The inflammatory-degenerative process in the knee joint, or 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 may collapse completely. This leads to impaired musculoskeletal function. Movement is only possible with the help of crutches, or the person becomes hostage to a wheelchair.
The knee joint is the second largest, after the hip, and the most complex in structure. It allows you to bend and straighten your leg in different directions, promotes correct body position and coordination in space. This is a strong and stable joint that can withstand 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 a violation of blood circulation and nutrition of joint tissues. First of all, the cartilage suffers. The quality and quantity of synovial fluid, which is located in the joint capsule and contributes to the smooth functioning of the knee, decreases. Friction occurs between the joint parts. Gradually, the cartilage cracks and collapses. Unprotected bones begin to rub against each other. Pain occurs and a crunching sound is heard.
Causes of the disease
It mainly affects older people, especially overweight women. As a result of hormonal changes, the cartilage in the knee wears down greatly. Gonarthrosis to varying 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 are engaged in repetitive physical labor. This group also includes athletes, people leading a sedentary lifestyle, and people with unfavorable environmental conditions. Often patients are people dependent on toxic substances (drugs, alcohol, smoking).
The cause of joint deformation may be work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Due to a lack of minerals and vitamins in the body, diet can be the trigger.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. According to the nature of the manifestations, the disease is divided into degrees:
- At this stage, there are no obvious clinical signs. There may be minor discomfort and pain after prolonged exercise, which disappears after rest. The pain is felt in the morning, when moving, it goes away after some time. Arthrosis of the 1st degree is rarely diagnosed, by chance, during a routine examination.
- Pain and stiffness in the knee increases. A person spares his leg and tries to load it less. As a result, the muscles atrophy, the joint is deformed, a formation can be felt, and the leg at the knee does not fully extend.
- The pain is constant. The leg does not straighten or bend, and it is difficult for the person to walk. Partial or complete loss of mobility develops. The cartilage is completely destroyed, friction between the bones of the joint increases with the formation of osteophytes.
In addition to pain in grades 2 and 3, a crunching sound is heard in the knee. Fluid and pieces of cartilage tissue can accumulate in the joint capsule, which leads to swelling. At a late stage, the inflammatory process is pronounced, the knee joint is deformed.
Diagnostics
If you have knee pain, you can contact your local physician, who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist, or endocrinologist.
To find out the causes and treatment of gonarthrosis, a comprehensive diagnosis is needed:
- general and biochemical blood test;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
An X-ray makes it possible to see the condition of the cartilage and changes in bones at 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 meniscus, synovial membrane, and the presence of fluid. This method is also used in the treatment of the knee, to remove pieces of cartilage or meniscus.
Treatment of knee arthrosis
Therapy is long and sometimes painful. Having appeared once, the disease reminds itself 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. 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 exercise-related preventive measures. Daily exercise, use of a contrast shower, swimming pool 2 times a week, and combating increased body weight are required.
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 destruction, the patient is prescribed medications from the group of chondroprotectors.
Severe severity requires oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. Additionally, painkillers are prescribed.
A solution of hyaluronic acid is injected into the joint. It is a substitute for intra-articular fluid and nourishes cartilage. When moving, it acts as a shock absorber for the joint. The manipulation is painful, it is carried out by a doctor after the acute period has subsided. If conservative treatment is unsuccessful, endoprosthetics is performed.
Along with drug therapy, exercises using special simulators and devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered through subcutaneous or intramuscular injections, ozone-based ointments, creams. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are in demand as an alternative to medications for joint restoration. 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 ointments or medications can restore cartilage. Drugs can only stop the process of destruction of cartilage tissue.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without appropriate treatment, the patient's condition quickly deteriorates. The knee cannot work, serious complications appear:
- joint deformity;
- cosmetic defect - curvature of a limb;
- infection with blood or lymph flow from another source of the body;
- due to the weakness of the ligaments, dislocations and fractures are observed, even during normal walking;
- bone fusion (ankylosis) occurs in the joint area, making movement impossible.
Complications develop if the patient does not see a doctor on time and the disease is advanced. Regular preventive examinations and timely treatment of general diseases of the body will help prevent the condition from worsening and maintain the motor function of the limb.