Knee osteoarthritis (gonarthrosis)

Osteoarthritis of the knee joint (also called gonarthrosis) is quite a common disease that has recently been found not only in the elderly, but also in young people.

Pathology is one of the main causes of disability for patients when they refuse to seek help from a traumatologist or orthopedic surgeon.

Let's consider why patients develop osteoarthritis of the knee joint, what are its main symptoms, how dangerous it is, and how to carry out effective treatment for the progressive destruction of the knee joint.

The main factors for the appearance of this pathology

The joints are constantly exposed to considerable stress. The knees are particularly affected: they are forced to do a lot of physical work, which is why they wear out quickly. The deformation process is intensified by the fact that the legs are forced to carry the body weight.

This fact further contributes to the fact that the knees begin to wear out and the cartilage tissue of the joint thins and breaks down.

The following reasons can accelerate the pathological process in the joints:

1. Increased body weight of the patient. Complete destruction of the joint occurs much faster and more intensely. It has been shown that the disease in question is three times more likely to occur in obese people than in people of normal weight.
2. Intense sport in which the joints are constantly injured.
3. Frequent fractures, previous knee injuries contribute to the fact that the patient begins to degenerate processes of the articular cartilage at a young age.
4. Anomalies in the location of the bones - the so-called valgus or varus deformity.
5. Poor development of the ligamentous apparatus of the knee leads to frequent injuries, dislocations. As a result of the injuries described, the patient develops osteoarthritis.
6. Damage to the meniscus triggers the degenerative process of destruction of the knee.
7. Constant stress leads to a deterioration in the health of the musculoskeletal system.
8. Disruption of metabolic processes in the body due to a lack of nutrients and minerals (bones suffer most from a calcium deficiency).

The following people also belong to the risk group:

• all athletes;
• Patients, regardless of gender, who have reached the age limit of 50 years;
• Women who have started menopause;
• Patients with varicose veins;
• People with poor inheritance.

What are the degrees of the disease?

The pathology in question develops gradually, very slowly. At first it may not appear, and the patient is in no hurry to see a doctor. Despite this, the pathological process has already begun, and if it is not stopped in time, the functions of the lower extremities will gradually be lost, which will result in the onset of disability.

For example, at grade 1, the patient can determine that the leg is getting tired, even if the load was low. A certain restriction in the mobility of the knee joint can be felt and a distinct crunch can be heard during the movement.

There is pronounced initial pain when the symptoms do not give you rest mainly in the morning. After the patient has "spread out", the symptoms gradually subside and increase again after exercise. At this stage of the development of the disease, there is no pronounced deformation of the bone tissue.

From grade 2 the pain gets worse. Walking is impaired as a result. Sometimes it is almost impossible for the patient to move normally, and a long rest is required even after a small amount of stress. When the joint space narrows, osteophytes grow on the bones and abnormal fluid builds up in the joint.

From grade 3 pain occurs not only at work, during sports, but also in complete rest. The deformity of the knee is very pronounced, which makes any movement difficult.

Common symptoms of the disease

It is necessary to pay attention to the general symptoms of osteoarthritis of the knee joint:

1. Pains. It doesn't appear suddenly, but mild discomfort can last for almost years. More severe pain is caused by trauma.
2. Deformation of the knee (it keeps its previous shape).
3. Accumulation of fluid in the intra-articular cavity. When its amount exceeds certain values, the so-called Baker's cyst develops. A tight elastic object appears on the hollow of the knee. It is most noticeable when the joint is stretched.
4. Knee grinding is observed when the pathology is in the second or third stage. It is very different from what is observed in a healthy person when they flex or straighten the knee. The sound is felt to be hard and painful. Sometimes the crunch interferes with active movements.
5. Decreased normal range of motion of the joint. Usually the patient cannot bend the affected leg, bend it. He can bend it at right angles, further movements are accompanied by severe pain.
6. Knee stiffness mainly occurs in stages 3. Sometimes patients can only walk with the limbs flexed.
7. Increased pain when the weather changes.
8. Significant thinning of the cartilage. In more advanced cases, bone exposure is sometimes noted. The x-ray of the knee shows a significant accumulation of osteophytes.

Types of osteoarthritis

Depending on the origin, osteoarthritis is primary (runs as an independent disease) or secondary - a complication of existing pathologies. Depending on the location, the pathology is right, left and bilateral.

