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Gonarthrosis

pain due to arthrosis of the knee joint

Most often, the disease occurs in elderly patients (especially women).Joint pain with gonarthrosis is explained by dystrophic changes in the cartilage covering the intra-articular surfaces of the bones.First, blood circulation in the vessels supplying the cartilage worsens.Subsequently the cartilaginous covering begins to thin and is completely erased.The bones inside the knee joint are exposed.As a result, they rub against each other as they walk, causing severe pain.

Over the years, bony growths begin to appear in the joint.They provoke the development of deformities, the leg bends.

Causes of gonarthrosis

Gonarthrosis of the knee joint occurs for various reasons.It is customary to distinguish two forms:

  • primary;
  • secondary.

Primary gonarthrosis usually develops in older people.Its appearance is due to:

  • metabolic disorders;
  • obesity;
  • hereditary predisposition;
  • take hormonal drugs.

The primary form affects two knee joints at the same time and is called bilateral gonarthrosis.But there are cases when the inflammatory process first covers one knee and only a few years later moves to the second.

Secondary gonarthrosis, on the contrary, is always unilateral.He is called:

  • heavy physical work and sports that put stress on the right or left knee joint;
  • trauma (ligament rupture, dislocation, hemorrhage in the cavity of the knee joint, damage to the meniscus, intraarticular fracture, etc.).
  • operations performed on the knee joint;
  • inflammation/swelling of the joint.

Symptoms of gonarthrosis

Common symptoms of gonarthrosis of the knee joints include:

  • severe knee pain during movement;
  • knee dysfunction;
  • swelling in the knee joint;
  • lameness;
  • joint stiffness;
  • instability in the affected joint.

The advanced stages of the disease are also characterized by deformation (curvature) of the leg.

In most cases, gonarthrosis develops slowly and proceeds through four successive stages.

Gonarthrosis of the knee joint of the first degree is characterized by the following symptoms:

  • Unexpressed pain in the knee when going up/down stairs, during squats.
  • “Initial” pain when starting to move.
  • Limitation of mobility.
  • Disappearance of discomfort when the patient "diverges".
  • Knee pain after intense physical activity.
  • The knee appears healthy or slightly swollen.
  • Manifestations of synovitis (inflammation of the inner lining, due to which fluid begins to form in the joint) may occur.

Bilateral gonarthrosis of the knee joint of the second degree has the following symptoms:

  • The pain becomes more intense.
  • Discomfort increases significantly during squats and walking.
  • The pain is localized on the inside of the knees and gradually disappears during rest.
  • Creaking knees.
  • The joint expands and fluid begins to accumulate inside it (synovitis).
  • Intra-articular fluid may fill the popliteal fossa at the back of the joint (Baker's cyst).
  • Individual joint areas are warm to the touch.
  • After physical warming up, the stiffness may disappear.
  • The shape of the legs in the knee area changes (curvature is observed).

The following symptoms are typical of third degree gonarthrosis:

  • The pain occurs day and night, during rest and while walking.The patient should seek a position to reduce the severity of the painful symptom.
  • The joint is difficult to straighten and bend.He is limited in his movements.It is not possible to straighten the leg completely.
  • An O- or X-shaped deformity of the lower extremities may form.
  • The knee joint significantly increases in size and becomes deformed.Severe synovitis is observed.
  • The patient's gait becomes unstable, trembling, and must use a cane/crutches or use outside assistance while moving.

There is also a fourth degree of gonarthrosis of the knee joints.Clinically, orthopedists classify it as the third stage of the disease.It can only be determined by x-rays.

In the fourth degree, the articular surfaces of the bones are so strongly deformed that there is almost no space between them, without which movement is impossible.The patient suffers from continuous pain.

If you notice similar symptoms, consult a doctor immediately.It is easier to prevent a disease than to deal with its consequences.

