The inflammatory-degenerative process in the knee joint or gonarthrosis occurs for various reasons. It has a very negative impact on a person's quality of life, sometimes causing disability. How to treat arthrosis of the knee joint and avoid complications?
What is arthrosis?
About 22% of the world's population suffers from gonarthrosis, 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 a malfunction of the musculoskeletal system. It is possible to move only with the help of crutches, or a person becomes a hostage of a wheelchair.
The knee joint is the second largest after the hip and the most complex structure. It allows you to bend and straighten the leg in different directions, promotes correct body position and coordination in space. It is a strong and stable joint that can support the weight of a person. Consists of 3 bones: the femur, tibia and fibula, as well as the patella or kneecap. Includes osteochondral structures, muscles, ligaments, and nerve fibers.
The disease begins with disruption of the blood flow and nutrition of the joint tissues. Cartilage suffers first. The quality and quantity of synovial fluid in the joint capsule, which contributes to the smooth functioning of the knee, decreases. Friction occurs between the connecting parts. Gradually, the cartilage cracks and collapses. Unprotected bones begin to rub against each other. There is pain and a crackling sound.
Causes of the disease
It mostly affects older people, especially overweight women. Hormonal changes cause a lot of wear and tear on the knee cartilage. Various degrees of gonarthrosis occur in more than 80% of people after the age of 60.
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 this disease increases in people who engage in repetitive physical work. This group also includes athletes, people with a sedentary lifestyle and people with adverse environmental conditions. Often patients are people addicted to toxic substances (drugs, alcohol, smoking).
The cause of the deformation of the joint can be work related to constant hypothermia. The 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, diet can be the cause.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. Depending on the nature of the manifestations, the disease is divided into degrees:
- There are no obvious clinical signs at this stage. After prolonged physical exertion, a slight discomfort and pain may appear, which disappears after rest. The pain is felt in the morning when moving, it goes away after a while. Grade 1 arthrosis is rarely diagnosed incidentally during a routine examination.
- Knee pain and stiffness increases. A person takes care of the leg and tries to put less strain on it. As a result, the muscles atrophy, the joint is deformed, the formation is felt, the leg at the knee does not fully extend.
- The pain is constant. The leg does not extend or bend, it is difficult for a person to walk. Partial or complete loss of mobility develops. Cartilage is completely destroyed, friction between the bones of the joint increases when osteophytes are formed.
In addition to 2nd and 3rd degree pain, a crackling sound is heard in the knee area. Fluid and pieces of cartilage can accumulate in the joint capsule, causing 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.
In order to find out the causes and treatment of gonarthrosis, it is necessary to carry out a detailed diagnosis:
- general and biochemical blood test;
- rheumatic studies;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
An X-ray allows you 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 edges of the patella, changes in the periosteum. Arthroscopy provides more detailed information about the menisci, the synovial membrane, and the presence of fluid. This method is also used to treat knees by removing pieces of cartilage or meniscus.
Treatment of knee arthrosis
Treatment is long and sometimes painful. A disease that appears once will remind you of yourself for the rest of your life. The main drugs used in 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 cause ulcers and erosions in the stomach and duodenum. Modern drugs cause fewer side effects, but are expensive.
Stage 1 treatments include preventive measures related to exercise. Daily exercise, contrast shower, pool 2 times a week and struggle with increased body weight are required.
In stage 2, you need to fix the joint - use an elastic bandage, bandage or orthosis. NSAIDs are used in the form of creams and ointments to relieve pain. In order to reduce the degree of cartilage destruction, the patient is prescribed drugs from the group of chondroprotectors.
In severe cases, NSAIDs should be taken. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS) with high glucocorticosteroid and low mineralocorticosteroid activity. In addition, pain relievers are prescribed.
Hyaluronic acid solution is injected into the joint. It is a substitute for the intra-articular fluid and nourishes the cartilage. When moving, it acts as a shock absorber for the joint. The manipulation is painful and is performed by a doctor after the acute period is over. If conservative treatment is unsuccessful, endoprosthesis is performed.
Together with drug therapy, exercises using special trainers and devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, injected under the skin or into the muscles, ozone-based ointments, creams. Manipulation promotes blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern nutritional supplements are in demand as an alternative to drugs for joint restoration. Exercise therapy and massage are indicated. The complex 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 case, only surgery will help. No ointments or drugs can restore cartilage. Drugs can only stop the process of cartilage tissue destruction.
Gonarthrosis progresses gradually, sometimes the disease lasts a year. In the absence of proper treatment, the patient's condition rapidly deteriorates. The knee cannot work, serious complications arise:
- joint deformation;
- cosmetic defect - curvature of the limb;
- infection with blood or lymph flow from another body source;
- due to the weakness of the ligaments, dislocations and fractures are observed even during normal walking;
- fusion of bones (ankylosis) occurs in the joint area, making movement impossible.
Complications develop if the patient does not consult a 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.