Goonarthrosis is a pathological process in the cartilage tissue of the knee joint, which leads to its deformation. This process is associated with high stress on the knees, wear and tear and salt deposits.
Myths about gonarthrosis
There are 3 most famous myths:
- "The diagnosis of gonarthrosis is the prerogative of people with increased physical activity, and people with predominantly sedentary work do not suffer from it. "In fact, excessive physical exertion contributes to cartilage deterioration. During sedentary work, there is a static effect on the knees, the blood supply is impeded. Also, a sedentary lifestyle leads to increased body weight.
- "Knee joint gonarthrosis is incurable, the disease progresses every day. "This disease is indeed chronic, but with proper and timely treatment, cartilage deterioration can be prevented.
- "With arthrosis, you need to move as little as possible and lie down more. "The patient with this pathology is assigned a special gymnastics, which strengthens the ligament apparatus. Only a few sports are really contraindicated.
Gonarthrosis is the destruction of articular cartilage in the knee joint and adjacent bone surfaces.
Manifestations of arthrosis of the knee joint
Manifestations depend on the severity of the deformity. The more it is expressed, the more pronounced the symptoms.
Symptoms of gonarthrosis:
- long asymptomatic period;
- discomfort in the knee region;
- pain syndrome;
- decreased mobility;
- morning stiffness for up to half an hour;
- the presence of a snap during active movement;
- gear shift.
Bilateral gonarthrosis occurs when the knee joints of both limbs are involved in the process. This is one of the most serious forms. Occurs in the elderly.
Right-sided gonarthrosis appears with excessive static or dynamic physical exertion on the right limb. More often in athletes.
Left-sided gonarthrosis occurs in overweight people and in athletes with loads on the left leg.
The reasons for the development of gonarthrosis
The gonarthrosis is primary and secondary. The primary can occur in childhood and adolescence, associated with joint malformations, and also in old age due to the natural aging process.
Secondary occurs due to existing injuries or illnesses. Main reasons:
- fractures, bruises, dislocations;
- overweight;
- the presence of an inflammatory process in the joint and the lack of adequate therapy;
- metabolic diseases, which are accompanied by the deposition of salts in cartilage tissues;
- operations;
- vitamin D deficiency;
- hormonal disorders;
- lifting weights;
- some sports (running, hockey, football).
Who is at risk?
The risk group includes:
- professional athletes;
- obese people;
- patients who have suffered trauma or surgery;
- people over 45 years of age;
- patients with varicose veins;
- those who have already had cases of arthrosis in the family.
The risk group also includes women who wear high-heeled shoes or flat, thin soles.
The exact causes of knee arthrosis are unknown.
The degree of gonarthrosis
Radiologically, this pathology is divided into 5 stages or degrees:
- Stage 0 - radiography without arthrosis;
- Stage 1 - the appearance of a small osteophyte;
- Stage 2 - the osteophyte has clear contours, the joint space is minimally altered;
- Step 3 - joint space narrowing;
- Stage 4 - pronounced lacunae narrowing, subchondral bone sclerosis.
1-degree knee gonarthrosis
The first degree is characterized by fatigue, mobility limitation is slightly expressed, and a snapping sound is heard. Pain arises upon waking up, sitting for a long time, and after physical exertion.
There is no deformation at this stage yet. The radiograph shows a narrowing of the joint space.
How to treat gonarthrosis?
For the treatment, a special group of drugs is used - chondroprotectants. They contain chondroitin and glucosamine, which restore cartilage structure and increase elasticity. NSAIDs are used to relieve pain.
Primary gonarthrosis is usually bilateral. Even with the development of a unilateral form of the disease, after a while the second limb is also involved in the pathological process.
The first symptoms of arthrosis of the knee joints are mild and atypical
treatment methods
In addition to drug treatment in the remission phase, the following methods are used:
- physiotherapy;
- massages;
- leech therapy;
- ultrasonic exposure;
- radon and hydrogen sulfide baths;
- phonophoresis, electrophoresis;
- paraffin wraps;
- the use of therapeutic mud.
These methods are used regardless of the stage of disease development during remission.
Is mud good for knee gonarthrosis? One of the indications for mud therapy is diseases of the musculoskeletal system. The therapy course takes place twice a year. Includes 10 to 15 procedures. The method can be used at home, and the dirt can be purchased at the pharmacy.
In the first degree, the patient is prescribed orthopedic shoes for the period of exacerbation to avoid the development of the deforming process. Women are advised to wear shoes with a dense sole of at least 1 cm, heel of 5 cm Normalize diet - reduce the amount of salt, spicy food. Cold meat and gelatin are part of the diet, as they are natural chondroprotectors.