Diagnosis of gonarthrosis of the knee joints

Diagnosis of the disease includes interviewing the patient, examining the inflamed joint, checking its volume and evaluating mobility.If gonarthrosis is suspected, the orthopedist prescribes instrumental methods:

  • X-ray. With gonarthrosis, the x-ray shows the narrowing of the cracks, thinning of the bone tissue and its compaction under the cartilage, ossification of the articular cartilage.There may be osteophytes: bony growths that run along the edges of the cartilage.
  • Ultrasound diagnosis of the knee joint.
  • Arthroscopy.During the study, the surgeon inserts a special microcamera connected to an arthroscope through punctures into the joint.An image of all parts of the studied area appears on the screen.
  • Magnetic resonance imaging (MRI).It allows you to evaluate the degree of damage to the knee joints.
  • A blood test is an auxiliary diagnostic method and does not always give a complete picture of the clinical picture.The fact is that with gonarthrosis, signs of inflammation in the blood may not be detected.

Treatment of gonarthrosis of the knee joints

Medicines

In the treatment of gonarthrosis of the knee joint the following groups of drugs are used:

  • anti-inflammatory;
  • painkillers;
  • condoprotectors (provide restoration of damaged cartilaginous tissue).

They are available in different forms: ointments, creams, gels, tablets, capsules, intra-articular and intramuscular injections.

Orthopedics

Orthopedic treatment of pathology involves the use of special devices to minimize the load on diseased joints:

  • orthopedic insoles for shoes,
  • orthoses (special rigid knee pads that limit the mobility of the affected joint),
  • reeds.

Surgery

Surgical methods are used in the treatment of gonarthrosis of the knee joint of the third degree.The indications for endoprosthesis are:

  • uncontrollable pain,
  • significant dysfunction of the knee and hip joints.

The time taken for the installation is 2-3 hours.Before installing the prosthesis, the destroyed part of the joint and the back of the kneecap are removed and the axis of the leg is aligned.If necessary, ligament restoration is performed.When the endoprosthesis is installed, the wound is sutured.

In the first hours after surgery, due to anesthesia, the patient does not feel his lower limbs.The rehabilitation period is long: 3-4 months.

It is impossible to perform endoprosthetic surgery if the patient suffers from osteoporosis (brittle and fragile bones).

Further methods of treatment of gonarthrosis

For gonarthrosis, as auxiliary treatment methods can be used:

  • manual therapy;
  • massage;
  • acupuncture;
  • hirudotherapy;
  • physiotherapy;
  • Physical therapy.

Physical therapy for gonarthrosis

Exercises for gonarthrosis of the knee joint are selected individually.Their regular implementation allows you to strengthen the muscles surrounding the inflamed joint and improve blood circulation in the area of the pathology.They should be performed lying on your back or sitting.

In the first days, therapeutic exercises for gonarthrosis of the knee joint should take no more than 10 minutes.Gradually, the training time should be increased to half an hour.It is important to perform all movements smoothly and make sure that the pain does not intensify.

Universal exercises include the following:

  • Raise the straight leg to a height of 15-20 cm from the floor and keep it in this position for the maximum time.
  • Raise the straightened leg to a height of 15-20 cm and gradually lower it to the starting position.
  • Flexion and extension of the legs while sitting on a chair.

Any squats and long walks are contraindicated without prior consultation with an orthopedist.

Features of treatment of gonarthrosis depending on the degree of the disease

Treatment of first degree gonarthrosis of the knee joint

The first degree of the disease is the mildest.The patient is prescribed:

  • Massage.
  • Therapeutic gymnastics.
  • Physiotherapy procedures.

If you are obese, weight loss is necessary.For this reason a special diet is followed.

Treatment of gonarthrosis of the knee joint of the second degree

Complex treatment of the pathology includes:

  • Performing the exercises recommended by the therapist.
  • Taking anti-inflammatories and painkillers, chondo protectors, introduction of hyaluronic acid into the joint.
  • Phytotherapeutic procedures (if there is no pronounced inflammatory process).
  • Weight normalization.

Treatment of third degree gonarthrosis

Therapeutic treatment of third-degree pathology is similar to the measures used in the second stage of the disease.However, in the absence of the expected effect, the patient is advised to undergo a surgical method.

If we talk about the beginning of the third degree, it is possible to remove part of the damaged cartilage and bone growths.Using an arthroscope, the doctor examines the cavity of the knee joint and studies the severity of the problem.

When areas of healthy tissue are preserved, corrective osteotomy is indicated.During this operation, the doctor corrects the shape of the bone by breaking it.Then install a special plate that allows you to fix the limb in the correct position.

