The inflammatory-degenerative process in the knee joint or gonarthrosis occurs for various reasons. It has an extremely negative impact on a person's quality of life, sometimes leading to 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 often affected. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint can completely fail. This leads to impaired musculoskeletal function. Movement is possible only with the help of crutches, or the person becomes hostage to 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 the leg in different directions, promotes correct body position and coordination in space. This is a strong and stable joint that can support the weight of a person. It consists of 3 bones: the femur, tibia and fibula, as well as the patella or kneecap. It includes osteochondral structures, muscles, ligaments and nerve fibers.
The disease begins with disruption of blood circulation and nutrition of joint tissues. First of all, the cartilage suffers. The quality and quantity of the synovial fluid in the joint capsule decreases and contributes to the smooth functioning of the knee. Friction occurs between the joint parts. Gradually, the cartilage cracks and fails. Unprotected bones begin to rub against each other. Pain appears and a cracking 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 down significantly. Gonarthrosis in varying degrees, after 60 years, occurs in more than 80% of people.
There are other causes of knee arthrosis:
- 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 developing the disease increases in people who engage in repetitive physical labor. This group also includes athletes, people who lead a sedentary lifestyle and people with unfavorable environmental conditions. Often patients are people addicted to toxic substances (drugs, alcohol, smoking).
The cause of joint deformation can be work related to constant hypothermia. A provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine myoma). Due to the lack of minerals and vitamins in the body, nutrition 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. There may be slight discomfort and pain after prolonged exercise, which disappears after rest. The pain is felt in the morning, when moving, after a while it passes. Arthrosis of the 1st degree is rarely diagnosed, by chance, during a routine examination.
- The pain and stiffness in the knee increases. One saves the leg and tries to put less strain on it. As a result, the muscles atrophy, the joint is deformed, a formation can be felt, and the knee leg does not fully extend.
- The pain is constant. The leg does not straighten or bend, and it is difficult for the man 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 addition to the pain in degrees 2 and 3, you can also hear a crackling 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, the knee joint is deformed.
Diagnostics
If you have knee pain, you can contact your local doctor, who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
To find out the causes and treatment of gonarthrosis, a comprehensive diagnosis is required:
- general and biochemical blood test;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
X-ray allows to see the state of the cartilage and changes in the bones in stages 2 and 3. 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 the treatment of the knee, to remove pieces of cartilage or meniscus.
Treatment of arthrosis of the knee
The therapy is long and sometimes painful. Having appeared once, the disease is remembered 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 eliminate inflammation and pain. Medicines are relatively cheap, but lead to the formation of ulcers and erosions of the stomach and duodenum. Modern drugs cause fewer side effects, but are expensive.
Treatment measures for phase 1 include preventive measures related to exercise. It requires daily exercise, use of contrast shower, swimming pool 2 times a week and fight against increased body weight.
Stage 2 requires fixation of the joint - use of an elastic bandage, bandage or orthosis. For pain relief, NSAIDs are used in the form of creams and ointments. To reduce the degree 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), which have high glucocorticosteroid activity and low mineralocorticosteroid activity. In addition, painkillers are prescribed.
A 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 wrist. The manipulation is painful, it is carried out by a doctor after the acute period subsides. If conservative treatment is unsuccessful, endoprosthetics is performed.
Along with drug therapy, exercises are prescribed using special simulators and devices (kinesitherapy). Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered through subcutaneous or intramuscular injections, ointments based on ozone, creams. Manipulation stimulates blood circulation, improves the effect of chondroprotectors and glucocorticosteroids.
Modern nutritional supplements are sought after as an alternative to drugs for joint restoration. Exercise and massage therapy is 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 situation, only surgery will help. No ointment or medicine can restore cartilage. Medicines can only stop the process of destruction of cartilage tissue.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without proper treatment, the patient's condition rapidly deteriorates. The knee cannot work, serious complications arise:
- joint deformity;
- cosmetic defect - distortion of a limb;
- infection with the bloodstream or lymph from another body source;
- due to the weakness of the ligaments, dislocations and fractures are observed, even during normal walking;
- fusion of the bones (ankylosis) occurs in the joint area, making movement impossible.
Complications develop if the patient does not go to the doctor in time and the disease is advanced. Regular preventive examinations and timely treatment of general diseases of the body will help prevent deterioration of the condition and maintain the motor function of the limb.