In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint occupies a leading place.
Gonarthrosis or osteoarthritis of the knee joint is a disease accompanied by slow destruction of the cartilaginous tissue of the joint, involving the entire joint in the pathological process, including ligaments, synovial membrane, subchondral bone and other elements of the joint.
Under the influence of various factors, such as infectious diseases (colds, flu, typhoid, tuberculosis, syphilis, sore throat and several others), injuries, functional congestion of the joint (for example, athletes, workers performing heavy physical labor, ballet dancers), trophism (nutrition) of the cartilaginous tissue of the knee joint is disrupted, as a result of which the cartilage becomes thinner and destroyed, sometimes to the point of completely disappearing.
Who is at risk?First of all, women over forty are at risk of developing osteoarthritis of the knee joint;this happens there twice as often as in the stronger half of humanity.In addition, the risk increases in women prone to overweight or obesity.
But overall, knee osteoarthritis is a disease of the elderly.And there is a simple explanation for this.As you know, cartilage tissue consists of about 70-80% water, due to which it is well absorbed.In addition, from a very young age, “regenerative” cells, chondrocytes, work actively.With age, the amount of moisture begins to decrease and, as a result, the ability to cushion the joint deteriorates, the cartilage becomes dry, brittle and cracks, and the existing chondrocytes do not have time to repair the damage.In many respects, this explains the appearance of gonarthrosis of the knee joint.
Causes of disease
Predisposing factors include being overweight, physical inactivity, chronic joint damage or systematic microtrauma of the joint, alcohol abuse, chronic stress, previous or existing diseases of the knee joint, such as:
- knee arthritis,
- sprain, partial or complete rupture of ligaments,
- intra-articular fracture of the femur or tibia,
- metabolic disorders, for example gout, and a number of other pathological conditions.
Very often, it is not possible to establish a specific cause that caused gonarthrosis of the knee joint;in this case they talk about a combined cause, that is, gonarthrosis was the result of several diseases at once.
In addition, the disease, depending on the reasons for its occurrence, is usually divided into two forms: primary and secondary.
The cause of primary osteoarthritis is age and the presence of associated factors, such as:
- Professional predisposition,
- Excess weight
- Obesity,
- Varicose veins of the lower limbs.
The cause of secondary gonarthrosis may be a previous injury to the knee (fracture, rupture of the ligamentous apparatus), called post-traumatic osteoarthritis of the knee joint.The cause may also be a previous infectious disease or inflammation of the knee joint.
Symptoms
Signs of osteoarthritis of the knee joint do not appear overnight;The development of the disease occurs gradually and often takes several months or even years.The pain that appears is constant and aggravated by physical activity - walking, running, going up or down stairs, etc.Another characteristic symptom of this disease is the presence of crackles in the joint, this can be a cracking or cracking sound in the knee.
Very common manifestations of knee osteoarthritis are also:
- increase in local temperature (the joint is hot to the touch) or general,
- the presence of swelling of the joint,
- increase its volume,
- difficulty moving,
- deformation of the joint with subsequent curvature of the limb.
As the disease progresses, when the cartilage tissue is completely destroyed, the body has no choice but to start defending itself.This is manifested by the growth of bone tissue on the bones that form the joint in the form of “spikes” (osteophytes), and deforming osteoarthritis of the knee joint occurs.Exudate appears in the joint cavities.
Depending on the size of the osteophytes and the degree of deformation, there are several degrees of knee osteoarthritis:
- Gonarthrosis 1st degree.Patients experience stiffness and mild pain in the joint in the morning or during prolonged sitting or standing.There is no deformation of the joint at this stage, mobility is completely preserved.An x-ray reveals a small osteophyte.
- 2nd degree gonarthrosis.Painful sensations appear not only in the morning, but also after prolonged exercise;the joint is deformed, the joint surfaces are expanded, which also leads to an increase in the volume of the joint, flexion is difficult and a crunching sensation is felt when performing movements.The x-ray shows a pronounced osteophyte, the joint space is not modified.
- Gonarthrosis 3 degrees.The manifestations are the same as in the second degree, only the symptoms become more severe.The pain is constant and does not subside even with rest and sleep.The function of the joint is almost completely lost;patients cannot bend or straighten their leg.As a result, lameness appears and movement becomes possible only with crutches or assistance.There is a serious deformity of the knee joint.An x-ray reveals a slight narrowing of the joint space.
