Gonarthrosis is a pathological process in the cartilage tissue of the knee joint, which leads to its deformation. This process is associated with high stress on the knees, ear and salt deposits.
Myths about gonarthrosis
There are 3 most famous myths:
- "The diagnosis of gonarthrosis is prerogative of people with increased physical activity and people with mostly sedentary work do not suffer from it. " In fact, excessive physical exercise actually contributes to cartilage deterioration. During sedentary work, a static effect occurs in the knees, the blood supply is disrupted. Moreover, a sedentary lifestyle leads to an increase in body weight.
- "Gonarthrosis of the knee joint is incurable, the disease is progressing every day. " This disease is indeed chronic, but with adequate timely treatment, cartilage deterioration can be prevented.
- "With osteoarthritis, you need to move as little as possible and stretch more. " A patient with such a pathology is assigned a special gymnastics, which strengthens the ligament apparatus. Only a few sports are really contraindicated.
Gonarthrosis is the destruction of articular cartilage at the knee joint and adjacent bone surfaces.
Manifestations of osteoarthritis of the knee joint
Manifestations depend on the severity of the deformity. The more it is expressed, the more pronounced the symptoms.
Symptoms of gonarthrosis:
- long asymptomatic period;
- discomfort in the knee area;
- pain syndrome;
- reduced mobility;
- morning hardening up to half an hour;
- the presence of a crisis during active movement;
- change in gait.
Bilateral gonarthrosis occurs when the knee joints of both limbs are involved in the process. This is one of the most severe forms. Occurs in the elderly.
Right gonarthrosis manifests itself with excessive static or dynamic physical exercise in the right limb. Most often in athletes.
Left gonarthrosis occurs in overweight people and in athletes with a load on the left leg.
Reasons for the development of gonarthrosis
Gonarthrosis is primary and secondary. Primary can occur in childhood and adolescence, which is associated with malformed joints, as well as in the elderly due to the natural aging process.
Secondary occurs due to existing injury or disease. Main reasons:
- fractures, bruises, dislocations;
- excess weight;
- the presence of an inflammatory process in the joints and lack of adequate therapy;
- metabolic diseases, which are associated with the deposition of salts in cartilage tissues;
- operations;
- vitamin D deficiency;
- hormonal disorders;
- weight lifting;
- some sports (running, hockey, football).
Who is at risk?
The risk group includes:
- professional athletes;
- obese people;
- patients who have suffered trauma or surgery;
- persons over 45 years of age;
- patients with varicose veins;
- those who have had cases of osteoarthritis in the family.
The risk group also includes women who wear high-heeled shoes or thin flat heels.
The exact causes of knee osteoarthritis are unknown.
Degree of gonarthrosis
Radiologically, this pathology is divided into 5 stages or degrees:
- Stage 0 - Absence of X-ray osteoarthritis;
- Stage 1 - the appearance of a small osteophyte;
- Stage 2 - osteophyte has clear contours, joint space changes minimally;
- Phase 3 - narrowing of the joint space;
- Stage 4 - marked narrowing of the gap, subchondral bone sclerosis.
Knee gonarthrosis 1 degree
The first degree is characterized by fatigue, limited mobility is expressed little and a crack is heard. The pain appears after waking up, sitting for a long time and after physical exercise.
There is still no deformation at this stage. Radiography shows a narrowing of the joint space.
How to treat gonarthrosis?
For treatment, a special group of drugs is used - chondroprotectors. They contain chondroitin and glucosamine, which restore cartilage structure and increase elasticity. NSAIDs are used to relieve pain.
Primary gonarthrosis is most often bilateral. Even with the development of a unilateral form of the disease, after a while the second limb is also involved in the pathological process.
The early symptoms of osteoarthritis of the knee joints are mild and not characteristic
Treatment methods
In addition to treatment with medication in the remission phase, the following methods are used:
- physiotherapy;
- massages;
- caterpillar therapy;
- ultrasonic exposure;
- baths with radon and hydrogen sulfide;
- phonophoresis, electrophoresis;
- paraffin wrappers;
- use of therapeutic mud.
These methods are used regardless of the stage of development of the disease during remission.
Is clay good for knee gonarthrosis? One of the indications for mud therapy are diseases of the musculoskeletal system. The course of therapy is performed twice a year. It involves from 10 to 15 procedures. The method can be used at home, and dirt can be purchased at the pharmacy.
In the first degree, the patient is prescribed orthopedic shoes for the period of deterioration to prevent the development of the deformity process. Women are advised to wear shoes with a dense sole at least 1 cm, a heel of 5 cm. Normalize your diet - reduce the amount of salt, spicy foods. Jelly meats and jellies are included in the diet as they are natural chondroprotectors.
