescribed extremely rarely. At stage 1 they can stimulate the restoration of cartilage tissue, at stage 2 they slow down its destruction, at stage 3 they are useless, since only fragments of the cartilage remain. But with bilateral gonarthrosis or polyarthrosis, when pathological processes in individual joints correspond to stages 1–2, chondroprotectors can be prescribed to protect them. Injections of hyaluronic acid allow you to increase the range of motion in the joint and reduce the intensity of pain by reducing bone friction. But they can be done only in the absence of an inflammatory process in the joint, and gonarthrosis at stage 3 is often accompanied by synovitis or complicated by arthritis.
The main goal of drug therapy at this stage is to relieve pain. For these purposes the following is used:
Most physiotherapeutic procedures are effective at stages 1–2 of arthrosis. For grade 3 arthrosis of the knee joint, treatment with physiotherapy methods somewhat reduces the severity of symptoms. They mainly resort to thermal procedures (application of paraffin, ozokerite) and cryotherapy (exposure to cold). Heat and cold relieve pain well, but heating is contraindicated in acute inflammatory processes. Sergei Bubnovsky recommends not resorting to drug pain relief for arthrosis, but treating the joints with contrasting temperatures. Amplipulse and electrophoresis with medications (dimexide, novocaine) also have a good effect.
A relatively new method of physiotherapy - shockwave therapy (shock wave therapy, the effect of acoustic waves on tissue) - deserves special attention. At stages 1–2, this technique slows down the formation of osteophytes, but sound waves cannot destroy massive bone growths. However, the procedures help strengthen muscles and ligaments, increase their elasticity, and stimulate blood circulation. So they can be recommended at stage 3 to counteract muscle atrophy, destroy joint mice, reduce pain intensity and improve mobility. Also, as a result of shock wave therapy, the sharp edges of osteophytes can soften, which injure the synovial membrane and soft tissues.
Therapeutic massage promotes vasodilation, activation of blood-lymph flow and circulation of synovial fluid inside the joint, normalizes muscle tone and increases their elasticity. All this justifies its use as an auxiliary method of treating arthrosis. But its effectiveness, like other therapeutic methods, is higher in the early stages.
Many doctors consider strengthening the muscles surrounding the knee joint through exercises to be the main alternative to surgery. Isometric muscle tension-relaxation exercises can be performed even when the range of motion in a joint is severely limited. At stage 3 of arthrosis, a persistent contracture is formed, and movements are limited by overgrown osteophytes. But even if it is not possible to restore the mobility of the leg in the knee, thanks to the pumped up muscles it will better cope with the supporting function. Basic principles of exercise therapy:
A few words should be said about an innovative method for treating arthrosis - cell therapy. Its principle:
This procedure starts the processes of regeneration of cartilage tissue. Theoretically, this method allows you to restore the cartilage layer even at stage 3 of arthrosis. But can cell therapy be considered as an alternative to surgery? At stage 3, the problems are not limited to wear and tear of the articular cartilage; by this point, bone tissue has been rebuilt, massive marginal growths have formed, the joint has become deformed, and the joint space has narrowed. Even if you grow new cartilage, these changes cannot be eliminated. So at a later stage, stem cell therapy needs to be combined with other treatments. Arthroscopic intervention may be indicated to remove osteophytes, traction therapy to widen the joint space and reduce pressure on the cartilage.
If for some reason the patient cannot undergo endoprosthetic surgery, grade 3 gonarthrosis must be treated using conservative methods. The main role at this stage is given to physical therapy; it helps to avoid final muscle atrophy and immobilization of the joint. It can be supplemented with physiotherapeutic procedures and massage. Drug pain relief is also carried out; the choice of drugs is determined by the severity of the pain syndrome. As for the promising direction - stem cell therapy, there is reason to believe that this method will eventually cure arthrosis, provided that treatment is started at an early stage. In advanced forms of arthrosis, even this innovative technique is not a full-fledged alternative to surgery.
