People over 40, especially overweight women, often experience knee pain. Such discomfort does not sleep at night, makes it difficult to move. And sometimes it doesn’t even allow you to live normally! After examining a doctor, a diagnosis of gonarthrosis is made. What it is? Why did you develop it? And is it possible to turn back the clock?
Pathology characteristic
Not many people understand, hearing a diagnosis of gonarthrosis, what it is. This is a degenerative-dystrophic pathology. It is characterized by a lesion and subsequent change in cartilage tissue. At the same time, the functioning of the joint is significantly reduced. Such an insidious disease slowly destroys the connective tissue.
Do not underestimate the pathology. It should be understood if gonarthrosis is diagnosed, what it is! A developing disease affects all elements of the joint. Cartilage, bone, ligaments, articular membrane, muscle suffer.
Under the influence of certain factors, there is a violation in the nutrition of cartilage. The lack of important elements provokes the development of degeneration. As a result, cell death occurs. Significantly reduced elasticity, elasticity of connective tissue. The patient forms a “dry joint”.
Further progression of the disease leads to the inability of the joint to perform the necessary functions. Outgrowths form and grow on the surface of the cartilage. Under such an effect, a change in the bone, shortening of the ligaments occurs. The patient experiences a significant limitation of mobility. And in the most advanced stage, the muscles atrophy.
The causes of the disease
There are many sources underlying the development of pathology. As a rule, gonarthrosis of the knee joint develops as a result of a combination of several reasons:
- increased load on the joint (squats, running, lifting weights);
- bone fractures in which the knee joint is involved;
- ligament rupture;
- trauma of the cartilaginous layer - meniscus;
- overweight.
Pathology does not develop immediately, but several years after exposure to a damaging factor. With a combination of several causes, the disease progresses much faster.
Risk factors
Certain diseases and conditions can accelerate the development of the disease. The risk group includes people who are faced with the following problems:
- Varicose veins of the lower extremities.
- Weak ligament-capsular articulation apparatus (genetically determined), provoking joint looseness.
- Arthritis (an inflammatory process in the knee), bearing a different etiology, is psoriatic, gouty, rheumatoid, reactive.
- Diseases of the metabolic system.
- Pathology of innervation of joints characteristic of spinal or craniocerebral injuries.
Types of disease
Physicians, given the mechanism of the occurrence of pathology, distinguish two main groups:
- Primary gonarthrosis. The disease develops against the background of normal joint health. She is not preceded by any injuries, inflammation. The causes of this pathology lie in diseases of the metabolic system, prolonged use of hormonal drugs, a genetic predisposition. Often, bilateral gonarthrosis develops. The pathological process covers both knees. Although in some cases, unilateral damage is observed. Primary gonarthrosis is characteristic mainly of the elderly.
- Secondary. This pathology develops against the background of injuries, tumors, inflammations. The source of the disease can serve as a surgery on the joint. The disease occurs in people at any age. Secondary gonarthrosis is usually one-sided.
Clinical manifestations that occur in a patient with the development of the disease directly depend on the progression of the degenerative process in the joint. Depending on this, 3 degrees of gonarthrosis are distinguished. Each of them is distinguished by its symptoms.
Symptoms of the 1st degree of illness
It is extremely difficult to determine the initial stage of development of pathology. The resulting changes in the cartilage tissue cannot be detected by x-ray examination. Diagnosis is based on a description of the symptoms by the patient.
Doctors have identified certain signs that can characterize 1 degree:
- joint pain;
- a feeling of tightening under the knee itself;
- dull nature of pain;
- stiffness of the joint, which occurs after prolonged sitting, sleeping;
- increased pain after exercise or standing;
- severe discomfort in the joint after squats, long walking;
- swelling of the knee, as a rule, independently passing.
Treatment methods
At this stage, the fight against such a pathology as knee gonarthrosis is quite effective. The treatment consists in applying:
- physiotherapy;
- Massage
- medical gymnastics.
The patient is recommended to reduce weight. It is advisable not to load the painful joints .
Symptoms of 2 degrees
At this stage, narrowing of the gap, the growth of bone growths - osteophytes is already evident. Even visually in the knee, you can see inflammation. X-ray can reliably determine grade 2 gonarthrosis.
The following symptoms may signal this stage of pathology:
- Pain discomfort is localized inside the joint or on the inside of the joint.
- While walking, a crunch is heard in the knee.
- The pain becomes intense, longer. After the rest disappears.
- In the morning, it is difficult to bend the knee.
- In the evening or at night there is pain in the calves.
- The leg does not fully extend.
- Visually visible swelling of the joint, the initial signs of deformation.
