Osteoarthritis of the knee (gonarthrosis)

Osteoarthritis of the knee joint (otherwise known as knee osteoarthritis) is a fairly common disease that has recently been discovered not only in the elderly, but also in young people.

Pathology is one of the main reasons why patients are disabled if they refuse to seek help from a traumatologist or orthopedist.

Let's see why patients develop gonarthrosis of the knee joint, what are its main signs, how dangerous it is and how effective the treatment of progressive knee destruction is.

The main factors for the appearance of this pathology

The joints are constantly exposed to significant stress. The knees are particularly affected: they are forced to perform heavy physical work, which is why they wear out quickly. The deformation process is intensified by the fact that the legs are forced to support the weight of the body.

This fact further contributes to the fact that the knees begin to wear down and the cartilage tissue in the joint becomes thinner and degraded.

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

1. Increased body weight of patients. In case of complete destruction of the joint occurs much faster and more intense. It has been proven that the disease in question in obese people occurs three times more often than in people of normal weight.
2. Intense sports, due to which the joints are constantly injured.
3. Frequent fractures, previous injuries to the knee contribute to the fact that the patient begins to degenerate the processes of the articular cartilage from an early age.
4. Abnormalities in the location of the bones - this is called valgus or varus deformity.
5. The poor development of the ligamentous apparatus of the knee leads to frequent injuries, dislocations. Due to the injuries described, the patient develops osteoarthritis.
6. Damage to the meniscus triggers the degenerative process of destroying 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 lack of calcium).

In addition, the following people belong to the risk group:

• all athletes;
• patients, regardless of their sex, who have reached the age of 50;
• women who have started menopause;
• patients with varicose veins;
• people with unfavorable heredity.

What are the degrees of the disease

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

So, at grade 1, the patient may notice that the leg gets tired, even though the load was light. Some limitation in the mobility of the knee joint is noticeable, and a strong crunch is heard during movement.

There are pronounced starting pains when the discomfort does not give rest mainly in the morning. Once the patient "disperses", the discomfort gradually decreases, increasing again after sports activities. At this stage of the development of the disease, there is no pronounced deformation of the bone tissue.

At grade 2, the pain worsens. Walking is impaired because of this. Sometimes it becomes almost impossible for the patient to move normally, and even after a light load, a long rest is required. As the joint space narrows, osteophytes grow on the bones, and pathological fluid builds up in the joint.

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

Common symptoms of the disease

Attention should be paid to the general symptoms of osteoarthritis of the knee joint:

1. Pain. It does not appear suddenly, however, slight discomfort can last for almost years. More intense pain is caused by trauma.
2. Deformation of the knee (it retains its former 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 back of the knee. It is most noticeable when the joint is extended.
4. Cracking of the knee is observed if the pathology is in the second, third stage. It differs significantly from what is seen in a healthy person when flexing or extending the knee. The sound is felt to be harsh and painful. Sometimes the crunch interferes with active movement.
5. Decreased normal range of motion in the joint. Usually the patient cannot bend, straighten the affected leg. He is able to bend it at a right angle, subsequent movements are accompanied by severe pain.
6. Knee stiffness occurs mainly in stages 3. Sometimes patients can only walk on bent limbs.
7. Increased pain when the weather changes.
8. Significant thinning of the cartilage. Sometimes in advanced cases bone exposure is noted. The knee x-ray shows a significant accumulation of osteophytes.

Varieties of osteoarthritis

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

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

1. Deforming osteoarthritis is characterized by a chronic course, irreversible changes in the joint.
2. Patellofemoral osteoarthritis develops due to intense and prolonged physical exertion.
3. Inflammatory osteoarthritis is caused by a prolonged, untreated inflammatory process in the joints.
4. Dysplastic osteoarthritis develops due to birth defects 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 with gout and other metabolic disorders.
7. Post-infectious osteoarthritis occurs as a result of insufficiently treated inflammatory pathologies.
8. The static form of the disease is detected when the knees are constantly exposed to increased pressure.
9. If the cause of the knee injury is not established, experts speak of idiopathic osteoarthritis.

Features of the treatment of the disease

In the early stages of the development of the disease, a rheumatologist and a traumatologist are involved in the treatment. If it has gone too far, the patient should see a surgeon. Finally, in some clinics there is a narrow specialist in joint diseases - an arthrologist.

The extent of therapeutic measures depends on the course of the disease. If it is possible to eliminate the cause of the pathology in question at an early stage, almost permanent recovery can be achieved.

The goals of any therapy are the complete elimination of pain, the restoration of destroyed cartilage and an increase in the range of active motion in the joint.

The course of treatment with drugs is chosen exclusively by a doctor. The patient cannot prescribe them for himself, as this 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, inflammation in the affected area. Sometimes injections into the joint cavity may be prescribed.
2. Products that improve blood circulation in the knee. They are muscle relaxants, antispasmodics. These provide good pain relief.
3. Products that restore joint cartilage, improve its normal nutrition.

Blocking novocaine helps relieve acute pain. The injection can be given from the outside or the inside of the joint. The easiest and safest method is to administer the medicine from the outside. With the right manipulation, the pain goes away almost immediately.

A strong NSAID ointment also helps with pain. It should be remembered that you should not use 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 for this serious illness is categorically prohibited.