A disease such as arthrosis is the most common pathology of the human musculoskeletal system. It is characterized by the slow destruction of cartilage, as well as some additional unfavorable processes in the periarticular area. The consequences of such a disease without therapy are the disability of the sick person. Therefore, it is very important to know how to be treated and what needs to be done for this. If the first symptoms occur, you must immediately contact a medical institution for a comprehensive comprehensive diagnosis and subsequent therapy based on the clinical signs of the disease.
Quite often, arthrosis accompanies a disease such as osteochondrosis. They are quite similar to each other, but have some differences. First of all, it is important to note that, unlike arthrosis, osteochondrosis causes only degeneration of the intervertebral discs, and not their destruction. In addition, due to the localization of osteochondrosis in different parts of the spine, and not in other areas, the symptoms also have some features of manifestation.
Arthrosis of the joints is a chronic disease that consists of degenerative-dystrophic changes in these structures of the human body. The process affects different parts of the joint, regardless of where they are located.
The disease is characterized by slow progression, although it can be accelerated by certain external factors. It all depends on the individual characteristics of the body, the diseases a person has and his way of life.
Treatment of joint arthrosis can be carried out by an arthrologist, rheumatologist and orthopedist. In the process of therapy and diagnosis, the help of some other specialists is often necessary, among which are a chiropractor, massage therapist, physiotherapist, exercise therapy trainer, arthroscopist or surgeon. The need to contact these specialists is determined by the method of treatment, the degree of progression of the disease, as well as the complications the person has.
According to the International Classification of Diseases, Tenth Revision, arthrosis belongs to the class Diseases of the musculoskeletal system and connective tissue, the group Arthropathy, and the subgroup Arthrosis. They have codes from M15 to M19. This includes arthrosis of the hip, first carpometacarpal, knee, shoulder joint, etc.
Over the past few decades, deforming arthrosis has become a younger disease due to the fact that it is increasingly being diagnosed not in older people, but in representatives of the middle age range and even in children. Despite this, the older a person becomes, the higher his risk of developing this disease. Gender does not play any role in most types of arthrosis - the disease occurs in both men and women. An exception to this rule is interphalangeal arthrosis, which is more often diagnosed in females.
In some cases, the causes may be unknown or impossible to determine. In such cases, the disease occurs on its own without any external factors. This condition is called idiopathic or primary arthrosis. Secondary arthrosis is a condition that is provoked by any pathological changes in the human body. The most common reasons for this are:
In addition to the diseases themselves, there are many different factors that provoke the risk of arthrosis:
Medical practice distinguishes three main degrees of arthrosis, which affect all joints of the human body without exception:
This in turn leads to either a complete absence of movement or to pathological low mobility, which is called neoarthrosis. At this stage of the disease, doctors cannot correct the situation with any other methods other than endoprosthetics.
For example, at the last stage of arthrosis of the knee joint, a person loses the ability to bend and straighten his leg, which is why he finds himself confined to a wheelchair. In this case, the closure of the knee may not occur in a natural position, which also causes certain difficulties in carrying out life activities.
Due to the difficulty of treating the final stages of the disease, it is very important to begin therapy at the first onset of symptoms. This greatly facilitates the process of therapy, rehabilitation, if required, and also minimizes the discomfort that a sick person may feel due to the disease.
Arthrosis has completely different symptoms, but the most distinctive of them is pain in the joints. Most often it occurs in cases where there is any stress or mechanical damage to the affected area.
In general, four large groups of symptoms can be distinguished that directly characterize a disease such as arthrosis:
Depending on the location of the disease, the individual characteristics of the body, as well as the degree of development of the disease, the manifestations of each of them depend.
Painful sensations with arthrosis are pronounced, especially after various types of stress. When a person comes to a state of rest, after a while the discomfort disappears. Localization of pain occurs directly in the place where changes in the usual structures of the body took place.
In some cases, pain with arthrosis can occur when a person is resting, being completely relaxed. They appear very sharply and severely, which can be compared to toothaches. Most often this happens in the morning. To prevent this from happening, it is recommended to begin treating the problem as early as possible.
