Inflammatory-degenerative process in the knee joint, or gonarthrosis, occurs for various reasons. This has a very negative impact on a person's quality of life, sometimes even leading to disability. How to treat arthrosis of the knee joint and prevent complications?
What is arthritis
About 22% of the world's population suffers from gonarthrosis, and women are more frequently affected. This dangerous disease is characterized by rapid development.
If treatment is not started on time, the knee joint may collapse completely. This causes musculoskeletal function disorders. Movement can only be carried out with the help of crutches, or the person becomes hostage to a wheelchair.
The knee joint is the second largest joint, after the hip, and its structure is the most complex. This allows you to bend and straighten your legs in different directions, improving body position and correct coordination in space. It is a strong and stable joint that is able to support a person's weight. Consists of 3 bones: the femur, tibia and fibula, and the patella or kneecap. Includes osteochondral structures, muscles, ligaments, and nerve fibers.
This disease begins with disruption of blood circulation and nutrition of joint tissue. First of all, cartilage suffers. The quality and quantity of synovial fluid located in the joint capsule and contributing to smooth knee function decreases. Friction occurs between joint parts. Gradually, the cartilage cracks and collapses. Unprotected bones start to rub against each other. Pain occurs and a crunching sound is heard.
Cause of this disease
This disease mainly affects elderly people, especially women who are overweight. Due to hormonal changes, the cartilage in the knee becomes severely damaged. Gonarthrosis of varying degrees, after 60 years, occurs in more than 80% of people.
There are other reasons for the appearance of knee arthrosis:
- congenital joint pathologies;
- dysplasia;
- injury, surgery;
- removal of the meniscus or part of it;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
The risk of developing this disease increases in people who do repetitive physical work. This group also includes athletes, people who lead a sedentary lifestyle, and people with less favorable environmental conditions. Often patients are people dependent on toxic substances (drugs, alcohol, smoking).
The cause of joint deformation may be work associated with persistent hypothermia. The provoking factor is the period after menopause, when a woman experiences gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Due to a 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 manifestation, the disease is divided into several degrees:
- At this stage, there are no clear clinical symptoms. There may be some discomfort and soreness after prolonged exercise, which disappears after rest. The pain is felt in the morning, when moving, over time it disappears. Grade 1 arthrosis is rarely diagnosed incidentally during a routine examination.
- The pain and stiffness in the knee increases. A person spares his legs and tries to reduce the load on them. As a result, the muscles atrophy, the joints deform, formations form, and the leg at the knee does not fully extend.
- The pain is constant. The legs are neither straight nor bent, and it is difficult for the person to walk. Partial or complete loss of mobility develops. Cartilage is completely destroyed, friction between joint bones increases with the formation of osteophytes.
In addition to pain in degrees 2 and 3, a crunching sound is heard in the knee. Fluid and pieces of cartilage tissue can build up in the joint capsule, causing swelling. In the final stage, the inflammatory process is pronounced, the knee joint is deformed.
Diagnostic
If you experience knee pain, you can contact your local doctor, who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
To determine the causes and treatment of gonarthrosis, a comprehensive diagnosis is required:
- general and biochemical blood tests;
- rheumatism test;
- radiography;
- Ultrasound and MRI can detect the disease in its early stages;
- arthroscopy.
X-ray makes it possible to see the condition of the cartilage and bone changes in stages 2 and 3. This is a narrowing of the joint space, osteophytes along the edge 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. Having appeared once, this disease will remind you for the rest of your 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. The drugs are relatively cheap, but cause 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 exercise-related preventive measures. Daily exercise, use of a contrast shower, swimming pool 2 times a week, and combating weight gain are necessary.
Stage 2 requires fixation 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 damage, patients are prescribed drugs from the group of chondroprotectors.
Severe severity requires administration of oral NSAIDs. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. Additionally, painkillers are also prescribed.
A hyaluronic acid solution is injected into the joint. It is a substitute for intra-articular fluid and provides nutrition to the cartilage. When moving, it acts as a shock absorber in the joints. The manipulation is painful, performed by the doctor after the acute period subsides. If conservative treatment is unsuccessful, endoprosthetics is performed.
Along with drug therapy, exercises using simulators and special devices (kinesitherapy) are also prescribed. Ozone therapy has a positive effect on the condition of the knees. This substance is used externally, administered by subcutaneous or intramuscular injection, ozone-based ointment, cream. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern food supplements are in great demand as an alternative to drugs for joint recovery. Exercise therapy and massage are indicated. A special set of exercises improves blood circulation and nutrition of cartilage cells, increases the elasticity of ligaments.
Complications and prevention
Damaged cartilage tissue and deformed bones cannot be treated. In this situation, only surgery will help. There are no ointments or medications that can restore cartilage. Medicines are only able to stop the process of destroying cartilage tissue.
Gonarthrosis develops gradually, sometimes the disease lasts for years. Without proper treatment, the patient's condition will quickly worsen. The knee cannot work, serious complications arise:
- joint deformity;
- cosmetic defects - curvature of the limbs;
- bloodstream or lymph infection from another source in the body;
- due to weakness of ligaments, dislocations and fractures are observed, even when walking normally;
- Bone fusion (ankylosis) occurs in the joint area, making movement impossible.
Complications develop if the patient does not see a doctor in time and the disease is advanced. Regular preventive examinations and timely treatment of common diseases of the body will help prevent worsening of the condition and maintain the motor function of the limbs.