The inflammatory-degenerative process in the knee joint, i. e. 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 collapse. This leads to impairment of musculoskeletal function. Movement is possible only with the help of crutches, or the person becomes a hostage of a wheelchair.
The knee joint is the second largest, after the hip, and the most complex in structure. It allows bending and straightening the legs in different directions, promotes proper body position and coordination in space. This is a strong and stable joint that can support a person's weight. It consists of 3 bones: femur, tibia and fibula, as well as the patella or knee. 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, the cartilage suffers. The quality and quantity of synovial fluid in the joint capsule decreases and contributes to the smooth functioning of the knee. Friction occurs between the parts of the joint. Gradually, the cartilage cracks and decays. Unprotected bones begin to rub against each other. There is pain and a creaking sound.
Causes of disease
It mainly affects older people, especially overweight women. As a result of hormonal changes, the cartilage in the knee wears down a lot. Gonarthrosis of various degrees, after 60 years, occurs in more than 80% of people.
There are other reasons for the appearance of knee arthrosis:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part thereof;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people who engage in repetitive physical work. This group also includes athletes, people who lead a sedentary lifestyle and people with unfavorable environmental conditions. Often, human patients are addicted to toxic substances (drugs, alcohol, smoking).
The cause of joint deformation can be work associated with constant hypothermia. The provoking factor is the period after menopause, when women develop gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Due to the 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 manifestations, the disease is divided into stages:
- At this stage, there are no obvious clinical signs. Minor discomfort and pain may occur after prolonged exercise, which disappear after rest. The pain is felt in the morning, when moving, it disappears after a while. Arthrosis of the 1st degree is rarely diagnosed accidentally, during a routine examination.
- Knee pain and stiffness increase. The person saves the leg and tries to put less strain on it. As a result, the muscles atrophy, the joint is deformed, formation can be felt, and the leg in the knee does not fully extend.
- The pain is constant. The leg does not straighten or bend, and the person has difficulty walking. 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 pain in degrees 2 and 3, there is a creaking 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 will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist if necessary.
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.
An X-ray allows insight into 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
The therapy is long and sometimes painful. Having appeared once, the disease reminds of itself for the rest of its 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 remove 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 stage 1 include preventive measures related to exercise. Daily exercise, use of a contrast shower, swimming pool twice a week and control of increased body weight are mandatory.
Stage 2 requires fixation of the joint - using an elastic bandage, bandage or orthosis. For pain relief, NSAIDs are used in the form of creams and ointments. In order 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 - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity - are indicated. 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 joint. Manipulation is painful, it is carried out by a doctor after the withdrawal of the acute period. If conservative treatment is unsuccessful, endoprosthetics are performed.
Along with drug therapy, exercises on special simulators and devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knees. The substance is used externally, applied through subcutaneous or intramuscular injections, ozone-based ointments, creams. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern nutritional supplements are sought after as an alternative to drugs for joint reconstruction. 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 situation, only surgery will help. No amount of ointments or drugs 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 deteriorates rapidly. The knee cannot work, serious complications appear:
- joint deformity;
- cosmetic defect - curvature of the extremities;
- infection through the flow of blood or lymph from another source in the body;
- due to the weakness of the ligaments, dislocations and fractures are observed, even during normal walking;
- bones join together (ankylosis) in the joint area, which prevents movement.
Complications arise if the patient does not go to the doctor on time, and the disease is advanced. Regular preventive examinations and timely treatment of general diseases of the body will prevent deterioration of the condition and maintain the motor function of the extremities.