Based on the features of the manifestation, the following types of the disease are distinguished.

1. Deforming osteoarthritis is characterized by a chronic, irreversible change in the joint.
2. Patellofemoral osteoarthritis develops due to prolonged intense physical exertion.
3. Inflammatory osteoarthritis is caused by a persistent, untreated inflammatory process in the joints.
4. Dysplastic osteoarthritis develops due to congenital abnormalities in the structure of the knee joint.
5. Post-traumatic osteoarthritis occurs as a result of frequent injuries to the musculoskeletal system.
6. Metabolic osteoarthritis occurs in gout and other metabolic disorders.
7. Post-infectious osteoarthritis occurs as a result of inadequately treated inflammatory pathologies.
8. The static form of the disease is recognized when the knees are constantly exposed to increased pressure.
9. If the cause of the knee lesion is not clear, experts speak of idiopathic osteoarthritis.

Features of the treatment of the disease

In the initial stages of the development of the disease, a rheumatologist and a traumatologist are involved in treatment. If she has gone too far, the patient should see a surgeon. After all, in some clinics there is a narrow specialist who deals with joint diseases - an arthrologist.

The extent of the therapeutic measures depends on how far the disease has progressed. If the cause of the pathology in question can be eliminated at an early stage, an almost permanent recovery can be achieved.

The goals of every therapy are complete freedom from pain, the restoration of damaged cartilage and an increase in the range of motion in the joint.

The course of treatment with drugs is selected exclusively by a doctor. The patient cannot prescribe it to himself as it can contribute to further destruction of the joint. The main drugs are prescribed:

1. Nonsteroidal anti-inflammatory tablets or ointments. Their action is aimed at relieving pain and inflammation in the affected area. Sometimes injections into the joint cavity can be prescribed.
2. Products that improve blood flow to the knee. These are muscle relaxants, antispasmodics. The latter are good at relieving pain.
3. Products that restore articular cartilage improve the normal nutrition in it.

The novocaine blockade helps relieve acute pain. The injection can be made from the outside or inside of the joint. The easiest and safest method is to give the medicine externally. With proper handling, the pain will go away almost instantly.

An ointment based on potent NSAIDs also helps to cope with pain. It should be remembered that you should not take strong drugs for a long time. Any drug, even the most effective, can have side effects and cause allergic reactions. This means that self-medication is generally not allowed for this serious illness.

Conservative treatment can be effective as long as the disease has not progressed too far. Surgical intervention is indicated for irreversible joint damage. A metal prosthesis is implanted.

This is the only way to restore knee mobility at the moment. The disadvantages of these operations are the limited lifespan of the prosthesis and the high price.

In arthroscopy, all surgical interventions are performed through microscopic punctures in the joint. During the operation, the affected cartilage fragments, clots, etc. are removed from the joint. In stage 3 of the disease, the type of intervention described has no effect.

A periarticular osteotomy is used to reduce the load. It is shown to be performed when the joint has not yet been completely destroyed.

To relieve the joint affected by the degenerative process, sticks and orthotics are used.

The duration of treatment for the disease depends on many factors. The course of therapy with chondroprotectors can be quite long - six months or even longer, since their effect manifests itself rather slowly. A qualified doctor can determine how long to take your prescribed medication.

The use of chondroprotectors in the treatment of osteoarthritis

To relieve pain, doctors prescribe nonsteroidal anti-inflammatory drugs (NSAIDs).

However, even new generation NSAIDs cannot prevent the pathological process from spreading. Chondroprotectors are increasingly used to reduce the intensity of joint degeneration and restore normal mobility.

Modern drugs of this group help restore joint tissue. This is due to the chondroitin content in them. It is a natural part of cartilage. Constant use of drugs of this group will help restore them and improve health.

Despite the wide range of drugs on offer, only a doctor can decide which is right for a patient. Injection of chondroprotectors is not shown to everyone, the drugs themselves are diluted in special solvents.

The use of dietary supplements is indicated if the patient follows the rules of a balanced diet, takes other drugs to support the joints.

The role of exercise therapy and physical therapy in treating osteoarthritis of the knee

With the described pathology, the patient is categorically contraindicated with a recumbent lifestyle. Physical activity in any musculoskeletal disorder is simply necessary for all categories of patients. Of course it has to be dosed; Each exercise is performed exclusively under medical supervision.