Since there is no way to bend the leg normally, gonarthrosis of the 2nd degree provokes a curvature of the spine. Gradually, changes begin to form in the body.
Methods of combating pathology
For grade 2 disease, the following treatment is recommended:
- reduction in joint load;
- exercise therapy classes;
- drug treatment, including anti-inflammatory, painkillers, drugs, chondroprotectors;
- physiotherapy.
Clinic 3 degrees
The stage is characterized by significant, and sometimes irreversible, changes in the articulation. An x-ray shows gross deformations in the structure of the cartilage. The patient constantly experiences pain, which practically does not subside.
Gonarthrosis of the 3rd degree causes the following symptoms in a person:
- Constant pain in the knee, not depending on the activity of the patient.
- Significantly limited mobility. The patient is limping.
- During weather changes, discomfort intensifies.
- The knee is deformed and increased in size. With the progression of the pathological process, the joint becomes O-shaped or X-shaped.
If gonarthrosis of the 3rd degree is accompanied by inflammation of the membrane (synovitis), then the knee significantly swells. Its contours are almost completely smoothed out. On the front side surfaces, a protrusion with a soft consistency is localized.
Recommended Fighting Methods
Extremely severe pathology is gonarthrosis of the 3rd degree. Treatment includes therapeutic methods. However, often the patient requires surgical intervention. In this case, two surgical treatment technologies are possible:
- Corrective osteotomy. It is allowed with partial destruction of the cartilage. In this case, bone growths are removed in the joint. The destroyed cartilage is removed.
- Endoprosthetics. Such an operation is performed in an advanced stage. If the cartilage is completely destroyed, it is completely or partially replaced with artificial materials.
Drug treatment
Depending on the stage of the disease and individual sensations, the orthopedic doctor may prescribe medications. As a rule, such therapy is recommended if a patient is diagnosed with grade 2 gonarthrosis.
Treatment consists in taking the following medications:
- NSAIDs, pain medication. With this pathology, the following drugs are often prescribed: Voltaren, Rofika, Celebrex, Movalis, Nimesil.
- Ointments. With pathology, warming preparations can be recommended: Gevkamen, Espol, Menovazin. If gonarthrosis is complicated by synovitis, ointments are prescribed to the patient: Fastum, Indomethacinum, Butadionovaya, Dolgit.
- Chondroprotectors. The most effective drugs are: Arthra, Arthron, Teraflex, Don, Chondroitin Complex. These funds are prescribed for a long period (about 6 months).
- Medications for internal input into the joint. With severe inflammation, injections of Hydrocortisone and Kenalog preparations are made no more than 3 times.
- Hyaluronic acid products. They are introduced into the joint after the abatement of inflammatory phenomena. Apply the medicine “Hyalur”, “Sinocrom”, “Ostenil”.
- Warming compresses. They are used to stimulate the blood supply to the joint, increase the production of lubricating fluid. Compresses with medical bile or drugs are recommended: Dimexide, Bischofite.
A sufficiently effective tool in the treatment of gonarthrosis is the drug "Piaskledin." This is a drug made from extracts from soybean plants and avocados. The course of treatment is long - at least 6 months.
Physiotherapy
Patients should be aware, if gonarthrosis is diagnosed, what it is. It is necessary to take the appointments of a doctor with all seriousness.
With an acute course of the disease, the sick knee needs to provide rest. In the future, physical exercises necessarily begin to gradually be introduced. As a rule, all exercises are performed lying on your back. It is very important to exercise carefully, smoothly. Exercise should not hurt.
With this pathology, you should avoid:
- squats
- long walk;
- flexion-extension of the knee;
- any movements during which pain in the joint is felt.
Physiotherapeutic treatment
To reduce inflammation in the joint, accelerate regeneration, stop pain, the following procedures may be recommended:
- diadynamic currents;
- electrophoresis with the drug "Novocaine";
- magnetotherapy;
- UHF;
- laser therapy;
- phonophoresis using the drug "Hydrocortisone";
- ozokerite or paraffin baths;
- mud therapy.
Orthopedic appliances
If necessary, the doctor will recommend special orthoses. These are knee pads made of hard material that limit movement in the joint. Orthopedic insoles can be assigned.
Sometimes the only solution is surgery. For example, if a patient has grade 3 gonarthrosis, treatment is possible only if he does not suffer from osteoporosis. After surgery for 3-6 months, the patient needs rehabilitation measures. Physiotherapy, exercise therapy, treatment in a sanatorium are prescribed.
Conclusion
Articular cartilage is not able to regenerate. Therefore, it is very important to detect the disease at an initial degree and immediately begin treatment. Therapeutic methods are justified only with the 1st and 2nd degree of gonarthrosis. With advanced pathology, only surgery can improve the patient's condition.