Crunching is also an indicative symptom of arthrosis. This is due to the fact that due to changes, the bones begin to rub against each other. It is also important to remember that some crunching can be present in a healthy person, so this symptom in itself does not indicate the presence of a problem.
Joint deformation is directly related to the formation of osteophytes on its surface. Most often, this symptom occurs in the absence of any adequate treatment for the disease for a long time.
Arthrosis of the joints can have different symptoms and treatment. This is influenced by many different factors. Before starting therapy, it is very important to conduct a comprehensive diagnosis of the disease.
The knee joint is called gonarthrosis. In the initial stages of the disease, the sick person only complains of some discomfort when walking. This is due to the fact that the surfaces of the joint begin to rub against each other.
Symptoms that impede a person’s movements begin to appear only at the second stage of their development. The patient is limited in his movements with his leg. He has a crunching sensation with any movements of the lower extremities.
Symptoms of arthrosis of the knee joint can appear for a long time before deformation changes begin. In this case, X and O-shaped curvatures of the lower extremities of a person are characteristic. This in turn leads to the inability to walk, confining the person to a wheelchair.
Knee arthrosis is a very serious disease, since, unlike other types of disease, it is capable of moving to the final stages of its development in a short time due to heavy loads, leading to disability of the patient. Therefore, it is very important to start therapy as early as possible.
Knee arthrosis symptoms and treatment are quite unpleasant. This is due to the fact that in the early stages, when conservative methods of therapy are indicated, patients do not always go to medical institutions. As the disease progresses, the following methods are often used:
Symptoms and treatment of arthrosis of the knee joint should be interrelated. Therefore, it is very important to undergo diagnostics before this. The most indicative in this regard are MRI, CT, radiography and ultrasound.
Treatment of the knee often requires quite invasive and unpleasant procedures, so it must be approached in advance, when you can limit yourself only to medications.
The hip joint is a problem, the main factor for the rapid progression of which is excess weight. People who have it move from the first degree of the disease to the second or third much faster. The primary form of this disease often develops after 50-60 years. The secondary form can arise due to various reasons much earlier.
The main reasons that provoke hip deforming arthrosis of the joints include:
Treatment of hip arthrosis should primarily be aimed at eliminating symptoms. This is due to the fact that the pain in the hip area is very intense and difficult to bear. Therefore, it is initially recommended to take anti-inflammatory drugs, chondroprotectors and synovial fluid prostheses. In addition to medications, significant results can be achieved with the help of physiotherapy. This applies primarily to massages, the use of “moist heat”, certain gymnastics, thermal and hydrotherapy, as well as treatment with electrical discharges. Treatment of hip arthrosis also involves the use of special orthopedic structures, such as canes, special pillows, bolsters, etc.
Surgical interventions that treat arthrosis of the joints in the hip area include the following types:
Exercises for arthrosis of this type should be carried out only with the help of special trainers who are able to control this process.
Hip arthrosis cannot be cured at home! But at home you can carry out special gymnastic exercises, take medications and follow a certain diet, if recommended by your doctor.
A disease such as shoulder arthrosis, in many cases, occurs due to too much physical activity. Most often, symptoms occur quite unexpectedly, but very clearly and strongly. A person begins to feel pain in the shoulder, which most often occurs when moving the arm to the sides and back. When palpating the lower parts of the collarbone and shoulder blades, the patient may also feel both discomfort and pain.
In some cases, arthrosis of the hands is accompanied by swelling in the joint area and slight redness. At the same time, due to the inflammatory process, local body temperature rises. As the disease progresses, mobility of the upper limbs becomes limited.
Treatment of shoulder arthrosis is carried out using both conservative methods and surgical intervention. They most often begin with drug treatment, physiotherapy and exercise therapy, hoping to restore cartilage tissue. At the same time, it is very important to take a comprehensive approach to eliminating the problem, and not concentrate on just one of the methods. If possible, it is necessary to develop the hand for as long as possible, while relieving the inflammatory process in it.
