Deforming arthrosis of the knee is also called gonarthrosis. This is a non-inflammatory degenerative disease that affects the cartilage inside the knee joint. The disease is more common in elderly and middle-aged people. According to statistics, female representatives are more prone to the development of gonarthrosis.
The disease can also occur in fairly young people. As a rule, this happens after injuries or very heavy loads, for example, those who are professionally involved in sports. Gonarthrosis of the knee joint develops over several years. In the initial stages, the disease is hidden, so a person may not pay attention to minor symptoms. It is believed that the cause of the disease is salt deposition. But this is not so. Provocateurs of the disease are changes in the structure of cartilage and joint nutrition.
Disease classification
Given the causes that precede the onset of the disease, gonarthrosis is divided into two types:
- Primary (idiopathic). His appearance is not preceded by injury. This type of disease affects elderly patients. Usually, primary gonarthrosis affects both knee joints at once.
- Secondary. The cause of this type of disease is various knee injuries, developmental pathologies, and other diseases that lead to joint disorders. Secondary gonarthrosis usually affects one joint and can occur at any age.
The degree of gonarthrosis of the knee
At first, the disease practically does not manifest itself, and a person may not suspect that he is developing such a serious ailment as deforming arthrosis. Pathology can form over many years, symptoms gradually increase. Gonarthrosis of the knee has three stages of development. The transition to each subsequent is characterized by more pronounced pain and greater destruction of the cartilage tissue of the joints.
First stage
Gonarthrosis of the knee joint of the 1st degree is characterized by dull pains that appear periodically and, as a rule, after a serious load on the leg. Sometimes the knee may swell slightly, and then the swelling disappears on its own. The joint is not yet deformed, but cracks appear on the cartilage, which, clinging to each other, prevent the smooth sliding of the joint.
Second stage
In the second stage of the disease, the symptoms increase. Pain is more frequent, intense and prolonged. Crunch is often heard in the joints. There are some restrictions on the movements, the reason for this is some deformation. Osteophytes resembling spikes begin to grow along the edges of the joint.
Third stage
The third is the last stage of gonarthrosis. At this stage, the disease reaches its maximum. A leg in the knee area hurts almost constantly, a person begins to limp. On an x-ray, significant joint deformation can be seen. The knee is hard to bend and unbend. Almost no cartilage.
Why does gonarthrosis develop?
Usually, the appearance of this disease is not due to one factor, but several at once. Most often, injuries become such a cause, for example, a person broke a shin, there was a rupture or tear of the ligaments, the meniscus and other traumatic injuries were damaged. But the disease does not appear immediately after the injury, usually after it takes several years. There are cases of the development of gonarthrosis already 3-4 months after the damage.
The next reason for the development of the disease can be significant stress on the knee joint. This can be a big load during sports. Sometimes people after the age of 40 to maintain their health begin to train harder. But at the same time they do not take into account that at their age the state of the joints is no longer the same as at a young age. Large loads on the joints lead to degenerative-dystrophic changes in them. Gonarthrosis can trigger deep squats and running.
Another factor that can cause the development of the disease can be obesity. A large weight increases the load on the musculoskeletal system, in particular on the knee joints. This can provoke both minor microtraumas and more severe injuries, for example, ruptures of ligaments or menisci. If, in addition to being overweight, the patient still has varicose veins, then gonarthrosis is especially difficult.
The next provocateur of the disease can be any form of arthritis (rheumatoid, psoriatic, reactive, and others) previously transferred.
Risk factors include neurological diseases that cause impaired innervation and metabolic disorders in the body, as well as genetic weakness of the ligaments. Various injuries of the spine and traumatic brain injuries can cause the development of deforming arthrosis of the knee joints.
Main symptoms
At different stages of gonarthrosis of the knee joint, the symptoms differ significantly - from minor pain in the first stage to severe pain and deforming changes in the knee in the late stages of the disease.
At the first stage, the patient has mild pain in the knees when he walks, sits or stands up, rises or falls down the stairs. As a rule, such sensations disappear when a person is in a calm state. At this stage, the “starting” pain is characteristic, which occurs when a person needs to take the first steps after he has sat, or stood still for a long time.
If you look at the knee, then visually it is not changed. But some patients have a slight swelling. This is due to the fact that sometimes fluid accumulation occurs in the joint, which leads to the development of synovitis. This, accordingly, leads to an increase in the volume of the joint, limitation of movements and a feeling of heaviness in it.
When the disease goes into the second stage, pain becomes more pronounced. The joint hurts even with minor loads, the pain intensifies during intense movements. The location of such pain is the anteroposterior surface of the joint. When a person has the opportunity to relax for a long time, then the painful sensations disappear, but as soon as he starts to move again, the symptoms resume.