The second method of surgical treatment is endoprosthesis, an operation to replace the entire knee joint or its individual parts with prostheses.

Treatment of gonarthrosis of the knee joints with folk remedies

Traditional recipes help to achieve good results only in stages 1 and 2 of the disease.When the cartilage tissue is destroyed and the joint is severely deformed, they are helpless.

Ficus tincture

The solution is prepared according to the recipe:

  • Pass the ficus leaf through a meat grinder.
  • Place in a glass container.
  • Add 100 ml of vodka.
  • Cover with a lid and leave to infuse for 3 weeks.
  • Store the prepared liquid in the refrigerator.Rub the joints with the tincture once a day for 10 days.

Clay compresses

  • Place the blue/red clay in a glass bowl.
  • Dilute with water to the consistency of sour cream.
  • Apply the clay to a linen/cotton fabric about 1.5-2 cm thick.
  • Apply to the painful joint.
  • Secure with a bandage and wrap with a towel.
  • Apply compresses 2-3 times a day.The duration of treatment is 1.5 weeks.

Dandelion tincture

  • Fill a glass bottle with dandelion flowers.
  • Pour over the triple cologne.
  • Close the lid.
  • Place in a dark place for a month.
  • After the specified period of time, strain the tincture.Rub her knees 2 times a day.

Apple cider vinegar for arthrosis of the knee joints

  • Mix 6 tablespoons of apple cider vinegar with 2 tablespoons of natural honey.
  • Apply the mixture to the joint area.
  • Cover with a cabbage leaf on top.
  • Wrap it in plastic and a scarf.
  • It is better to apply the compress at night.Remove after the leaves are completely dry.The course of treatment lasts approximately 4 weeks.

Garlic with celery and lemon

  • 250 g of celery, 120 g of garlic, 3 lemons, chop, mix.Transfer to a three-liter jar and add boiling water.
  • Cover with a warm blanket.
  • After cooling, use 70 ml before meals, first once a day, after a few days - 2-3 times a day.

Diet for gonarthrosis

The diet for gonarthrosis of the knee joint is aimed at normalizing body weight, combating obesity and saturating the body with nutrients.If the patient is able to lose weight, the pain becomes less pronounced as the joints are placed under less stress.In this case, you should not starve or resort to mono diet.Nutrition should be balanced.

Proteins help restore intraarticular cartilage.The patient can get them from lean meats, cheeses, cottage cheese, fish, lentils, beans and buckwheat.Jellied meat based on bone broth is useful for gonarthrosis, as it contains a lot of collagen.

Carbohydrates should be obtained by eating fruits and vegetables.Fats should be predominantly vegetable.Small amounts of butter are allowed.Vitamins, especially group B, are of great importance for improving the patient's condition.They are found in eggs, legumes, bananas, dairy products, cabbage, nuts and lentils.

It is forbidden to drink alcohol if you suffer from gonarthrosis of the knee joints.It not only has a negative effect on the body as a whole, but also increases appetite, which is undesirable.

The danger of gonarthrosis

With first and second degree gonarthrosis there is no question of disability.The third stage of the disease can incapacitate the patient, when the functions of the joints are completely lost and movement without assistance becomes impossible.

It should be understood that gonarthrosis is a chronic pathology that constantly progresses.Proper selection of medications and regular physical activity are necessary for a favorable prognosis.

Group at risk for gonarthrosis

The risk group for gonarthrosis includes:

  • professional dancers;
  • athletes;
  • builders, loaders, miners;
  • people with hereditary predisposition;
  • obese people;
  • with bad posture;
  • suffered fractures;
  • with malformations of the ligament-articular system;
  • affected by hormonal, rheumatoid and metabolic diseases.

Prevention of gonarthrosis

To reduce the risk of developing gonarthrosis of the knee joints, the following recommendations should be followed:

  • do physical exercise;
  • avoid excessive physical activity;
  • check your weight;
  • seek qualified medical assistance for injuries, inflammatory diseases of the joints;
  • do not overcool (in case of problems, it is recommended to wear warm knee pads);
  • drink 2 liters of water a day;
  • wear comfortable shoes;
  • avoid stressful situations.

This article is published for educational purposes only and does not constitute scientific material or professional medical advice.