Gonarthrosis, or knee joint disease, is a serious degenerative-dystrophy of the knee joint, which destroys the cartilage tissue structure of the joint, resulting in deformation and loss of function of the knee. joint. Pathology often leads to disability in humans.
The deformation of the gonads of the knee occupies the leading position among all joint diseases, and if at first only a small part of the joint is affected, then if not properly treated, when the diseaseinto the late stage of development, all are involved in the pathological process.
Most disease develops in people over 40 years old, but in athletes, the disease can occur at a young age (after a serious joint injury).
Women are most susceptible to joint deformity, but it usually occurs in men and even in young children. In order not to make the situation worse, you need to be aware of the first signs of the disease.
Types
The classification of gonarthrosis depends on its etiology and locale. Each cultivar has its own developmental characteristics, always being cautious of when prescribing treatment by a doctor. But in terms of nature of manifestation, they are practically the same.
Thus, the acute forms of osteoarthritis of the knee, depending on the etiology of the disease, are as follows:
- Primary gonarthrosis disease.The disease develops without any prerequisites. The risk group includes the elderly, women and obese patients. Gonarthrosis of the primary type knee joint can develop over many years without manifesting in any way. But the earlier it is detected, the more favorable the prognosis of treatment is.
- A secondary fibroidof the knee that occurs from trauma, but it can also be the result of various infectious diseases. If the damaged joints are healed in time, the patient has every chance to avoid the disease.
There are localized types of osteoarthritis:
- Right gonadal fibroids, developing in the joint tissue of the right knee. It occurs most commonly in athletes, as well as in people whose jobs require constant exertion.
- Left genital fibroidsinvolving the left knee during pathology. Occurs in professionals engaged in sports, as well as in patients diagnosed with obesity.
- Bilateral Osteoarthritisdestroys the joint tissue of the knees of both legs. This type of disease is considered to be the most severe, both in terms of symptoms and point of view of treatment. In most cases, the gonarthrosis type of the knee joint develops in the elderly, i. e. it is idiopathic.
Anatomic and pathological changes
The knee joint is formed from the joint surface of the tibia and femur. In its front part is a kneecap which, during its movement, glides gently along the depression between the ducts of the femur.
The femur and tibia together with the knee cushion are covered with elastic clay cartilage 5-6 mm thick. It helps reduce friction during one's physical activity and in the event of a fall, it performs the function of shock absorption.
Pathological changes of the joints: disturbances in stages
At the first stage of degenerative knee osteoarthritis, blood circulation is first affected. The small blood vessels that supply blood to the hyalin joint are interrupted, resulting in the dry surface of the joint. It becomes less elastic and cracks start to form on its surface.
As a result, instead of slipping smoothly, these flowers touch each other. The inflammation gradually begins to develop, and the diseased cartilage, shifts slightly, interferes with each other to fulfill their functions. Due to the formation of a large number of small cracks in the area of the tissues that make up the cartilage, they gradually lose their buffering properties.
During the second stage of gonarthrosis progression, compensatory changes in the bone region begin to occur. Under the effect of increased loads, the joint floor gradually begins to flatten, which leads to a compression of the area below the cartilage (the bone area below the cartilage).
Joint surfaces along the edges begin to overgrow with the skeletal process, looking like spikes on x-ray film.
As the lubricating fluid in the joint thickens, it loses most of its function. This leads to a rapid increase in cartilage degeneration. For this reason, it looks like a thin thread on the x-ray film, or it's completely invisible.
If you notice something like this, it means that the disease progresses smoothly (or quickly - it all depends) into the 3rd stage of development.
At the third stage of knee osteoarthritis, there is a noticeable deformity of the bone. They seem to be pressed together leading to reduced joint mobility. The cartilage tissues are almost completely dry.
Causes and predisposition factors
The causes of dry joints of the knee joint are not separated - doctors often identify several factors at once that lead to the development of the disease.
The most common and common reasons are:
- a previous joint injury (medium or high severity); broken leg
- , especially if there is an injury in the joint;
- violates the integrity of the cambered structure;
- tearing or complete tearing of the ligament;
- is excessive stress on the knee joint.
Acute arthritis of the knee joint is directly related to a person's age. Therefore, it is found that people over the age of 40 are most susceptible to this disease, because during this period, the flexibility of cartilage begins to decrease, and the lubricated joint fluid gradually "depletes".
To delay this moment, the patient should play sports, but moderate physical activity and not lead to general discomfort.
Excess weight is also one of the factors that lead to the development of gonarthrosis. The fact that being overweight puts additional stress on bones and joints, not possible but affects their health.