Another method is weight correction. Reducing body weight to an optimal level for a given patient will reduce the load on the musculoskeletal system.
Grade 2 gonarthrosis
In the second degree, the pain intensifies, due to which movement is significantly limited. Walking long distances causes severe pain syndrome. The patient needs to rest to continue.
If treatment is not started (or is ineffective), arthrosis of the knee joint progresses further.
Crushing becomes high, lameness appears. The affected joint is deformed. An inflammatory process takes place in the inner membrane of the joint.
On plain radiography, a narrowing of the joint space, the appearance of spines in the bone (osteophytes) is observed.
Treatment
Drug therapy is based on the use of NSAIDs. They have analgesic and anti-inflammatory effects. Also, chondroprotectives are prescribed.
After the exacerbation passes, physiotherapy exercises, massages are prescribed.
Diet recommendations:
- increase the amount of vegetables;
- include jelly and meat with jelly in the diet;
- eat lean fish twice a week;
- prefer lean meat;
- eat bran bread.
It is also recommended to include in the diet bananas, nuts, eggs, spinach, pulses, liver, cabbage.
In addition to orthopedic shoes, special knee braces are prescribed.
From surgical interventions, arthroscopic removal of deforming tissue is used. This method has a short term effect of 2-3 years.
Knee gonarthrosis, symptoms and grade 3 treatment
The most severe degree. Pain syndrome occurs during movement and at rest. Mobility in the knee is as limited as possible and sometimes impossible. The deformation is pronounced. There is practically no common space on the radiogram.
The progressive destruction of cartilage and bones in the later stages leads to the development of ugly deformities of the knee, which increase in size.
Treatment
At this stage, in addition to NSAIDs, hormonal drugs are prescribed to the patient. They are injected intravenously or into the joint. Severe pain syndrome is relieved with pain relievers.
In stage 3, the operation is already shown - endoprosthesis. The individual bony elements or the entire joint are replaced. Contraindication: osteoporosis.
Arthroplasty complications:
- marginal skin necrosis;
- rejection of the prosthesis;
- neurovascular diseases (paresis, thrombosis).
In addition to the endoprosthesis, there is an arthrodesis operation - removal of deformed tissue and joint. It is rarely used.
Osteotomy - excision of bone edges to redistribute load.
Physiotherapy
Exercises for gonarthrosis of the knee joint can relieve pain, strengthen the muscular system and stimulate blood flow to them.
- Exercise 1. The patient lies on their back, raises their straight leg and holds it for at least 30 seconds, then the second. Execution time should be reduced to 2 minutes.
- Exercise number 2 "Bike". Lying on your back mimics riding a bike with your feet. 20 to 50 repetitions.
- Exercise number 3. The patient lies on his stomach, alternately bending the legs, trying to reach the buttocks with the heel. 20 to 50 repetitions.
- Exercise number 4. It is done in the same way as above, but statically. That is, the patient holds the limb in this position for 20-30 seconds.
Patients are advised to stretch:
- Exercise 1. Standing, lean forward, trying to reach the floor without bending your knees. Hold for 20 seconds, inhaling air through your nose, exhaling through your mouth.
- Exercise number 2. Sitting on the floor with your legs straight, try to wrap your feet in your arms, keeping your knees straight. Hold this position for up to 30 seconds. Perform 2-3 approaches. If the flexibility is not enough to reach the feet, they hold the leg by the leg and try to pull the body as close to the legs as possible.
- Exercise number 3. Same position as above. The patient takes the foot by the foot, tries to straighten it and holds it as high above the ground as possible. If the exercise is difficult to do, the leg is placed in the leg region. Hold for 10-30 seconds and then do it with the other leg.
Contraindication is the period of exacerbations and the presence of an acute inflammatory process. Patients are prohibited from running, taking long walks and squatting.
After performing the physical therapy exercises, it is helpful to massage the muscles of the thigh, leg, and affected limb. The joint itself must not be influenced, this will increase inflammation.
Disease prevention
This disease is not hereditary, so its development can be prevented. This requires:
- avoid injuries while playing sports;
- doing stretching and joint gymnastics, yoga;
- eat properly;
- maintain a normal body weight;
- if you experience any discomfort in the knee region, consult a physician;
- drink a lot of water;
- after 40 years, taking chondroprotectors prophylactically;
- don't overcool the joints;
- in the presence of early stages of the process and during remission, do not increase physical activity, do not run;
- wear orthopedic shoes;
- wear knee braces when playing sports.