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Gonarthrosis

knee osteoarthritis pain

Most often, the disease occurs in elderly patients (especially women). Pain in the joints with gonarthrosis is due to dystrophic changes in the cartilage, which covers the intra-articular surfaces of the bones. First of all, the blood circulation in the vessels that supply the cartilage deteriorates. Then the cartilaginous coating begins to thin, completely erased. The bones inside the knee joint are exposed. As a result, when walking, they rub against each other, severe pain occurs.

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

Causes of gonarthrosis

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

  • primary;
  • secondary.

Primary knee osteoarthritis usually develops in older people. Its occurrence is due to:

  • violations of metabolic processes;
  • obesity;
  • hereditary predisposition;
  • taking hormonal drugs.

The primary form affects two knee joints at once and is called bilateral knee osteoarthritis. But there are cases when the inflammatory process first covers one knee, and only after a few years passes to the second.

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

  • heavy physical labor and sports, giving a load on the right or left knee joint;
  • trauma (rupture of ligaments, dislocation, hemorrhage in the cavity of the knee joint, damage to the meniscus, intra-articular fracture, etc. ).
  • operations performed on the knee joint;
  • joint inflammation/swelling.

Symptoms of gonarthrosis

Among the common symptoms of gonarthrosis of the knee joints are:

  • severe knee pain when moving;
  • knee dysfunction;
  • swelling of the knee joint;
  • lameness
  • joint stiffness;
  • instability of the affected joint.

The deformity (curvature) of the leg is also characteristic of the later stages of the disease.

In most cases, knee osteoarthritis develops slowly and goes through four successive stages.

Knee osteoarthritis of the first degree is characterized by the following features:

  • Unexpressed pain in the knee when going up/down stairs, when doing squats.
  • "Starting" pains at the beginning of the movement.
  • Mobility restriction.
  • Disappearance of discomfort when the patient "diverges".
  • Knee pain after heavy physical exertion.
  • The knee looks healthy or slightly swollen.
  • There may be manifestations of synovitis (inflammation of the inner wall, due to which fluid begins to form in the joint).

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

  • The pain becomes more intense.
  • Discomfort sharply increases during squats, walking.
  • The pain is localized inside the knees and gradually disappears at rest.
  • Crunch in the knees.
  • The joint expands, fluid begins to accumulate inside (synovitis).
  • Intra-articular fluid can fill the popliteal fossa at the back of the joint (Baker's cyst).
  • When touched, individual joint areas feel warm.
  • After a physical warm-up, the stiffness may disappear.
  • The shape of the legs in the knee area changes (there is a curvature).

For gonarthrosis of the third degree, the following symptoms are characteristic:

  • The pains disturb day and night, during rest and during walking. The patient should seek a position to reduce the severity of the painful symptom.
  • The joint is difficult to unfold and fold. He is limited in his movements. The leg cannot be fully straightened.
  • An O-shaped or X-shaped deformity of the lower limbs may form.
  • The knee joint significantly increases in size, becomes deformed. There is marked synovitis.
  • The patient's gait becomes unsteady, shaky, he has to use a stick/crutches, resort to outside help during movement.

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

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

If you experience similar symptoms, contact your doctor immediately. It is easier to prevent a disease than to deal with the consequences.

Diagnosis of gonarthrosis of the knee joints

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

  • X-ray. With gonarthrosis, the x-ray shows a narrowing of the cracks, a rarefaction of the bone tissue and its compaction under the cartilage, ossification of the articular cartilage. Perhaps the presence of osteophytes - bony growths along the edges of the cartilage.
  • Ultrasound diagnosis of the knee joint.
  • arthroscopy. During the study, the surgeon inserts a special micro-camera connected to the arthroscope into the joint through punctures. An image of all parts of the study area appears on the screen.
  • Magnetic resonance imaging (MRI). It helps to assess the degree of damage to the knee joints.
  • A blood test is an auxiliary diagnostic method and does not always give a full picture of the clinical picture. The fact is that with gonarthrosis, signs of inflammation in the blood may not be determined.

Treatment of gonarthrosis of the knee joints

Medications

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

  • anti-inflammatory;
  • painkillers;
  • chondroprotectors (provide the restoration of destroyed cartilage tissue).

The forms of their release are different - 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 mobility in a diseased joint),
  • canes.

Operation

Surgical methods are used in the treatment of gonarthrosis of the knee joint of the third degree. Indications for stents are:

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

The time spent on implantation is 2-3 hours. Before installing the prosthesis, the destroyed part of the joint and the back of the patella are removed, the axis of the leg is aligned. The ligaments are restored if necessary. When the stent is placed, the wound is sutured.

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

It is impossible to perform an arthroplasty operation if the patient suffers from osteoporosis (brittleness and fragility of the bones).

