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Gonarthrosis

pain due to osteoarthritis of the knee joint

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

Over the years, bone growths begin to appear in the joint.They provoke the development of deformity, the leg becomes bent.

Causes of gonarthrosis

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

  • primary;
  • secondary.

Primary gonarthrosis usually develops in elderly people.Its occurrence 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.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 work and sports that put pressure on the right or left knee joint;
  • trauma (ligament rupture, dislocation, hemorrhage into the cavity of the knee joint, meniscus injury, intra-articular fracture, etc.).
  • operations performed on the knee joint;
  • inflammation/swelling of the joint.

Symptoms of gonarthrosis

Common symptoms of knee joint gonarthrosis include:

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

The final 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.

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

  • Unexpressed pain in the knee when going up/down stairs, during squats.
  • “Initial” pain when starting to move.
  • Mobility limitation.
  • 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 second-degree knee joint has the following symptoms:

  • The pain becomes more intense.
  • Discomfort increases markedly during squatting and walking.
  • The pain is located on the inside of the knees and gradually disappears during rest.
  • Knee-crushing.
  • 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 feel 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 for third-degree gonarthrosis:

  • The pain occurs day and night, during rest and when walking.The patient should seek a position that reduces the intensity of the painful symptom.
  • The joint is difficult to straighten and bend.He has limited movements.It is not possible to fully straighten the leg.
  • 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, shaky, and he or she needs to use a cane/crutches or resort to external help to move.

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 through x-rays.

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

If you notice similar symptoms, see a 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 interviewing the patient, examining the inflamed joint, checking its volume and assessing mobility.If gonarthrosis is suspected, the orthopedist prescribes instrumental methods:

  • X-ray. With gonarthrosis, the x-ray shows narrowing of the fissures, 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 microvideo camera connected to an arthroscope into the joint through punctures.An image of all parts of the studied area appears on the screen.
  • Magnetic resonance imaging (MRI).Allows you to assess the degree of injury to the knee joints.
  • A blood test is an auxiliary 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

Medicines

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

  • anti-inflammatory;
  • analgesics;
  • chondoprotectors (provide restoration of damaged cartilaginous tissue).

They come 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 braces that limit mobility in the affected joint),
  • canes.

Surgery

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

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

The time spent on implantation is 2 to 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 few hours after surgery, due to anesthesia, the patient cannot feel their lower limbs.The rehabilitation period is long - 3-4 months.

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

Additional methods of treating gonarthrosis

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

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

Exercise therapy for gonarthrosis

Exercises for gonarthrosis of the knee joint are selected individually.Its regular application makes it possible to strengthen the muscles surrounding the inflamed joint and improve blood circulation in the area of the pathology.They must be performed lying on your back or sitting.

In the first few 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 make all movements smoothly and ensure 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 as long as possible.
  • Raise the straight 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 the treatment of gonarthrosis depending on the degree of the disease

Treatment of first-degree knee joint gonarthrosis

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, a special diet is followed.

Treatment of second-degree knee joint gonarthrosis

Complex treatment of pathology includes:

  • Performing exercises recommended by the therapist.
  • Taking anti-inflammatory and analgesics, chondoprotectors, introducing 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, it is recommended that the patient 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 protrusions.Using an arthroscope, the doctor examines the cavity of the knee joint and studies the severity of the problem.

When preserving areas of healthy tissue, corrective osteotomy is indicated.During this operation, the doctor corrects the shape of the bone by breaking it.Then he 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 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 at stages 1 and 2 of the disease.When the cartilaginous tissue is destroyed and the joint becomes severely deformed, they become powerless.

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

Dandelion tincture

  • Fill a glass bottle with dandelion flowers.
  • Pour triple cologne on top.
  • Close the lid.
  • Place in a dark place for a month.
  • After the specified period of time, strain the tincture.Rub your 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 leaf.
  • Wrap in plastic and a tissue.
  • It is best to apply the compress at night.Remove after the leaves are completely dry.The course of treatment is about 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 less stress is placed on the joints.In this case, you should not starve yourself or resort to a mono-diet.Nutrition must be balanced.

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

Carbohydrates must be obtained through the intake of vegetables and fruits.Fats must be predominantly vegetable.Small amounts of butter are permitted.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 have 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

In first and second degree gonarthrosis, we are not talking about disability.The third stage of the disease can leave the patient incapacitated, when joint functions are completely lost and movement without assistance becomes impossible.

It must be understood that gonarthrosis is a chronic pathology in constant evolution.For a favorable prognosis, proper selection of medications and regular exercise are necessary.

Risk group for gonarthrosis

The risk group for gonarthrosis includes:

  • professional dancers;
  • athletes;
  • builders, loaders, miners;
  • people with hereditary predisposition;
  • obese people;
  • with poor posture;
  • suffered fractures;
  • with malformations of the ligamentous-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 followed:

  • do physical exercise;
  • avoid excessive physical activity;
  • control weight;
  • seek qualified medical help for injuries, inflammatory joint diseases;
  • do not overcool (if there is a problem, it is recommended to use warm knee pads);
  • drink 2 liters of water per 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.