A traumatologist or rehabilitation therapist individually selects special exercises for each patient. There is no need to think that different classes of classes found on the internet are suitable for all patients without exception.

For some, they can be very useful, while for others, they can do great harm. All loads should be gentle and aimed at the fastest and most complete restoration of the functions of the affected joints.

At home, it is advisable to do a simple exercise: while lying down, lift your leg, hold it for a few minutes, and then lower it again. It is harmless and can also be done by patients in the third stage of the disease. Exercises to stretch the joint capsule are performed under medical supervision. However, if it causes pain, the execution must be stopped immediately.

Physiotherapeutic methods of treating a disease include:

• massage (it is strictly forbidden to do it without a medical certificate);
• manual therapy (it should be as gentle as possible, not cause discomfort);
• medical laser treatment;
• Effect on reflexogenic points with the finest needles;
• Treatment with heat or cold (again, you do not need to do heat treatments at home);
• Magnetic field treatment;
• Phonophoresis;
• Electrophoresis;
• Paraffin therapy;
• Ozokerite treatment;
• Moxibustion with wormwood.

Diet for osteoarthritis of the knee

Proper nutrition is the basis for the successful treatment of degenerative diseases of the musculoskeletal system. Due to an improperly formulated diet, the patient may gain weight. The lack of vitamins and microelements aggravates the course of the pathology.

Anyone with osteoarthritis of the knee should increase the amount of vitamin and mineral fortified foods in their daily diet.

Nutritionists recommend closely monitoring the calorie content of foods. Fasting or extreme diets are strictly prohibited. They can harm, body weight will gain even more.

It is essential to ensure that the breakfast is balanced. You need to eat at least five times a day. For snacks, it is recommended to use fruits and bread.

The following foods and dishes are excluded:

• sweet lemonade;
• fatty meals;
• semi-finished products;
• Spices;
• Dishes with flavor and odor enhancers;
• Fatty Meat;
• fried dishes;
• White cabbage;
• Tomatoes and peppers;
• Oranges, lemons;
• Chocolate;
• Bananas, grapes (they are very high in calories).

Meat and jelly jellies are useful. They contain a large amount of collagen, which helps restore bone. Jellied meat is prepared in such a way that it contains less fat, so the calorie content is lower.

Sources of protein for people with osteoarthritis can be dairy products - cheese, cottage cheese, or kefir. It is very useful to consume legumes. Be sure to include nuts in your diet.

It is necessary to observe the drinking regime. If there are no accompanying kidney diseases, it is recommended to consume approx. 2 liters of water.

About alternative treatment for the disease

It is worth remembering that traditional methods cannot replace effective methods of official medicine. And therefore they should be used in complex treatment, there can be no other therapy for this serious disease.

To relieve knee swelling, use regular soda. The fabric is moistened with soda slime and wrapped around the knee. At the top, in order to increase the thermal effect, it is advisable to attach a plastic bag. Keep the prepared compress all night.

A similar compress is made by adding table vinegar. Acetylsalicylic acid tablets must be taken parallel to the application of compresses.

Burdock leaves are very useful for the knee. Before applying the leaves, it is advisable to lubricate the knee with vegetable oil. It is necessary that there are several layers of leaves.

All of this is packed in a plastic bag. Compresses with birch leaves are made in the same way.

Medicinal bile is good at relieving inflammation, swelling, and pain. It is used at night in the form of warming compresses. Bile has practically no side effects.

Treatment with honey is carried out in cases when the patient is not allergic to it. After warming up the sore joint with a heating pad, it should be lubricated with honey and a gentle massage should be performed. Then attach the burdock leaves to the knee.

Prevention of osteoarthritis of the knee

Preventing a disease is much easier than curing it. Preventive measures include:

• high quality, balanced diet with the use of a sufficient amount of proteins, vitamins and calcium;
• Elimination of bad habits;
• the fight against obesity;
• Normalization of physical activity;
• Preventing joint injuries while exercising or doing heavy physical work.

When the first symptoms appear, it is important to see a doctor immediately. In a clinic interview it can be determined which doctor is treating the osteoarthritis of the knee. It is advisable to undergo a full medical examination to find out the cause of the development of the disease.

Osteoarthritis of the knee joint is a serious disease: if not avoided, there is a risk of disability and complete immobility. To prevent this from happening, you need to properly treat the affected joint. Therapeutic measures started at an early stage contribute to the almost complete remission of this pathology, help to maintain high performance and quality of life.