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Gonarthrosis

Pain due to osteoarthritis of the knee joint

Most often the disease occurs in older patients (especially women).Joint pain in gonarthrosis is explained by dystrophic changes in the cartilage covering the intra-articular surfaces of the bones.First, blood flow to the vessels supplying the cartilage deteriorates.Then the cartilage begins to become thinner and is completely destroyed.The bones in the knee joint are exposed.This causes them to rub against each other when walking and cause severe pain.

Over the years, bone growth occurs in the joint.They provoke the development of a deformity, the leg is bent.

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;
  • Taking hormonal medications.

The primary form affects two knee joints at the same time and is called bilateral gonarthrosis.However, there are cases when the inflammatory process initially affects one knee and only a few years later spreads to the second knee.

Secondary gonarthrosis, on the other hand, is always one-sided.His name is:

  • heavy physical work and sports that put strain on the right or left knee joint;
  • Trauma (torn ligaments, dislocation, hemorrhage into the knee joint cavity, meniscus damage, intra-articular fracture, etc.).
  • operations on the knee joint;
  • Inflammation/swelling of the joint.

Symptoms of gonarthrosis

The most common symptoms of gonarthrosis of the knee joints include:

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

In the late stages of the disease there is also a deformation (curvature) of the leg.

In most cases, gonarthrosis develops slowly and progresses in four successive stages.

First degree gonarthrosis of the knee joint is characterized by the following symptoms:

  • Unspoken pain in the knee when climbing stairs and doing squats.
  • “Initial pain” when starting movement.
  • Restriction of mobility.
  • Disappearance of discomfort when the patient “deviates”.
  • Knee pain after heavy physical activity.
  • The knee looks healthy or slightly swollen.
  • Manifestations of synovitis (inflammation of the inner mucous membrane, as a result of 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.
  • The symptoms increase significantly when squatting and walking.
  • The pain is localized to the inside of the knees and gradually disappears at rest.
  • Crunch in the knees.
  • The joint expands and fluid begins to accumulate in it (synovitis).
  • Intra-articular fluid can fill the popliteal fossa at the back of the joint (Baker's cyst).
  • Individual joint areas feel hot.
  • After physical warm-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, at rest and when walking.The patient must find a position to reduce the severity of the pain symptom.
  • The joint is difficult to extend and bend.His movement is restricted.It is not possible to fully straighten the leg.
  • An O- or X-shaped deformity of the lower extremities may form.
  • The knee joint enlarges significantly and becomes deformed.Severe synovitis is observed.
  • The patient's gait becomes unstable, shaky, he has to use a stick/crutches when moving or resort to outside help.

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

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

If you notice similar symptoms, seek medical attention immediately.It is easier to prevent an illness 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 assessing mobility.If gonarthrosis is suspected, the orthopedist prescribes instrumental methods:

  • Roentgen.In gonarthrosis, the X-ray shows narrowing of the cracks, thinning of the bone tissue and its compaction under the cartilage, and ossification of the articular cartilage.There may be osteophytes - bone growths that run along the edges of the cartilage.
  • Ultrasound diagnostics of the knee joint.
  • Arthroscopy.During the examination, the surgeon inserts a special microvideo camera connected to an arthroscope through punctures into the joint.An image of all parts of the examined area appears on the screen.
  • Magnetic resonance imaging (MRI).It allows assessing the extent of damage to the knee joints.
  • A blood test is a supportive diagnostic method and does not always provide 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

Medication

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

  • anti-inflammatory;
  • painkillers;
  • Chondoprotectors (ensure the restoration of damaged cartilage tissue).

They come in different forms – ointments, creams, gels, tablets, capsules, intra-articular and intramuscular injections.

Orthopedics

In the orthopedic treatment of pathologies, special devices are used to minimize the load on diseased joints:

  • orthopedic insoles for shoes,
  • Orthoses (special rigid knee pads that limit mobility in the affected joint),
  • sticks.

surgery

Surgical methods are used to treat third-degree knee joint gonarthrosis.Indications for endoprosthetics are:

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

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

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

Endoprosthetic surgery is not possible if the patient suffers from osteoporosis (brittleness and brittleness of the bones).

