In the knee joint, the inflammatory-degenerative process or gonarthrosis occurs for various reasons. It has an extremely negative impact on a person's quality of life, sometimes leading to disability. How do we 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 commonly 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 damage to the functioning of the musculoskeletal system. Movement is possible only with the help of crutches, otherwise the person becomes a hostage of the wheelchair.
The knee joint is the second largest, after the hip, and has the most complex structure. It allows bending and straightening the leg in different directions, promotes correct body position and spatial coordination. It is a strong and stable joint that can withstand the weight of a person. It consists of 3 bones: the femur, tibia and fibula, and the patella or patella. It includes osteochondral structures, muscles, ligaments, and nerve fibers.
The disease begins with a violation of the blood circulation and nutrition of the joint tissues. First of all, the cartilage suffers. The quality and quantity of synovial fluid in the joint capsule, which contributes to the smooth functioning of the knee, decreases. Friction occurs between the joint parts. Gradually, the cartilage cracks and collapses. Unprotected bones begin to rub against each other. Pain occurs and a grinding sound 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 out to a large extent. Gonarthrosis of various degrees occurs in more than 80% of people after 60 years.
There are other reasons for the appearance of knee arthrosis:
- congenital joint pathology;
- dysplasia;
- injuries, surgeries;
- 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 perform repetitive physical work. This group also includes athletes, people who lead a sedentary lifestyle and people living with unfavorable environmental conditions. Patients are often people addicted to toxic substances (drugs, alcohol, smoking).
The cause of joint deformation can be work 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 root cause.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. Depending on the nature of the manifestations, the disease is divided into stages:
- There are no obvious clinical symptoms at this stage. After a long workout, minor discomfort and pain may occur, which will disappear after rest. The pain is felt in the morning and goes away after a while when moving. Grade 1 arthrosis is rarely, accidentally, diagnosed during a routine examination.
- Knee pain and stiffness increase. People take care of their feet and try to put less strain on them. As a result, the muscles atrophy, the joint is deformed, formation is felt, the leg at the knee does not fully extend.
- The pain is constant. The leg does not straighten or bend, and the person has difficulty walking. 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 grade 2 and 3 pain, you can also hear a creaking sound in the knee. Fluid and pieces of cartilage tissue can accumulate in the joint capsule, leading to swelling. In the late stage, the inflammatory process is pronounced, and the knee joint is deformed.
Diagnostics
If you have knee pain, contact your local doctor who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
To learn the causes and treatment of gonarthrosis, a comprehensive diagnosis is necessary:
- general and biochemical blood test;
- rheumatic studies;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
X-rays make it possible to monitor the condition of the cartilage and the changes in the bones in the 2nd and 3rd stages. 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 to treat the knee, to remove pieces of cartilage or meniscus.
Treatment of knee arthrosis
Therapy is long and sometimes painful. Having appeared once, the disease will remind you throughout your 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) belonging to the group of phenylacetic acid derivatives. They eliminate inflammation and pain. The drugs are relatively cheap, but lead to ulcers and erosion of the stomach and duodenum. Modern drugs cause fewer side effects, but are expensive.
Stage 1 treatment measures include exercise prevention measures. Daily exercise, contrast showers, 2 swimming pools per week, and the fight against increased body weight are required.
Stage 2 requires immobilization of the joint - an elastic bandage, bandage or orthosis. NSAIDs are used in the form of creams and ointments to relieve pain. In order to reduce the rate of cartilage destruction, the patient is prescribed drugs from the group of chondroprotectors.
In case of severe severity, oral administration of NSAIDs is necessary. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. In addition, pain relievers are prescribed.
A hyaluronic acid solution is injected into the joint. It replaces the intra-articular fluid and nourishes the cartilage. During movement, it acts as a shock absorber for the joint. The manipulation is painful and is performed by a doctor after the acute period has ended. If conservative treatment is unsuccessful, an endoprosthesis is performed.
In addition to drug therapy, exercises with special simulators and devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered by subcutaneous or intramuscular injections, ozone-based ointments and creams. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are sought after as an alternative to drugs for joint repair. Exercise therapy and massage are recommended. A series of special exercises improves the blood circulation and nutrition of cartilage cells and increases the flexibility of ligaments.
Complications and prevention
Decayed cartilage tissue and deformed bones cannot be treated. In this case, only surgery will help. No ointment or medication can restore cartilage tissue. Medicines can only stop the process of cartilage tissue destruction.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. In the absence of proper treatment, the patient's condition deteriorates rapidly. The knee does not work, serious complications occur:
- joint deformity;
- cosmetic defect - curvature of the limb;
- infection with blood or lymph flow from another source in the body;
- due to the weakness of the ligaments, dislocations and fractures are observed, even during normal walking;
- bone fusion (ankylosis) occurs in the area of the joint, which makes movement impossible.
Complications develop if the patient does not consult a doctor in time and the disease has progressed. Regular preventive examinations and timely treatment of general diseases of the body help to prevent worsening of the condition and maintain the motor function of the limb.