Treatment of arthrosis of the shoulder joint by surgical method is carried out if conservative therapy has not brought the desired result. In this case, the affected joint is replaced with a special prosthesis made from materials that can serve the human body for more than ten years.
It is better not to treat arthrosis with folk remedies! They can only relieve some symptoms, such as discomfort or pain; it is impossible to eliminate the cause of the problem.
Arthrosis of the ankle joint is, like other types of disease, a progressive chronic disease. The causes of this disease are the same as the causes of other types. That is why treatment should be carried out in the same way. The main differences that the ankle joint has is the effect on it of certain gymnastic exercises.
Ankle arthrosis of the joints provokes symptoms in the form of painful sensations in the area where the foot meets the leg. Because of this, it often becomes difficult for a person to walk, which is why people seek help with this problem more often than with a disease of the shoulder girdle. This type often occurs in people with increased physical activity or in athletes in whom this area of the body is often subject to various mechanical damage.
Ankle arthrosis of the joints forces a person to do exercises that would help develop the area of the lower limbs. It is important to remember that if the cause of the disease is a systemic disease, physical exercises should be comprehensive, aimed at all parts of the body. This is due to the fact that problems in the ankle can only be the initial manifestation of polyarthrosis.
Arthrosis symptoms and treatment are varied, so it is very important before starting therapy to correctly diagnose and accurately determine the cause of the disease. This can only be done in a medical facility under the guidance of a qualified doctor.
Gonarthrosis of the third degree is a degenerative lesion of the knee joint, in which destruction of articular cartilage and compensatory bone growth (formation of osteophytes) occurs. The impetus for the development of pathology is the incorrect distribution of the load on the lower limb. Osteophytes play the role of destroyed cartilage tissue, but aggravate the course of the disease.
The clinical picture is presented in the form of a pronounced pain syndrome that occurs even after minor physical activity and at rest, with night pain. The knee changes its shape (deformation), movements in it are sharply limited, the muscles of the lower leg on the affected side gradually atrophy due to limited mobility of the limb.
Due to the presence of a large number of bone growths, some osteophytes can break off and cause joint blockade. This condition is manifested by the inability to actively flex and extend the leg at the knee joint.
The joint space on the x-ray image is narrowed to the limits of the slit-like opening due to marginal bone growths (osteophytes) on the articular surfaces of the bones.
This pathology is diagnosed based on patient complaints, identification of predisposing factors (trauma, endocrine diseases, heavy physical activity), X-ray data, ultrasound, and arthroscopy.
Disability is assigned in the presence of grade 3-4 gonarthrosis, significant limitation of life activity due to a pathological process in the knee.
When assigning a disability group, the following is taken into account:
The patient undergoes re-examination annually.
In orthopedics for gonarthrosis, there are two methods of treating pathology: conservative and surgical.
The first includes:
The surgical method for treating grade 3 gonarthrosis includes surgery to correct the load on the lower limb.
It is carried out to reduce pain and prepare for surgery. Includes unloading of the knee, during which it is necessary to use additional sources of support in the form of a cane.
If pain is of high intensity, patients should move with the help of crutches.
The analgesic effect of drugs, physiotherapy, and spa treatment is used.
The main groups of drugs used for treatment:
NSAIDs have an analgesic and anti-inflammatory effect. The most commonly used in clinical practice are Diclofenac, Indomethacin, Ibuprofen, and Analgin. To avoid side effects, the drugs are taken in courses.
Hyaluronate is a substance consisting of protein and carbohydrate molecules. Various biological environments, including synovial fluid, contain it normally.
The role of hyaluronic acid is to facilitate the sliding of the articular surfaces of bones. When administered intra-articularly, patients note improved mobility in the damaged area and elimination of pain.
The action of hyaluronate is aimed at its binding to the components of cartilage, which helps retain water in the cartilage tissue, and also helps to increase its elasticity and improve shock-absorbing properties.
If the patient has an inflammatory process in the knee joint, a course of anti-inflammatory therapy is first administered.
Contraindications for intra-articular administration of the drug include:
The release form is presented in the form of a syringe with a solution. The injection is carried out under aseptic conditions.