Additional methods of treating gonarthrosis

The following supportive treatment methods can be used for gonarthrosis:

  • manual therapy;
  • Massage;
  • Acupuncture;
  • hirudotherapy;
  • physiotherapy;
  • Movement therapy.

Exercise therapy for gonarthrosis

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

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

Universal exercises include:

  • Raise the straightened leg to a height of 15-20 cm from the floor and hold 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 when sitting on a chair.

Squats and long walking are contraindicated without first consulting an orthopedist.

Features of the 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.
  • Physiotherapeutic procedures.

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

Treatment of second degree knee joint gonarthrosis

Complex treatment of pathology includes:

  • Performing the exercises recommended by the therapist.
  • Taking anti-inflammatory and painkillers, chondoprotectors, introduction of hyaluronic acid into the joint.
  • Phytotherapeutic procedures (if there is no pronounced inflammatory process).
  • Normalization of weight.

Treatment of third degree gonarthrosis

Therapeutic treatment of third degree pathology is similar to measures taken in the second stage of the disease.However, if the expected effect does not occur, the patient is recommended to undergo 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 outgrowths.Using an arthroscope, the doctor examines the cavity of the knee joint and determines how serious the problem is.

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

The second method of surgical treatment is endoprosthetics - an operation in which the entire knee joint or individual parts of it are replaced 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.If the cartilage tissue is destroyed and the joint is severely deformed, they are weak.

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 let it brew 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 about 1.5-2 cm thick onto the linen/cotton fabric.
  • Apply to the painful joint.
  • Secure with a bandage and wrap with a towel.
  • Make compresses 2-3 times a day.The duration of treatment is 1.5 weeks.

Dandelion tincture

  • Fill a glass bottle with dandelion flowers.
  • Pour triple cologne over it.
  • Close the lid.
  • Store in a dark place for a month.
  • After the specified time, strain the tincture.Rub her knees twice a day.

Apple cider vinegar for osteoarthritis 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 cabbage leaves.
  • Wrap in plastic wrap and a scarf.
  • It is best to use the compress at night.Remove the leaves after they are completely dry.The treatment duration is approximately 4 weeks.

Garlic with celery and lemon

  • 250 g celery, 120 g garlic, 3 lemons, chop and mix.Pour into a three liter jar and add boiling water.
  • Cover with a warm blanket.
  • After cooling, take 70 ml before meals, initially 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 manages to lose weight, the pain becomes less severe because there is less strain on the joints.In this case, you should not starve yourself or resort to a mono diet.The diet should be balanced.

Proteins contribute to the restoration of intra-articular cartilage.The patient can get them from lean meat, cheese, cottage cheese, fish, lentils, beans and buckwheat.Jellied meat from bone broth is useful for gonarthrosis as it contains a lot of collagen.

Carbohydrates should be consumed by eating vegetables and fruits.Fats should be predominantly vegetable.Small amounts of butter are allowed.Vitamins, especially group B vitamins, are of great importance in 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.Not only does it have a negative effect on the entire body, but it also increases appetite, which is undesirable.

The risk of gonarthrosis

In the case of first and second degree gonarthrosis, we do not speak of a disability.In the third stage of the disease, the patient can become incapacitated when the functions of the joints are completely lost and movement becomes impossible without help.

It should be understood that gonarthrosis is a chronic pathology that is constantly progressing.For a favorable prognosis, the correct selection of medication and regular exercise are necessary.

Risk group for gonarthrosis

The risk group for gonarthrosis includes:

  • professional dancers;
  • Sportsman;
  • construction workers, loaders, miners;
  • people with a hereditary predisposition;
  • obese people;
  • with poor posture;
  • suffered fractures;
  • with malformations of the ligament-articular apparatus;
  • suffer from hormonal, rheumatoid and metabolic diseases.

Prevention of gonarthrosis

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

  • engage in physical activity;
  • avoid excessive physical activity;
  • control weight;
  • seek qualified medical help in case of injuries and inflammatory diseases of the joints;
  • do not overcool (if you have problems, it is recommended to wear warm knee pads);
  • drink 2 liters of water per day;
  • wear comfortable shoes;
  • Avoid stressful situations.

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