As the disease progresses, the range of motion of the diseased joint gradually begins to decrease. With movements, you can hear a crunch in the knee. Visually, the joint begins to expand, its configuration changes. Synovitis begin to appear more often and are characterized by a large accumulation of fluid. In the third stage of the development of gonarthrosis, pain almost does not leave a person. They do not allow him to live in peace, not only during movements, but also at rest. To fall asleep in the evening, the patient has to look for a comfortable position for a long time. Sometimes, even at night, pain does not allow a person to sleep.
How to bend and unbend a joint becomes more and more difficult, even it becomes impossible to straighten a leg completely. There is a deformation and an increase in the joint in volume. Often in patients with knee gonarthrosis, varus or hallux valgus deformities appear, they become O-shaped or X-shaped. Deformation leads to an unstable and overwhelming gait. Sometimes patients are so hard to walk that they begin to use a cane or crutches.
Diagnosis of gonarthrosis
A significantly greater effect of treatment can be expected in case of timely contact to a medical institution. At the very beginning of the disease, at its first stage, it is impossible to identify any external signs of gonarthrosis. Therefore, additional diagnostic studies are carried out.
At later stages, a specialist can detect joint deformation, coarse bone contours, curvature of the axis of the lower limb and restriction of movement in it. If you move the patella in the transverse direction, you will usually hear a crack.
A more accurate diagnosis can be made by making an x-ray of the knee joint. Thanks to this research method, it is possible to determine how pronounced pathological changes in the joint. By taking repeated pictures after a certain time, you can observe the development of the disease. X-ray is a very affordable and inexpensive procedure, so it has always been and remains the main way that helps to determine the presence of gonarthrosis. Also, this method is necessary in order to exclude the presence of any other pathologies, for example tumors.
At the beginning of the disease, significant changes in the joints in the x-ray may be absent. With further progression of the disease, a densification of the subchondral zone is noticeable, as well as a narrowing of the joint space.
The diagnosis of gonarthrosis, as a rule, is made only if the clinical and radiological signs of the disease are combined. Indeed, in older people, x-ray images can also show changes in the joints, but there are no pathological symptoms.
Computed tomography and MRI are also often used to make the correct diagnosis, which help to identify existing changes in the soft tissues.
How to treat knee gonarthrosis
If diagnosed with deforming arthrosis, an orthopedist should be involved in the treatment of this disease. The sooner the patient goes to the doctor, the better, the result of treatment depends on this.
The following methods give good results:
- drug therapy;
- physiotherapy (laser, electrophoresis, ultrasound, magnetotherapy);
- therapeutic mud;
- Exercise therapy;
- massage.
Medication includes the use of chondroprotectors. These drugs help improve metabolic processes in the diseased joint, and prevent its destruction. Drugs that replace synovial fluid are also used. Sometimes a doctor may prescribe the administration of steroid hormones directly to the joint. Such patients are also shown spa treatment.
Patients can use individual insoles or special orthoses. To slow down the development of the disease, it is recommended to avoid heavy loads on the joints, engage in physical therapy, do not gain extra pounds, walk in comfortable shoes, correctly alternate loads and rest.
Surgery
If gonarthrosis has passed into the third stage of its development, then conservative treatment becomes ineffective. If a person is constantly tormented by severe pain, the joint cannot perform the functions assigned to him, and the patient is still of a rather young age, then in this case the best way to treat knee joint gonarthrosis is surgery. During surgery, a knee replacement with an endoprosthesis is performed. The rehabilitation period after surgery lasts from 3 to 6 months.
Physiotherapy
Exercise therapy is one of the methods of combating an ailment. Only therapeutic exercises should be carried out under the supervision of the attending physician.
Recommended exercises for gonarthrosis of the knee:
- Walking in place with high knees.
- While holding on to the support, do alternate bending and extension of the legs at the knees.
- Move the feet from the toe to the heels without lifting them off the floor.
- Lie on your back. Bend the leg at the knee and pull the knee to the stomach, help with your hands. Repeat the same with the other leg.
There are a lot of such exercises, but in each individual case they should be selected by a specialist.
Alternative methods of treatment
Not bad has proven itself in the fight against gonarthrosis of the knee joint folk treatment. It offers the use of ointments and compresses based on natural ingredients:
- A compress of 3 tablespoons of apple cider vinegar and 1 tablespoon of honey helps relieve pain and the inflammatory process.
- You can get a good result by simply rubbing honey into the affected area, as this beekeeping product has a pronounced antiseptic effect.
- To a sick knee attach a leaf of cabbage or plantain.
- Insist on triple cologne dandelion leaves. Rub into a sore knee.
Treatment of gonarthrosis of the knee joint with folk remedies will help reduce pain, relieve inflammation, but it can not completely cure this ailment.