Additional methods of treating gonarthrosis

With gonarthrosis, as auxiliary methods of treatment, the following can be used:

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

Exercise therapy for knee osteoarthritis

Exercises for gonarthrosis of the knee joint are selected individually. Their regular implementation allows you to strengthen the muscles that surround the inflamed joint, improve blood circulation in the area of pathology. They must be performed lying on the back or seated.

In the first days, therapeutic exercises for gonarthrosis of the knee joint should take no more than 10 minutes. Gradually, the class time should be increased to half an hour. It is important to do all movements smoothly, to ensure that the pain does not increase.

General exercises include:

  • Raise the extended leg to a height of 15 to 20 cm from the floor and keep it in this position for as long as possible.
  • Raise the straightened leg to a height of 15-20 cm and gradually lower it to its original position.
  • Flexion and extension of the legs, seated on a chair.

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

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

Treatment of gonarthrosis of the knee joint of the first degree

The first degree of the disease is the easiest. The patient is affected:

  • Massage.
  • Physiotherapy.
  • Physiotherapy procedures.

In the presence of obesity, weight loss is necessary. For this, a special diet is observed.

Treatment of knee osteoarthritis of the second degree knee joint

Comprehensive treatment of pathology includes:

  • Perform the exercises recommended by the therapist.
  • Take anti-inflammatory and analgesic drugs, chondroprotectors, introduce hyaluronic acid into the joint.
  • Phytotherapeutic procedures (if there is no pronounced inflammatory process).
  • Normalization of weight.

Treatment of third degree knee osteoarthritis

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

If we are talking 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 extent of the problem.

If areas of healthy tissue are preserved, a corrective osteotomy is indicated. During this operation, the doctor corrects the shape of the bone by means of a fracture. Then he installs 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

Folk recipes help to achieve good results only at 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 dish.
  • Add 100ml of vodka.
  • Close the lid and leave to infuse for 3 weeks.
  • Store the prepared liquid in the refrigerator. Rub the joints with tincture once a day for 10 days.

Clay compresses

  • Place the blue/red clay in a glass dish.
  • Dilute with water to the consistency of sour cream.
  • Apply clay to a linen/cotton fabric about 1. 5-2cm thick.
  • Apply to affected joint.
  • Secure with a bandage and wrap with a towel.
  • Make compresses 2 to 3 times a day. The course of treatment is 1. 5 weeks.

dandelion tincture

  • Fill a glass bottle with dandelion flowers.
  • Top with triple cologne.
  • Close the cover.
  • Put for a month in a dark place.
  • After the specified period of time, strain the tincture. Rub his knees twice a day.

apple cider vinegar for knee arthritis

  • Mix 6 tablespoons of apple cider vinegar with 2 tablespoons of natural honey.
  • Apply the mixture to the joint area.
  • Garnish with cabbage leaves.
  • Wrap with plastic wrap and a scarf.
  • It is best to apply a compress in the evening. Remove after complete drying of the leaves. The duration of treatment is about 4 weeks.

Garlic with celery and lemon

  • 250 g celery, 120 g garlic, mince 3 lemons, mix. Transfer to a three-liter jar, pour boiling water.
  • Cover with a warm blanket.
  • After cooling, the agent should be consumed 70 ml before meals, first 1 time per day, after a few days - 2-3 times per 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 manages to lose weight, the pain becomes less pronounced, since the joints are less stressed. In this case, you should not starve or resort to the help of mono-diets. The diet should be balanced.

Protein helps restore intra-articular cartilage. Their patient can get lean meats, cheeses, cottage cheese, fish, lentils, beans, buckwheat. Useful for knee osteoarthritis jelly made from bone broth, as it contains a lot of collagen.

Carbohydrates should be obtained by eating vegetables and fruits. The fats must be mainly vegetable. A small amount of butter is allowed. Vitamins, especially of group B, are of great importance in improving the patient's condition. They are found in eggs, legumes, bananas, dairy products, cabbage, nuts and lentils.

Alcohol with gonarthrosis of the knee joints is prohibited. This not only has a negative effect on the body as a whole, but also increases appetite, which is undesirable.

The danger of gonarthrosis

With gonarthrosis of the first and second degrees, there is no talk of disability. The third stage of the disease can make the patient disabled, when joint functions are completely lost and unassisted movement becomes impossible.

It should be understood that knee osteoarthritis is a chronic pathology in constant evolution. In order for the prognosis to be favorable, a competent selection of drugs and regular exercise are necessary.

Gonarthrosis risk group

The risk group for gonarthrosis includes:

  • professional dancers;
  • athletes;
  • builders, loaders, miners;
  • people with a hereditary predisposition;
  • obese people;
  • with posture disorders;
  • suffered fractures;
  • with malformations of the ligamento-articular apparatus;
  • suffering from hormonal, rheumatoid and metabolic diseases.

Prevention of gonarthrosis

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

  • doing physical education;
  • avoiding excessive physical activity;
  • control 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.