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 and can sometimes lead to disability. How to treat arthrosis of the knee joint and prevent complications?
What is arthrosis
Approximately 22% of the world's population suffers from gonarthrosis, and women are more frequently affected. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint may collapse completely. This leads to deterioration of musculoskeletal system functions. Movement is only possible with the help of crutches or the person is confined to a wheelchair.
The knee joint is the second largest and most structurally complex joint after the hip. It allows you to bend and straighten your leg in different directions, supports correct body position and coordination in space. This is a strong and solid joint that can withstand the weight of a person. It consists of 3 bones: the femur, tibia and fibula, and the patella or kneecap. It 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, cartilage suffers. The quality and quantity of synovial fluid, which is located in the joint capsule and contributes to the proper functioning of the knee, decreases. Friction occurs between connecting parts. Gradually the cartilage cracks and collapses. Unprotected bones begin to rub against each other. Pain occurs and a crackling sound is heard.
Causes of the disease
It mostly affects older people, especially overweight women. As a result of hormonal changes, the cartilage in the knee wears out to a great extent. After 60 years, varying degrees of gonarthrosis occur in more than 80% of people.
There are other reasons why knee arthrosis occurs:
- 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 contracting the disease increases in people who engage in repetitive physical labor. This group also includes athletes, people leading a sedentary lifestyle and people with unfavorable environmental conditions. Most often, patients are people addicted to toxic substances (drugs, alcohol, cigarettes).
The cause of joint deformation may be work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Diet can be a trigger due to lack of minerals and vitamins in the body.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. According to the nature of the symptoms, the disease is divided into degrees:
- There are no obvious clinical symptoms at this stage. Mild discomfort and pain may occur after prolonged exercise and may disappear after rest. The pain is felt in the morning and goes away after a while while moving. Grade 1 arthrosis is rarely diagnosed incidentally during routine examination.
- Pain and stiffness in the knee increases. A person saves his leg and tries to load it less. As a result, the muscles atrophy, the joint is deformed, a formation is felt, and the leg at the knee does not fully extend.
- The pain is constant. The leg does not straighten or bend, making it difficult for the person to walk. Partial or complete loss of movement develops. Cartilage is completely destroyed, and with the formation of osteophytes, the friction between the bones of the joint increases.
In addition to 2nd and 3rd degree pain, a crackling sound is heard in the knee. Fluid and pieces of cartilage tissue can accumulate in the joint capsule, causing swelling. At a late stage, the inflammatory process is evident, the knee joint is deformed.
Diagnosis
If you have knee pain, you can contact your local doctor, who will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist if necessary.
A comprehensive diagnosis is needed to find the causes and treatment of gonarthrosis:
- 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 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, synovial membrane and the presence of fluid. This method is also used in knee treatment to remove pieces of cartilage or meniscus.
Treatment of knee arthrosis
Therapy is long and sometimes painful. The disease that occurs once will remind you of itself for the rest of your life. The main drugs used in 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 inexpensive, but lead to the formation of ulcers and erosion in 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 exercise, use of a contrast shower, swimming pool 2 times a week and the fight against increased body weight are necessary.
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 degree of cartilage destruction, the patient is prescribed drugs from the chondroprotector group.
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. Painkillers are also prescribed.
A hyaluronic acid solution is injected into the joint. It replaces the intra-articular fluid and nourishes the cartilage. It acts as a shock absorber for the joint while moving. Manipulation is painful, it is performed by the doctor after the acute period has passed. If conservative treatment fails, an endoprosthesis is 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, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern nutritional 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 case, only surgery will help. No ointment or medication can repair cartilage. Medicines can only stop the process of destruction of cartilage tissue.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without appropriate treatment, the patient's condition rapidly deteriorates. The knee cannot function, serious complications arise:
- joint deformity;
- cosmetic defect - curvature of a limb;
- infection by blood or lymph flow from another source in the body;
- due to the weakness of the ligaments, dislocations and fractures occur even during normal walking;
- Bone fusion (ankylosis) occurs in the joint area, making movement impossible.
If the patient does not consult a doctor in time and the disease progresses, complications develop. Regular preventive examinations and timely treatment of general diseases of the body will help prevent worsening of the condition and preserve the motor function of the limb.