The inflammatory-degenerative process in the knee joint, or gonarthrosis, occurs for various reasons. It has an extremely negative impact on a person's quality of life, sometimes leading to disability. How to treat osteoarthritis of the knee joint and prevent complications?
What is osteoarthritis?
Approximately 22% of the world's population suffers from gonarthrosis and women are affected more frequently. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint may collapse completely. This leads to impaired musculoskeletal function. Movement is only possible with the help of crutches, or the person is held hostage by a wheelchair.
The knee joint is the second largest, after the hip, and the most complex in structure. Allows you to bend and straighten your leg in different directions, promotes correct body position and coordination in space. It is a strong and stable joint that can support the weight of a person. It consists of 3 bones: the femur, tibia and fibula, as well as the kneecap or patella. It includes osteochondral structures, muscles, ligaments and nerve fibers.
The disease begins with a violation of blood circulation and nutrition of joint tissues. First of all, the cartilage suffers. It decreases the quality and quantity of synovial fluid, which is found in the joint capsule and contributes to the proper functioning of the knee. Friction occurs between the parts of the joint. Little by little, the cartilage cracks and collapses. The unprotected bones begin to rub against each other. Pain occurs and a crunch is heard.
Causes of the disease
It mainly affects older people, especially overweight women. As a result of hormonal changes, the cartilage in the knee wears out a lot. Gonarthrosis to varying degrees, after the age of 60, occurs in more than 80% of people.
There are other reasons for the appearance of knee osteoarthritis:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part of it;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people who do repetitive physical work. This group also includes athletes, people leading a sedentary lifestyle and people with unfavorable environmental conditions. Often patients are people dependent on toxic substances (drugs, alcohol, smoking).
The cause of joint deformation may be work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Due to the lack of minerals and vitamins in the body, diet can be the trigger.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. Depending on the nature of the manifestations, the disease is divided into degrees:
- At this stage, there are no obvious clinical signs. There may be slight discomfort and pain after prolonged exercise, which disappears after rest. The pain is felt in the morning, when moving it disappears after a while. First degree osteoarthritis is rarely diagnosed, by chance, during a routine examination.
- Increases pain and stiffness in the knee. A person saves his leg and tries to carry it less. As a result, the muscles atrophy, the joint is deformed, a formation can be felt, and the leg at the knee is not fully extended.
- The pain is constant. The leg does not straighten or bend and the person finds it difficult to walk. A partial or complete loss of mobility develops. The cartilage is completely destroyed, friction between the bones of the joint increases with the formation of osteophytes.
In addition to pain in grades 2 and 3, a cracking sound is heard in the knee. Fluid and pieces of cartilage tissue can accumulate in the joint capsule, causing swelling. At a late stage, the inflammatory process manifests itself and the knee joint is deformed.
Diagnosis
If you have knee pain, you can contact your local doctor, who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
To know the causes and treatment of gonarthrosis, a comprehensive diagnosis is needed:
- general and biochemical blood test;
- rheumatic tests;
- bone scan;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
An x-ray allows you to see the condition of the cartilage and changes in the bones in stages 2 and 3. These include a narrowing of the joint space, osteophytes along the edges of the kneecap, and changes in the periosteum. Arthroscopy provides more detailed information about the meniscus, synovial membrane, and the presence of fluid. This method is also used in the treatment of the knee, to remove pieces of cartilage or meniscus.
Treatment of knee osteoarthritis.
The therapy is long and sometimes painful. Having appeared once, the disease is remembered for the rest of your life. The main drugs used for treatment are non-steroidal anti-inflammatory drugs. In most cases these are medications based on non-steroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. The drugs are relatively cheap, but they cause the formation of ulcers and erosions in the stomach and duodenum. Modern medications cause fewer side effects, but are expensive.
Treatment measures for stage 1 include preventative measures related to exercise. Daily exercise, use of a contrast shower, swimming pool 2 times a week and combating body weight gain are required.
Stage 2 requires fixation of the joint: the use of an elastic bandage, bandage or orthosis. To relieve pain, NSAIDs are used in the form of creams and ointments. To reduce the degree of cartilage destruction, the patient is prescribed drugs from the group of chondroprotectors.
Severe severity requires oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated: synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid activity and low mineralocorticosteroid activity. Additionally, pain relievers are prescribed.
A hyaluronic acid solution is injected into the joint. It is a substitute for intra-articular fluid and nourishes cartilage. When moving, it acts as a shock absorber for the joint. The manipulation is painful and is performed by a doctor once the acute period has subsided. If conservative treatment is unsuccessful, a stent is performed.
Along with drug therapy, exercises with simulators and special devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered by subcutaneous or intramuscular injections, ozone-based ointments and creams. Manipulation stimulates blood circulation, improves the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are in great demand as an alternative to joint restoration drugs. Exercise therapy and massage are indicated. A series of special exercises improves blood circulation and nutrition of cartilage cells and increases the elasticity of ligaments.
Complications and prevention.
Destroyed cartilage tissue and deformed bones cannot be treated. In this situation, only surgery will help. No ointment or medicine can restore cartilage. Drugs can only stop the process of destruction of cartilage tissue.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without proper treatment, the patient's condition deteriorates rapidly. The knee cannot function, serious complications appear:
- joint deformity;
- cosmetic defect: curvature of a limb;
- infection with blood or lymph flow from another source in the body;
- due to the weakness of the ligaments, dislocations and fractures are observed, even during normal walking;
- Bone fusion (ankylosis) occurs in the joint area, making movement impossible.
Complications develop if the patient does not consult the doctor in time and the disease is advanced. Regular preventive examinations and timely treatment of general diseases of the body will help prevent the condition from worsening and maintain the motor function of the limb.