Conservative treatment can be effective, provided the disease has not gone too far. In case of irreversible damage to the joint, surgical intervention is indicated. The implantation of a metal prosthesis is performed.

This is currently the only way to restore mobility to the knee. The disadvantages of these operations are the limited life of the prosthesis, the high price.

In arthroscopy, all surgical procedures are performed by performing microscopic punctures in the joint. During the operation, fragments of cartilage, clots, etc. affected are removed from the joint. In stage 3 of the disease, the type of intervention described is ineffective.

To reduce the load, a periarticular osteotomy is used. This is shown to be done when the joint is not yet completely destroyed.

To unload the joint affected by the degenerative process, canes and orthotics are used.

The duration of treatment for the disease depends on many factors. Treatment with chondroprotectors can be quite long - six months or even more, since their effect is manifested quite slowly. A qualified healthcare professional can determine how long you need to take your prescribed medications.

The use of chondroprotectors in the treatment of osteoarthritis

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

However, even new generation NSAIDs cannot prevent the spread of the disease process. To reduce the intensity of joint degeneration and restore its normal mobility, chondroprotectors are increasingly used.

Modern drugs of this group help restore joint tissue. This is due to the chondroitin content they contain. It is a natural component of cartilage. Constant consumption of drugs of this group helps to restore it, improve health.

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

The intake of food 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 physiotherapy in the treatment of knee osteoarthritis

With the described pathology, the patient is categorically contraindicated in a lying down lifestyle. Physical activity for any disease of the musculoskeletal system is simply necessary for all categories of patients. Of course, it must be dosed; any exercise is carried out exclusively under the supervision of a doctor.

For each patient, a traumatologist or rehabilitation therapist individually selects special exercises. There is no reason to think that the different sets of classes that can be found on the Internet will be suitable for all patients without exception.

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

At home, it is recommended to perform a simple exercise: while lying down, raise your leg, hold it for a few minutes and then lower it. It is harmless and can be performed even by patients with the third stage of the disease. Under the supervision of a doctor, exercises are performed to stretch the joint capsule. But if it causes pain, then the execution should be stopped immediately.

Physiotherapeutic methods of treating a disease include:

• massage (it is strictly forbidden to do it without the testimony of a doctor);
• manual therapy (it should be as gentle as possible, not cause discomfort);
• medical laser treatment;
• impact on reflexogenic points using the finest needles;
• heat or cold treatment (again, you do not need to perform heat treatments at home);
• magnetic field treatment;
• phonophoresis;
• electrophoresis;
• paraffin therapy;
• ozokerite treatment;
• moxibustion with wormwood.

Nutrition for knee osteoarthritis

Good nutrition is the basis for effective treatment of degenerative diseases of the musculoskeletal system. Due to a poorly formulated diet, the patient may gain weight. The lack of vitamins, microelements worsens the course of the pathology.

All people with knee osteoarthritis should increase the amount of foods fortified with vitamins and minerals in their daily diet.

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

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

The following foods and dishes are excluded:

• sweet soda;
• fatty meals;
• semi-finished products;
• spices;
• dishes containing flavor and odor enhancers;
• fatty meats;
• fried food;
• White cabbage;
• tomatoes and peppers;
• oranges, lemons;
• Chocolate;
• bananas, grapes (they are very caloric).

Jelly meat and jelly are useful. They contain a large amount of collagen, due to which the bone is restored. Jelly meat is prepared in such a way that it contains less fat, so its calorie content will decrease.

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

It is necessary to observe the regime of alcohol consumption. Provided that there are no associated kidney diseases, it is recommended to consume about 2 liters of water.

About the alternative treatment of the disease

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

To relieve swelling in the knee, use regular soda. The fabric is moistened with soda oatmeal and wrapped around the knee. Above, to strengthen the thermal effect, it is advisable to attach a plastic bag. Keep the compress prepared for the whole night.

A similar compress is made with the addition of food vinegar. Along with the imposition of compresses, it is necessary to take tablets of acetylsalicylic acid.

Burdock leaves are very useful for the knee. Before applying the leaves, it is advisable to lubricate the knee with vegetable oil. There must be several layers of leaves.

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

Medical bile is good for relieving inflammation, swelling, and pain. It is used in the form of heating compresses at night. The bile has virtually no side effects.

Treatment with honey is carried out in cases where the patient is not allergic to it. After the painful joint is warmed with a heating pad, it should be lubricated with honey and a gentle massage should be performed. After that, tie burdock leaves to the knee.

Prevention of knee osteoarthritis

Preventing illness is much easier than curing it. Prevention measures include:

• a balanced diet of high quality with the use of a sufficient amount of protein, vitamins and calcium;
• eradication of bad habits;
• the fight against overweight;
• normalization of physical activity;
• prevention of joint injuries during sports or intense physical work.

When the first symptoms of trouble appear, it is important to seek immediate medical attention. During a clinical consultation, it is possible to know which doctor is treating knee osteoarthritis. It is advisable to undergo a full medical examination in order to find out the cause of the development of the disease.

Osteoarthritis of the knee is a serious disease: if ignored, there is a risk of disability and complete immobility. To avoid this, you need to properly treat the affected joint. Therapeutic measures started early contribute to the almost complete remission of this pathology, help to maintain high performance, quality of life.