The inflammatory-degenerative process in the knee joint, or gonarthrosis, occurs for several 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
About 22% of the world's population suffers from gonarthrosis, and women are more commonly affected. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint may collapse completely. This leads to reduced functioning of the musculoskeletal system. Movement is possible only with the help of crutches, otherwise the person becomes hostage to a wheelchair.
The knee joint is the second largest, after the hip, and the most complex in structure. This allows you to bend and extend your leg in different directions, which promotes correct posture and coordination in space. This is a strong and stable joint that can withstand the weight of a person. Consists of 3 bones: the femur, tibia and fibula, as well as the patella or kneecap. 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. The quality and quantity of the synovial fluid, which is located in the joint capsule and contributes to the smooth functioning of the knee, decreases. Friction occurs between the joint parts. Gradually the cartilage cracks and collapses. Unprotected bones begin to rub against each other. Pain occurs and a cracking sound is heard.
Causes of the disease
It mainly affects older people, especially overweight women. Due to hormonal changes, the cartilage in the knee wears out considerably. Gonarthrosis occurs to varying degrees in more than 80% of people after the age of 60.
There are other reasons for the occurrence of knee osteoarthritis:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part thereof;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people engaged in repetitive physical labor. This group also includes athletes, people leading a sedentary lifestyle and people with adverse environmental conditions. Patients are often people who are dependent on toxic substances (medications, alcohol, smoking).
The cause of joint deformity may be work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological diseases (fibroadenoma, endometriosis, uterine fibroids). Diet can be the trigger due to a deficiency of minerals and vitamins in the body.
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 symptoms. There may be minor discomfort and pain after prolonged exertion, which disappears after rest. The pain is felt in the morning, with movement it disappears after some time. Osteoarthritis of the 1st degree is rarely diagnosed incidentally during a routine examination.
- Pain and stiffness in the knee increase. A person saves his leg and tries to put less strain on it. As a result, the muscles atrophy, the joint is deformed, a formation is felt, and the leg at the knee does not fully extend.
- The pain is constant. The leg does not straighten or bend and it is difficult for the person to walk. There is a partial or complete loss of mobility. The cartilage is completely destroyed, the friction between the bones of the joint increases with the formation of osteophytes.
In addition to pain in grades 2 and 3, a grinding sound can be 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 is pronounced, the knee joint is deformed.
Diagnostics
If you have knee pain, please contact your local doctor. If necessary, he or she will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
To find out the causes and treatment of gonarthrosis, a comprehensive diagnosis is needed:
- general and biochemical blood test;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
An X-ray makes it possible to see the condition of the cartilage and changes in bones in stages 2 and 3. This is a narrowing of the joint space, osteophytes along the edges of the patella, changes in the periosteum. Arthroscopy provides more detailed information about the meniscus, synovial membrane and the presence of fluid. This method is also used to treat the knee, where pieces of cartilage or meniscus are removed.
Treatment of knee osteoarthritis
The therapy is long and sometimes painful. After appearing once, the disease remembers the rest of your life. The main drugs used for treatment are nonsteroidal anti-inflammatory drugs. Most often these are drugs based on nonsteroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. Medicines are relatively cheap, but lead to the formation of ulcers and erosions of the stomach and duodenum. Modern medicines cause fewer side effects, but are expensive.
Treatment measures for phase 1 include exercise-related preventive measures. Daily exercise, use of a contrast shower, swimming 2 times a week and counteracting an increase in body weight 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.
In severe severity, oral administration of NSAIDs is required. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. Painkillers are also prescribed.
A solution of hyaluronic acid is injected into the joint. It is a replacement for intra-articular fluid and nourishes the cartilage. During movement it acts as a shock absorber for the joint. The manipulation is painful and is performed by a doctor after the acute period has passed. If conservative treatment is unsuccessful, endoprosthesis is performed.
In addition to drug treatment, exercises with special simulators and devices (physitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered via subcutaneous or intramuscular injections, ozone-based ointments, creams. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern nutritional supplements are in great demand as an alternative to drugs for joint repair. Exercise therapy and massage are indicated. A set of special exercises improves blood circulation and nutrition of cartilage cells, increases the elasticity of ligaments.
Complications and prevention
Destroyed cartilage tissue and deformed bones cannot be treated. In this situation, only surgery will help. There are no ointments or medications that can repair 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 rapidly deteriorates. The knee cannot work, serious complications occur:
- joint deformity;
- cosmetic defect - curvature of a limb;
- infection with blood or lymph flow from another source of 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 arise if the patient does not visit a doctor in time and the disease has progressed. Regular preventive examinations and timely treatment of general body diseases will help prevent the condition from worsening and preserve the motor function of the limbs.