- There is also a fourth step, in which there is complete immobilization in the affected joint with additional deformity.X-rays reveal sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of osteoarthritis of the knee joint
To achieve good results from treatment, you need to seek help from a qualified rheumatologist, and if he is not there, from a therapist, because it is they who know how to cure osteoarthritis of the knee joint.Under no circumstances should you try to treat it yourself, this can only make an already bad situation worse.Before starting treatment, it is extremely important to make a correct diagnosis, because a correct diagnosis is the key to successful treatment.
Treatment of knee osteoarthritis is a fairly long process and depends on a number of factors (type of osteoarthritis, cause of osteoarthritis, degree of the disease).Treatment is complex and includes drug and non-drug treatment and in some cases surgical treatment is indicated.
Drug treatment of osteoarthritis of the knee joint is aimed primarily at relieving the main manifestations of the disease, such as:
- Pain ;
- Inflammation of joint and periarticular tissues.
In addition to relieving the symptoms of the disease, medications are used to:
- restoration of joint tissues,
- improve trophism and blood circulation,
- strengthen the body's defenses,
- eliminating allergic reactions.
To relieve pain symptoms, various non-narcotic analgesics are used;in rare cases, narcotic pain relievers are prescribed for a short time.The most commonly used medications belong to the group of nonsteroidal anti-inflammatory drugs.They have a combined anti-inflammatory, analgesic and antipyretic effect.
Chondroprotectors are used to restore cartilage tissue and improve joint mobility.Medicines stimulate the activity of cartilage cells - chondrocytes and help them restore tissues.Intra-articular administration of chodroprotectors gives a good effect.In recent years, a new effective product based on hyaluronic acid has appeared.Because of its effect, this medicine is called “liquid prosthesis”.After injection into a painful joint, this medication forms a protective film on the damaged cartilage and gradually restores the normal lubrication characteristics of the joint.
Muscle relaxants are used to relieve muscle spasms;in addition to their relaxing effect, they have a positive effect on blood circulation in the affected joint.
Among non-drug methods of treating gonarthrosis, manual and physical therapy are widely used.Magnetic therapy, acupuncture, electrophoresis and massage, hardware traction (joint traction) and others are of the greatest importance.Recently, the practice of treating osteoarthritis has included methods such as laser therapy and cryotherapy (exposure to liquid nitrogen).Along with physiotherapy, exercise therapy for osteoarthritis of the knee joint also gives a good effect.Exercise therapy involves using various physical exercises for therapeutic purposes.
Gymnastics for osteoarthritis of the knee joint
At the beginning of the disease, physical stress on the affected joint should be minimized.You should not run, jump, lift weights, walk quickly, or squat.Exercises for osteoarthritis of the knee joint can be performed only after completing treatment, under the supervision of your attending physician.
It is necessary to choose exercises that help strengthen the muscles and ligaments of the affected knee joint, but do not lead to excessive mobility of the joint.In other words, exercises should include minimal dynamic activity.It is useful to perform exercises to stretch the ligaments and joint capsules.The rules here are the same, perform the exercises gently, without any effort.
When performing gymnastic exercises, it is important to follow a few rules:
- Do not perform exercises while overcoming pain,
- If an exercise causes pain, it should be replaced with a gentler one.
Massage for osteoarthritis of the knee joint has a beneficial effect on restoring the functions of the knee joint.At the site of exposure, blood vessels dilate, blood circulation improves, and metabolism accelerates.Massage procedures improve lymphatic flow, which helps eliminate residual inflammation.Massage strengthens the muscular system, increases oxygen flow, improves gas exchange, normalizes their tone and increases plasticity.
Diet for knee osteoarthritis
Recently, medical experts have discovered that there is no direct relationship between the incidence of knee OA and nutrition.However, an indisputable fact is that the development of osteoarthritis is greatly influenced by the presence of excess weight in a person.If the cause of the disease was precisely excess weight, then it is obvious that nutrition for osteoarthritis of the knee joint should be aimed at gradually reducing body weight.This will require a diet change and diet change.Foods should be less high in calories, fried foods and foods high in fat should be excluded from the diet.Eat more vegetables, fruits and fluids.
Prevention of osteoarthritis of the knee joint
In order for the joints to remain healthy as long as possible, it is necessary to regularly engage in physical education and gymnastics, but you should not get too carried away, so that this does not lead to overload of the joints.Swimming provides the best effect and minimal stress on the joints.If you play professional sports, you must use joint protection.It is useful to alternate physical activity and rest;you don't have to stay still for long.
Compliance with all these simple rules, combined with a healthy lifestyle and proper nutrition, will not allow osteoarthritis of the knee joint to spoil anyone's life.