In medicine, the term "gonarthrosis" refers to the defeat of intra-articular cartilage, which has a degenerative-dystrophic character. The disease is non-inflammatory in nature. According to statistics, pathology is most often diagnosed in people over 40 years old, but it also occurs in younger people. Patients with this disease need to understand that gonarthrosis of the knee joint is a disease that progresses without timely treatment and can lead to serious consequences, including disability.
Development mechanism
The start of the pathological process occurs when the blood supply to the bone vessels is disturbed, which occurs under the influence of various adverse factors. As a result, cartilage degeneration is observed at the cellular level. The fabric becomes thinner, cracks form on it, its color changes. Gradually, the disease progresses: the cartilage disappears completely, the bones are exposed. She, having lost protection from friction and externalinfluences, begins to grow, bend and thicken.
The development of the disease occurs in several stages:
- Violation of metabolic processes. Metabolism in cartilage largely depends on the osmotic pressure. With its increase, the release of synovial fluid occurs, with a decrease, its absorption. This ensures proper nutrition of the cartilage. Under the influence of adverse factors, metabolic disorders occur, as a result of which the release of synovial fluid decreases and the tissue becomes thinner under pressure.
- Degradation of collagen fibers. The cells that make up the cartilage tissue soften, their functioning is disrupted. It loses elasticity and elasticity, due to which its depreciation properties deteriorate.
- The formation of osteophytes. Due to the violation of the coherence of metabolic processes, growths of a pathological nature are formed on the bone tissue. They, in turn, contribute to the innervation of the synovial membrane, in which inflammation develops. The natural result is a significant limitation of joint mobility.
According to statistics, gonarthorosis most often affects the inside of the knee joint. As a rule, it is diagnosed in middle-aged and elderly people, as well as in athletes.
Reasons
There are the following provoking factors, under the influence of which the process of disease development starts:
- circulatory disorders;
- failure of metabolicprocesses;
- overweight;
- hereditary predisposition;
- fragility of blood vessels;
- knee injuries (fracture, fissure, dislocation, torn ligaments, pinched menisci, etc.);
- inflammatory processes in the joints;
- high intensity physical activity, including age inappropriateness;
- old injuries that have not been fully healed;
- congenital malformations of the musculoskeletal system;
- impaired sensitivity of the lower extremities.
In addition, the risk of developing the disease increases with psycho-emotional instability, prolonged exposure to stress, depression. Constant nervous tension provokes a spasm of muscle tissue, resulting in gonarthrosis.
Signs of pathology
The disease has several degrees of severity:
- first;
- second;
- third.
Each of them has its own symptoms. Treatment of gonarthrosis of the knee also depends on the severity of the disease.
The initial stage of the development of pathology is characterized by mild symptoms or their absence. In most cases, a person is not aware of the development of a serious disease, since minor pain sensations are extremely rare. Meanwhile, the treatment of gonarthrosis at this stage leads to the best results.
In order to prevent the progression of the disease, it is recommended to consult a doctor if the following appearwarning signs (even if they are extremely mild):
- pain aching character;
- slight stiffness of the joint when trying to bend or straighten the knee;
- crunch;
- puffiness.
As a rule, the treatment of gonarthrosis of the 1st degree consists in the use of non-drug methods of therapy.
At the next stage of the development of the disease, the symptoms become more pronounced. Both knee joints and one can be involved in the pathological process.
The second degree is characterized by the presence of the following features:
- Pain. In most cases, they periodically disturb in the morning. The nature of the pain is irregular, as a rule, it is short-lived and disappears on its own.
- Discomfort resulting from long walking. For this reason, most people try to minimize the load on the joint, which is not the right solution. The lack of normal physical activity also negatively affects the course of the disease.
- Meteorological dependence. At low atmospheric pressure, the osmotic index increases, due to which pronounced pain occurs.
- Joint stiffness.
At this stage of the development of the disease, the structure of the cartilage changes, it deforms, the joint space narrows, and osteophytes form.
Gonarthrosis of the 3rd degree is the most dangerous and difficult stage of development. It is characterized by pronounced symptoms. Treatment of gonarthrosis of the joints on thisstage is associated with a number of difficulties, since the bone tissue has already grown enough.