In this case, which foot has more load plays an important role. For example, if your "prop" is your left leg, there is a high chance that you may have left gonarthrosis.
In obesity, constant pressure on the joints leads to microscopic injury and rupture of small blood vessels. There may also be a rupture of a meniscus or ligament, which is considered a manifestation of a serious joint injury.
This disease is extremely difficult for patients with symptoms of varicose veins clearly. In this case, the patient will be consulted by a vein doctor.
A high risk of developing this pathology also exists in people:
- has previously suffered from different types of arthritis;
- is unfavorable hereditary;
- has a problem with the ligament apparatus;
- has a metabolic disorder;
- had traumatic brain injury;
- was injured in an accident;
- suffered a spinal injury.
Many of these factors are often closely related. Determining the exact cause helps to make an accurate diagnosis and prescribe accurate and effective osteoarthritis treatment for the patient.
Clinical manifestations
Symptoms of gonarthrosis do not manifest themselves immediately - they begin to appear gradually, depending on the stage of the disease. For this reason, the clinical picture must be considered in stages.
First stage
In the early stages of the disease, the patient complains of mild pain in the knee area, which increases with exertion. They become especially intense when descending and ascending stairs.
In addition to pain, the patient also feels stiffness when moving, "spasm" in the joint area. It is felt in the scalp and passes as the muscles of the knee are relaxed.
Another characteristic feature is the so-called "pain syndrome onset". It develops in the patient's first steps. As the knee gets used to the load, this abnormality goes away without leaving a trace.
Second stage
At this point, knee effusion symptoms become more intense and more noticeable. The pain gradually increased, causing considerable difficulty and discomfort while walking. Pain syndrome goes away after a long rest, but when it comes to exertion it feels the same way.
Arthritis causes swelling of the knee joint, visible to the naked eye. There is a strong, uncomfortable scratching sound when walking. Movements become more difficult and more limited.
Third stage
The pain becomes very severe and there is nothing the patient can do without pain reliever. The patient has difficulty bending the knee, feeling stiff when moving. It becomes deformed and increases in size. In severe cases, the patient cannot move without additional assistance.
All these signs of knee effusion disease patients should not ignore. This disease can keep people in bed for a long time, and sometimes lead to disability.
Which doctors treat knee fibroids?
To diagnose and treat fibroids of the knee, an orthopedic specialist should be seen. If surgery is necessary, you may need the help of a surgeon.
Diagnostic measures
To determine the cause of the disease, an integrated approach to examining the patient is of utmost importance.
The diagnostic diagram consists of several stages:
- Visual orthopedic examination and physical examination. The doctor determines whether the patient has symptoms of acute knee effusion, palpates the affected leg, takes bone measurements, and conducts angiometry - a test that can be used to evaluate a person's mobilityjoints at different angles.
- Clinical blood test to evaluate ESR.
- Blood chemistry.
- Look at urine and blood for fibrinogen, urea, and other substances.
- X-rays are one of the most common screening methods for arthritis. However, in the early stages, the snapshots do not show any changes - they can only be noticed at later stages of development. X-rays showed narrowed joints, sclerotic changes in the cartilage area, bone tissue damage and salt deposition.
- Ultrasound is the most informative diagnostic procedure. However, official test results can be obtained if the ultrasound is done with the X-ray. The
- MRI allows you to thoroughly examine all layers of joint tissue, cartilage and bone, and notice the first dystrophic changes in the early stages of joint disease. However, MRI has one major downside - the process is quite expensive. But its high accuracy contributes to 99. 9% diagnostic accuracy.
Treatment
Treatment of acute arthritis of the knee, like a diagnosis, requires an integrated approach. But first of all it is necessary to apply drug treatment, since the affected joint can become inflamed at any time.
Medicines
What is the treatment for knee osteoarthritis with medicine and which medicine should I choose? Only one trauma doctor talked about this. Usually, drugs of the following groups are included in the treatment regimen:
- COX-1 or 2 nonsteroidal anti-inflammatory drugs. The first group of drugs can cause serious damage to the gastrointestinal tract so it cannot be used for long. The same cannot be said about drugs in the COX-2 group, which are gentler. They are administered intramuscularly or intravenously.
- Treatment of knee arthritis has also been associated with the use of hormonal drugs. They help reduce inflammation and swelling in the knee. Their use is recommended if bursitis (synovitis) is present.
- Treatment with chondroprotectors.
- Apply ointments, gels, creams. They improve blood circulation, warm up, reduce swelling and inflammation.
Method one
How to cure a knee effusion with this technique? The main elements of the therapeutic program are:
- using drugs (NSAIDs, chondroprotectors, pain relievers, ointments, creams, gels);
- mild physical therapy exercises;
- manual therapy;
- physiotherapy;
- apply an anti-inflammatory warm compress with a medicinal solution.