The drug is injected into the joint capsule.
A standard treatment regimen requires three to five injections. Dosage regimen – one injection once a week. The interval between subsequent courses is decided on an individual basis.
Possible side effects include:
In case of undesirable consequences, ice is applied to the injection site for ten minutes. If an allergic reaction occurs, further use of preparations with hyaluronic acid is prohibited.
Products that stimulate the production of hyaluronic acid in tissues include:
In the treatment of gonarthrosis, the analgesic effect is achieved through laser and magnetic therapy, heat therapy, electrophoresis and cryotherapy.
Laser radiation, when passing through the skin, affects the pathologically altered tissue and starts the recovery process. The action of the infrared laser is aimed at reducing the sensitivity of nerve endings and increasing blood flow to the joint.
With the help of magnetic therapy, an increase in the tone of the vascular wall and acceleration of recovery reactions are achieved. In the affected knee, metabolic processes are accelerated and inflammation is reduced.
Thermal procedures include ozokerite therapy. The composition of ozokerite includes mineral oils, resins and paraffins. Compresses or applications are applied to the affected joint. Warming up the tissue improves microcirculation and reduces the intensity of pain.
Electrophoresis is a method of administering drugs using electric current without violating the integrity of the skin. The advantages of electrophoresis include local action, which ensures delivery of the drug directly to the cartilage tissue. The risk of side effects is minimal. In a short time, a high concentration of the drug is achieved at the site of the lesion. Novocaine, dimexide and other drugs with analgesic and anti-inflammatory effects are used.
Contraindications for treatment with physiotherapeutic methods include:
PRP therapy is a new way to treat stage 3 gonarthrosis. This is a method of treating joints, muscles and tendons by injecting platelet-rich plasma. Used to shorten the recovery time of cartilage.
The procedure consists of several stages. First, 15–20 ml of blood is drawn from the patient, after which the biological material is placed in an hourglass-shaped tube. The blood is then centrifuged, causing it to be divided into three parts:
In the next step, a platelet suspension is collected using a syringe. The result is 1.5 ml of platelet-rich plasma. Tissue regeneration is triggered when their concentration increases seven to ten times in the affected area. It is the platelet concentration that matters, not the volume of plasma administered.
Platelet-rich plasma is injected into the joint under local anesthesia.
The course of treatment consists of 2–5 sessions, between which there is a break for a week.
Preparation for the procedure involves stopping medications that affect the blood coagulation system two weeks in advance. During the day you need to avoid drinking alcohol. Foods enriched with ascorbic acid should be added to the diet.
Substances called “growth factors” are released from platelets in the affected area. Thanks to their action, the number of stem cells from which cartilage tissue is formed increases. The advantage of this type of therapy is the absence of allergies, since the base is created from the patient’s own biomaterial.
The following contraindications exist for PRP therapy:
Arthrosis of the third degree limits physical activity. You can start training only after consulting a doctor due to the high risk of injury.
Indications, duration of training on an exercise bike and the interval between them are determined based on the range of motion in the joint, intensity of pain, the presence of synovitis and concomitant pathologies.
If the analgesic effect of conservative treatment is insufficient, as well as when a disability group is assigned for stage 3-4 gonarthrosis, surgery cannot be avoided. Surgical interventions are performed to improve the patient’s quality of life, and if there are contraindications from other organs, they can be canceled.
In orthopedics for gonarthrosis, open operations are used, which include: intra-articular, extra-articular and arthroplasty. Among intra-articular operations, arthroscopy is successfully used.
It is a treatment method using endoscopic technology, which does not require dissection of the articular cavity. The operation is performed using thin flexible instruments under video camera control. Arthroscopy provides the opportunity to clean the joint cavity from cartilage decay products, eliminate joint blockage, and administer medications.
This operation alleviates the patient’s condition, but does not eliminate the cause of the disease. It allows you to extend the time until knee replacement or corrective osteotomy. Restoring limb function after arthroscopy takes a short time, and the risk of infectious complications is minimal.