The last stage is manifested by the following symptoms:
- severe pain that is regular;
- visible changes in gait;
- pronounced knee deformity;
- weather dependence (pain increases with changing weather conditions);
- crunching when moving, they become stiff.
At this stage, the damage to the cartilage tissue is maximum, the gap between the joints narrows, large spikes form on the bones, as a result of which the shape of the knee changes.
Diagnosis
It is necessary to consult a radiologist when the first alarming symptoms appear. It is this specialist who deals with the treatment of gonarthrosis and further observation of the patient.
During the appointment, the doctor conducts an initial diagnosis, including a survey and examination. The information obtained allows him to preliminarily establish a diagnosis. To confirm or exclude it, the doctor sends the patient for an X-ray examination. Using this method, it is possible to determine the stage of the disease, which is fundamentally important when drawing up a treatment regimen for gonarthrosis.
Along with radiography, modern methods are widely used: magnetic resonance and computed tomography. In the process of their implementation, changes are detected not only in bone structures, but also in soft tissues, which allows timely detection of a number of complications.
Conservative therapies
The choice of scheme directly depends on the degree of development of the disease. Based on the results of the diagnosis, the doctor determines which drugs and procedures will bring maximum efficiency in each case.
Treatment of gonarthrosis of the 1st degree involves the use of the following methods:
- Physiotherapy (iontophoresis, mud baths, UHF, etc.).
- Massage.
- Therapeutic gymnastics.
- Osteopathy.
- Sanatorium and spa treatment.
In addition, in order to achieve maximum effectiveness in the treatment of gonarthrosis, patients need to follow a diet. Its task is to reduce body weight, which is one of the main causes of the development of pathology. The diet should also be balanced, and the diet should be organized in such a way that it contains 4-5 meals. At the same time, the serving size should not exceed 250 g. In addition, the menu must include products that help restore cartilage tissue. These include: aspic, jelly, meat broth, jelly.
In most cases, for the treatment of gonarthrosis of the knee joint of the 1st degree, it is sufficient to use the above methods, but sometimes doctors consider it appropriate to prescribe chondroprotectors. These are drugs that have a positive effect on the condition of cartilage tissue and contribute to its restoration. They can be taken internally or used externally.
For pain, a rheumatologist prescribes non-steroidal anti-inflammatory drugs (NSAIDs). They are also available in both tablet andin the form of gels, ointments and creams.
In the treatment of gonarthrosis of the knee joint of the 2nd degree, one cannot do without medicines. At this stage, the therapy regimen, as a rule, looks like this:
- Reception or external use of drugs: chondroprotectors, hyaluronic acid, corticosteroids, non-steroidal anti-inflammatory drugs.
- Physiotherapy.
- Massage.
- Therapeutic gymnastics.
- Stay in sanatoriums and resorts.
NSAIDs have a complex effect: they eliminate inflammation, relieve pain and help restore normal joint function. As a rule, the doctor prescribes the following drugs: Diclofenac, Ibuprofen, Indomethacin, Nimesulide.
The composition of chondroprotectors is represented by substances that are analogues of those that make up cartilage tissue. The course of treatment with such drugs is long, but they can significantly improve the course of the disease and stop its development.
Products containing hyaluronic acid are analogues of synovial fluid. They speed up the process of cartilage repair, protecting it from damage, and reduce bone friction.
Corticosteroids are sometimes prescribed to treat gonarthrosis of the knee. These hormonal preparations significantly improve the course of the disease. In most cases, they are used in the form of injections. Despite the high efficiency, this method is not very common. This is due to the high risk of developing serious side effects.effects.
Thus, the treatment of gonarthrosis of the 2nd degree is reduced to the reception and external use of medications. The maximum effectiveness of therapy is achieved through auxiliary methods: massage, physiotherapy, etc. In exceptional cases, doctors recommend intra-articular injections of hormonal drugs.
Treatment of gonarthrosis of the knee joint of the 3rd degree is associated with a number of difficulties, due to the presence of a pronounced deformation of the bone tissue, which is almost impossible to return to its original form.
The main goals of therapy at this stage are:
- elimination of the inflammatory process;
- relieving the patient from pain;
- restoration of joint mobility.
