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 are more often affected. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint can completely collapse. This leads to impaired musculoskeletal function. Movement is possible only with the help of crutches, or the person becomes hostage to a wheelchair.
The knee joint is the second largest, after the hip, and the most complex in structure. It allows you to bend and direct the leg in different directions, promotes the correct position of the body and coordination in space. This is a strong and stable joint that can support the weight of a person. It consists of 3 bones: the femur, tibia and fibula, as well as the patella or kneecap. Includes osteochondral structures, muscles, ligaments, and nerve fibers.
The disease begins with a violation of blood circulation and nutrition of joint tissues. First of all, the cartilage suffers. The quality and quantity of synovial fluid, which is located in the joint capsule and contributes to the smooth functioning of the knee, decreases. Friction occurs between joint parts. Gradually, the cartilage cracks and collapses. The exposed bones begin to rub against each other. Pain occurs and a cracking noise is heard.
Causes of the disease
It mainly affects older people, especially overweight women. As a result of hormonal changes, the cartilage of the knee wears down a lot. Gonarthrosis in various degrees, after 60 years, appears in more than 80% of people.
There are other reasons for the appearance of knee arthrosis:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part of it;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people who are engaged in repetitive physical work. This group also includes athletes, people who lead a sedentary lifestyle and people with unfavorable environmental conditions. Often patients are people addicted to toxic substances (drugs, alcohol, tobacco).
The cause of the deformation of the joints can be work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Due to the lack of minerals and vitamins in the body, diet can be the cause.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. According to the nature of the manifestations, the disease is divided into degrees:
- At this stage, there are no obvious clinical signs. There may be minor discomfort and pain after prolonged exercise, which disappears after rest. The pain is felt in the morning, when I move, it goes away after some time. First-degree arthrosis is rarely diagnosed by chance during a routine examination.
- Pain and stiffness in the knee increase. A person saves his leg and tries to load it less. As a result, the muscles atrophy, the joint is deformed, a formation can be felt, and the leg at the knee is not fully extended.
- The pain is constant. The leg does not straighten or bend and it is difficult for the person to walk. Partial or complete loss of mobility develops. The cartilage is completely destroyed, the friction between the bones of the joint increases with the formation of osteophytes.
In addition to pain in grades 2 and 3, a cracking noise is heard in the knee. Fluid and pieces of cartilage tissue can accumulate in the joint capsule, leading to swelling. At a late stage, the inflammatory process is pronounced, the knee joint is deformed.
Diagnosing
If you have knee pain, you can contact your local doctor, who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
To find out the causes and treatment of gonarthrosis, a comprehensive diagnosis is needed:
- general and biochemical blood test;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
An X-ray makes it possible to see the condition of the cartilage and changes in the bones in stages 2 and 3. This is a narrowing of the joint space, osteophytes along the edges of the patella, changes in the periosteum. Arthroscopy provides more detailed information about the meniscus, the synovial membrane and the presence of fluid. This method is also used in the treatment of the knee, to remove parts of the cartilage or meniscus.
Treatment of knee arthrosis
Therapy is long and sometimes painful. Having appeared once, the disease remembers itself for the rest of life. The main drugs used for treatment are non-steroidal anti-inflammatory drugs. Most often these are drugs based on non-steroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. Medicines are relatively cheap, but lead to the formation of ulcers and erosions of the stomach and duodenum. Modern drugs cause fewer side effects, but are expensive.
Treatment measures for stage 1 include exercise-related preventive measures. Daily exercise, the use of a contrast shower, the pool 2 times a week and the fight against increased body weight are required.
Stage 2 requires immobilization of the joint - the use of an elastic bandage, bandage or orthosis. To relieve pain, NSAIDs are used in the form of creams and ointments. To reduce the rate of cartilage destruction, the patient is prescribed medications from the group of chondroprotectors.
Severe severity requires oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. In addition, painkillers are prescribed.
A hyaluronic acid solution is injected into the joint. It is a substitute for intra-articular fluid and nourishes cartilage. When it moves, it acts as a shock absorber for the joint. The manipulation is painful, it is performed by the doctor after the acute period has subsided. If conservative treatment is unsuccessful, endoprosthetics are performed.
Along with drug therapy, exercises using simulators and special equipment (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered through subcutaneous or intramuscular injections, ozone-based ointments, creams. Manipulation stimulates blood circulation, increases the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are in demand as an alternative to drugs for joint restoration. Exercise therapy and massage are indicated. A set of special exercises improves blood circulation and nutrition of cartilage cells, increases the elasticity of ligaments.
Complications and prevention
Destroyed cartilage tissue and deformed bones cannot be treated. In this situation, only surgery will help. No ointment or medicine can restore cartilage. Medicines can only stop the process of cartilage tissue destruction.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without proper treatment, the patient's condition deteriorates quickly. The knee cannot function, serious complications appear:
- joint deformity;
- cosmetic defect - curvature of a limb;
- 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;
- in the joint area, bone fusion occurs (ankylosis), making movement impossible.
Complications develop if the patient does not go to the doctor in time and the disease is advanced. Regular preventive examinations and timely treatment of general body diseases will help prevent deterioration of the condition and preserve the motor function of the limbs.