Another method is weight correction. Reducing body weight to an optimal level for a given patient will reduce the load on the musculoskeletal system.
Grade 2 gonarthrosis
In the second degree, the pain intensifies, due to which movement is significantly restricted. Long-term walking over long distances causes severe pain syndrome. The patient should rest to continue.
If treatment is not started (or is ineffective), osteoarthritis of the knee joint progresses further.
Cracking is done loudly, lameness appears. The affected node is deformed. An inflammatory process occurs in the inner membrane of the joint.
On plain X-ray, a narrowing of the joint space, the appearance of vertebrae in the bone (osteophytes) appears.
Treatment
Drug therapy is based on the use of NSAIDs. They have analgesic and anti-inflammatory effects. Further, chondroprotectors are prescribed.
After the deterioration has passed, physiotherapy exercises, massage are prescribed.
Diet recommendations:
- increases the amount of vegetables;
- include jelly and jelly meat in the diet;
- eat lean fish twice a week;
- give preference to lean meat;
- eat whole wheat bread.
It is also recommended to include in the diet bananas, nuts, eggs, spinach, legumes, liver, cabbage.
In addition to orthopedic shoes, special knee pads are prescribed.
From surgical interventions, arthroscopic removal of deforming tissue is used. This method has a short-term effect of 2-3 years.
Knee gonarthrosis, symptoms and grade 3 treatment
The heaviest rate. Pain syndrome occurs during movement and at rest. Knee mobility is as limited as possible, and sometimes impossible. The deformation is pronounced. There is virtually no common space on the roentgenogram.
Progressive destruction of cartilage and bone in the final stages leads to the development of ugly knee deformities, which increase in size.
Treatment
At this stage, in addition to NSAIDs, the patient is prescribed hormonal medication. They are injected intravenously or inside the node. Severe pain syndrome is relieved with painkillers.
In stage 3, surgery is already indicated - endoprosthetics. Individual bone elements or the entire joint are replaced. Contraindications: osteoporosis.
Complications of arthroplasty:
- marginal skin necrosis;
- rejection of the prosthesis;
- neurovascular disorders (paresis, thrombosis).
In addition to endoprosthetics, there is the operation of arthrodesis - the removal of deformed tissues and joints. Rarely used.
Osteotomy - cutting the edges of the bones to redistribute the load.
Physiotherapy
Exercises for gonarthrosis of the knee joint can relieve pain, strengthen the muscular apparatus and stimulate blood flow in them.
- Exercise # 1. The patient lies on his back, raises his leg straight and holds it for at least 30 seconds, then the second. Execution time should be around 2 minutes.
- Exercise number 2 "Bicycle". Lying on your back imitate cycling with your feet. Repeat 20 to 50 times.
- Exercise number 3. The patient lies on his stomach, bends his legs, trying to reach the buttocks with heels. Repeat 20-50 times.
- Exercise number 4. It is done in the same way as the previous one, only statically. That is, the patient adjusts the limb to this position for 20-30 seconds.
Patients are advised to lie down:
- Exercise # 1. In a standing position, bend over, trying to reach the floor without bending your knees. Hold for 20 seconds, inhaling air through nose, exhaling through mouth.
- Exercise number 2. Sitting on the floor with straight legs, try to wrap your arms around your legs, keeping your knees straight. Hold this position for up to 30 seconds. Perform 2-3 approaches. If the flexibility is not enough to reach the foot, they take the foot from the lower leg and try to pull the body as close to the feet as possible.
- Exercise number 3. The same position as when performing the previous one. The patient takes the foot for the leg, tries to direct it and holds it as high as possible on the floor. If the exercise is difficult to do, then the foot is taken in the area of the lower leg. Hold the position for 10-30 seconds, then do it with the other leg.
Contraindication is the period of exacerbations and the presence of an acute inflammatory process. Patients are forbidden to run, walk long and do squats.
After performing physiotherapy exercises, it is useful to massage the muscles of the thigh, lower leg into the affected limb. The joint itself should not be affected, this will increase inflammation.
Disease prevention
This disease is not hereditary, so its development can be prevented. This requires:
- avoid injuries during sports;
- do stretching and joint gymnastics, yoga;
- eat properly;
- maintain a normal body weight;
- if you experience any discomfort in the knee area, consult a doctor;
- drink enough water;
- after 40 years, take prophylactic chondroprotectors;
- do not cool the joints too much;
- in the presence of the early stages of the process and during forgiveness, do not increase physical activity, do not run;
- wear orthopedic shoes;
- use knee pads when doing sports.