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 do you treat osteoarthritis in the knee joint and prevent complications?
What is osteoarthritis
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 can completely collapse. This leads to reduced 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 patella. Includes osteochondral structures, muscles, ligaments, and nerve fibers.
The disease begins with a violation of blood circulation and nutrition of joint tissue. 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 primarily affects older people, especially obese women. As a result of hormonal changes, the cartilage in the knee becomes very worn. Gonarthrosis of varying degrees, after 60 years, occurs in more than 80% of people.
There are other reasons for the appearance of knee osteoarthritis:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part thereof;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- hypothyroidism.
The risk of developing the disease increases in people who are involved in repetitive physical work. This group also includes athletes, people who lead a sedentary lifestyle, and people with unfavorable environmental conditions. Patients are often people who are addicted to 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, the diet can be the triggering factor.
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 longer training, which disappears after rest. The pain is felt in the morning, when you move, it goes away after some time. Osteoarthritis 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 put less strain on it. As a result, the muscles atrophy, the joint is deformed, a formation can be felt, and the bone 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 the 2nd and 3rd grade, a crunching sound is heard in the knee. Fluid and pieces of cartilage tissue can accumulate in the joint capsule, leading to swelling. At a late stage, the inflammatory process is pronounced, the knee joint is deformed.
Diagnostics
If you have pain in your knee, you can contact your local doctor 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 necessary:
- 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 the bones in stages 2 and 3. This is a narrowing of the joint space, osteophytes along the edges of the kneecap, changes in the periosteum. Arthroscopy provides more detailed information about the meniscus, the synovial membrane, and the presence of fluid. This method is also used to treat the knee, to remove pieces of cartilage or meniscus.
Treatment of osteoarthritis of the knee
The 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. Medicine is relatively cheap, but leads to the formation of ulcers and erosions of the stomach and duodenum. Modern drugs produce fewer side effects, but are expensive.
Treatment measures for stage 1 include exercise-related preventive measures. Daily exercise, use of contrast shower, swimming pool 2 times a week and combating increased body weight are required.
Stage 2 requires fixation of the joint - 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 medication 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. In addition, 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 passed. If conservative treatment fails, endoprosthetics are 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, increases the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are in demand as an alternative to medication for joint recovery. 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
Damaged cartilage tissue and deformed bones cannot be treated. In this situation, only surgery will help. No ointment or medication can restore cartilage. Medicines can only stop the process of cartilage tissue destruction.
Gonarthrosis develops gradually, sometimes the disease lasts for years. Without appropriate treatment, the patient's condition deteriorates rapidly. The knee cannot function, serious complications appear:
- joint deformity;
- cosmetic defect - curvature of a limb;
- infection with blood or lymph flow from another source in 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 in 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.