The inflammatory-degenerative process or gonarthrosis in the knee joint occurs for various reasons. It has an extremely negative impact on a person's quality of life, sometimes causing 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 affected. This insidious disease is characterized by rapid development.
If treatment is not started in time, the knee joint may completely collapse. This leads to musculoskeletal dysfunction. Movement is possible only with the help of crutches or the person becomes a hostage of a wheelchair.
The knee joint is the second largest after the hip and the most complex in structure. It allows you to bend and straighten your leg in different directions, promotes the correct position of the body and coordination in space. This is a strong and stable combination that can withstand the weight of a person. It consists of 3 bones: the femur, tibia and fibula, as well as the patella or kneecap. It contains 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 helps the knee function properly, decreases. Friction occurs between joint parts. Gradually, the cartilage cracks and collapses. Unprotected bones begin to rub against each other. Pain occurs and a creaking 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 knee wears out a lot. 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, operations;
- removal of the meniscus or part of it;
- arthritis;
- back diseases;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people engaged in repetitive physical labor. This group also includes athletes, people living a sedentary lifestyle and people with unfavorable environmental conditions. Often patients are addicted to toxic substances (drugs, alcohol, cigarettes).
The cause of joint deformation can be work related to constant hypothermia. The inciting factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine myoma). Due to lack of minerals and vitamins in the body, diet can be a trigger.
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. After long-term exercise, there may be slight discomfort and pain, which disappears after rest. The pain is felt in the morning, when moving, it disappears after a while. Grade 1 arthrosis is rarely diagnosed accidentally during a routine examination.
- Pain and stiffness in the knee increases. A person does not spare his leg and tries to load it less. As a result, the muscles atrophy, the joint is deformed, the formation can be felt, and the leg at the knee does not fully extend.
- The pain is constant. The leg does not straighten or bend, and it becomes difficult for a 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 the 2nd and 3rd degrees, in addition to the pain, a crunching sound is heard in the knee. 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 the causes and treatment of gonarthrosis, a comprehensive diagnosis is necessary:
- general and biochemical blood test;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
X-ray examination allows to see the state of the cartilages 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 presence of meniscus, synovial membrane and fluid. This method is also used in the treatment of the knee, to remove pieces of cartilage or meniscus.
Treatment of knee arthrosis
Therapy is long and sometimes painful. Once the disease appears, it reminds of itself until the end 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 relieve inflammation and pain. Medicines are relatively cheap, but cause ulcers and erosion of the stomach and duodenum. Modern drugs cause fewer side effects, but are expensive.
Treatment measures for stage 1 include preventive measures related to exercise. Daily exercises, use of contrast shower, 2 times a week swimming pool and fight against increased body weight are required.
Stage 2 requires fixation of the joint - the use of an elastic bandage, bandage or orthosis. NSAIDs are used in the form of creams and ointments to relieve pain. To reduce the rate of cartilage destruction, the patient is prescribed drugs from the group of chondroprotectors.
Severe severity requires oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS) with 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 end of the acute period. If conservative treatment fails, endoprosthetics are performed.
In addition to drug therapy, exercises using 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 through subcutaneous or intramuscular injections, ozone-based ointments, creams. Manipulation stimulates blood circulation, increases the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are required as an alternative to drugs for joint recovery. Exercise therapy and massage are indicated. A set 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. In this case, 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. In the absence of appropriate treatment, the patient's condition quickly deteriorates. The knee cannot work, serious complications appear:
- joint deformation;
- cosmetic defect - curvature of the limb;
- infection by blood or lymph flow from another source of the body;
- due to the weakness of the ligaments, dislocations and fractures are observed even during normal walking;
- bone fusion (ankylosis) occurs in the joint area, making movement impossible.
Complications develop when the patient does not consult a doctor in time and the disease progresses. Regular preventive examinations and timely treatment of general diseases of the body will help prevent the deterioration of the condition and protect the motor function of the limb.