Also, according to the famous rheumatologist, diet plays an important role in joint disease. By using a properly formulated diet and using all of the above techniques, you can achieve amazing results from therapy in the shortest time possible.
Method two
Usually, the treatment of effusion of the knee like any other joint disease is done by this method.
Evolution of a famous doctor based on application:
- pills;
- surgical intervention;
- adhere to the diet to get rid of excess fluids from the body;
- kinesitherapy;
- physiotherapy.
The doctor also recommends swimming more in the pool, going to the sauna and going for massages. This will help improve the patient's health, especially if the disease has not been treated for a long time.
Third method treatment
Treating the gonarthrosis of the knee with this technique completely eliminates the dynamic load, as they can significantly speed up the deformation process. Exercise should be slow, low amplitude.
For example, sitting on the "top" seat, facing back. Extend your feet, but don't let them touch the floor. Gently wave each leg in turn. Do the exercise until you feel a little tired. The number of hits depends on the patient's condition.
Surgery
How to treat advanced knee osteoarthritis? In this case, there is only one exit - operation. There are several types of surgery for osteoarthritis of the knee:
- Removes deformed cartilage tissue and diseased joints (arthrodesis). It is extremely rare.
- Removes damaged cartilage tissue without removing the joint. This intervention is called arthroscopic resection. It is performed with a special device - a joint endoscope. Simple but effective procedure takes no more than 3 years.
- Sawing and fixing the diseased joint from another angle. This is called circumference surgery. The technique is quite complicated but can cause the patient to forget 3-5 years.
Rarely interventions with surgery and only in the absence of a cure, at least 1-2 years. In the early stages of the disease, surgery is almost never performed.
Hormonal drugs
Hormonal drugs are considered the most common treatment for gonarthrosis. This is a type of surgery that allows you to completely maintain the mobility of the affected knee. But, despite its effectiveness, this technique requires a long recovery. In addition, it can lead to quite serious consequences.
The residence of the "real" patient with an artificial joint implant, can serve for 20 years. Although of course it all depends on the material in which it was made. This procedure is not cheap, but quite effective, which is why it has become particularly popular.
Physical therapy exercise
Sedentary therapy is prescribed by the doctor depending on the stage of the disease. However, the rules for doing the exercise are the same for all cases:
- avoids excessive stress on the knee joint;
- is prohibited from sudden and forced movements;
- does not perform full force exercises on the affected joint.
Exercises allowed:
- gently shook her legs while kneeling on a blanket spread on the floor;
- kneeling neatly in old posture;
- in the same position, alternately straighten your legs, trying not to let your heels fall off the floor, then bend again, avoiding sudden movement.
These exercises, combined with medicine and physiotherapy, will give great results.
Physiotherapy
All physiotherapy procedures are prescribed for relief from gonarthrosis. Among the most effective techniques, it should be noted:
- electrophoresis with medicinal solutions;
- magnetotherapy; Ultrasound therapy
- ;
- microprocessor;
- paraffin therapy;
- bathe with radon or hydrogen sulfide; Sludge treatment
- .
To prevent recurrence, physical therapy courses should be done at least 2 times a year. This will help prolong the remission period.
Massage
Knee massage is done to improve blood circulation. It is carried out along the flow of lymph in the direction from the periphery to the central region. Popliteal fossils are not involved in this process.
Usually, along with massage, manual therapy sessions are conducted with the aim of gradually stretching the diseased joint. Such procedures stabilize the patient's condition, but can only be performed by a specialist.
Does gonarthrosis be completely cured?
Is it possible to completely cure osteoarthritis? Perhaps no one, even the most experienced trauma doctor, will be able to give a clear answer to this question. It all depends on the severity of the disease. If you engage in therapy in the early stages of its development, you may stop further deformity of the joint.
However, if the pathology is detected at a terminal stage, even surgical intervention does not guarantee complete disappearance of the unpleasant symptoms. Surgery only helps to heal for a few years, after which it can repeat on its own.
Precautions
To prevent gonarthrosis, it is necessary:
- avoid knee injury;
- continuous exercise (squatting, running, raising and lowering the legs);
- enriches the diet with foods high in vitamins;
- limit the use of salt, hot spices, fried foods, smoked products, sweets;
- maintains normal physical shape;
- Get immediate medical attention in case of the mildest knee injury;
- oral prophylactic chondroprotectors after reaching 35 years of age;
- consumes the daily amount of water (2 liters).
By following these simple recommendations, you'll protect yourself from osteoarthritis as well as other ailments that can impair your quality of life in the long run.