For the first two purposes, NSAIDs, corticosteroids, chondroprotectors, hyaluronic acid products are prescribed. However, in advanced cases, the treatment of gonarthrosis of the knee joint with drugs is ineffective. In such situations, the doctor recommends a bone traction procedure in combination with physiotherapy, and the issue of the appropriateness of surgical intervention is also decided.
Surgical treatment
In extremely severe cases, conservative methods of therapy do not bring a positive result. In these situations, surgery is the only way to avoid disability and maintain mobility.
Currently, the following operations are being performed to treat gonarthrosis of the joints:
- Arthroplasty. This methodinvolves the replacement of natural tissue with implants. They are anatomically shaped and perform all the functions of the joint.
- Arthrodesis. The operation, during which the complete immobilization of the joint, which is not amenable to treatment.
- Arthrolysis. This method is characterized by excision of adhesions after opening the joint cavity.
- Arthroplasty. This is an operation during which new surfaces are modeled, between which tissues taken from the patient are laid.
The choice of method is made by the doctor based on the results of the diagnosis. The rehabilitation period is approximately 6 months. At this time, it is necessary to strictly follow all the doctor's prescriptions and regularly perform physical exercises that strengthen the muscles and provide the joint with optimal load.
Therapeutic gymnastics
It is an integral part of the therapeutic schemes used at all stages of the disease. In addition, with the help of gymnastics, the rehabilitation period after surgery is shortened and joint mobility is restored faster.
Complex of exercises:
- Stand up straight, hands down. Shaking your body lightly.
- Standing, pull the heel of the right foot to the buttock. Then the limb must be straightened. Number of approaches - 20. Repeat the exercise with the left leg.
- Place your palms on your knees in a standing position. Make circular movements with the joints (alternately).
- Walk on all fours and forward and backward.
- Lie on your back. Pull up tochest right leg bent at the knee. Take hold of the sock with your hands and try to straighten the limb. Repeat the exercise with the other leg.
- Tie an expander tape to the ankles. Fix its other end, for example, on a battery. Lie on your back and bend your legs, trying to pull them to your chest.
Regular performance of these exercises improves the course of the disease and increases the effectiveness of drug therapy.
Unconventional methods
Treatment of gonarthrosis with folk remedies does not eliminate the need to visit a rheumatologist. In addition, they must be agreed with the doctor so as not to aggravate the situation.
Most Effective Recipes:
- Prepare dandelion flowers (it is allowed to use both freshly picked and pharmacy ones). Place them in a dark glass bottle. Pour the flowers with alcohol or classic vodka without additives. Store in a cool place for 1 month. After this period, lubricate the joint twice a day.
- Chop 1.5 kg of Jerusalem artichoke leaves and stems. Pour hot water over them. Liquids will need 8 liters. Allow the infusion to cool, then lower the affected joint into it for 30 minutes. The course of treatment is 10 days.
- Mix 5 g of fat (preferably pork) and 1 g of table s alt. Apply the resulting mass to the joint and wrap it with a warm scarf. The procedure must be done twice a day.
Forecast
It is important to understand that it is impossible to completely get rid of the disease. Patients with a similar diagnosis are forced to undergo regular courses of treatment. disease without timely medical attentionwill slowly progress, significantly worsening the quality of life. The natural result of ignoring pathology is disability.
In patients who sought medical help in a timely manner, the prognosis in most cases is favorable, regardless of the degree of gonarthrosis of the knee joint. Treatment of pathology is carried out using modern methods that allow you to stop the development of the disease and return the patient's quality of life to a normal level.
In closing
The term "gonarthrosis" refers to a disease in which there is a gradual destruction of cartilage tissue. As a result of its destruction, the bones are exposed, friction occurs between them. Then osteophytes begin to form, which significantly limits the patient's motor activity.
The disease has several stages of development. At the initial stage, a person, as a rule, does not suspect the presence of a serious illness. In most cases, pathology is detected during an examination scheduled for another reason. Many patients turn to a specialist only when pain in the knee joint occurs regularly.
The treatment regimen for gonarthrosis involves taking medications, invasive procedures (injections), physiotherapy, therapeutic exercises, osteopathy, massage, diet and staying in sanatoriums and resorts. In addition, positive dynamics can be achieved by non-traditional methods of therapy. If conservative treatment fails, surgicalintervention.
