Arthrosis of the knee joint (gonarthrosis) is a degenerative lesion of the joint, which eventually leads to its deformation. Cartilage tissue begins to break down in it. Gradually, the functionality of the knee is impaired and the patient loses the ability to move normally. This disease is very common.
Treatment of arthrosis of the knee is long-term, but it cannot provide a complete cure for the problem. However, therapy is needed in order to preserve the mobility and functionality of the joint as long as possible, as well as improve the patient's quality of life.
It is possible to classify gonarthrosis of the knee joint for the reasons of its development. It is primary and secondary. The first type of the disease occurs most often. It also has another name - idiopathic osteoarthritis. The exact reason for the development of this form of knee arthrosis is difficult to establish, since there are too many influencing factors.
The secondary type of pathology is clearly tied to one reason or another. For example, it often occurs after a knee injury due to severe physical exertion of the knee joint. Such gonarthrosis is often genetically determined. Certain diseases can also cause dystrophic changes in the knee joint: diabetes mellitus, rheumatoid arthritis, congenital deformity of the lower extremities.
Why pathology develops
The knee joint is one of the most complex joints in the human body. It is formed by the femur, tibia and patella. The articulation also includes triangular cartilage with curved edges - menisci. The well-coordinated work of the knee is ensured by the musculo-ligamentous apparatus. Almost all bone surfaces of the joint are covered by cartilage tissue, the thickness of which is about 0. 5 cm. It feeds on blood vessels, as well as in a diffuse way (obtaining useful substances from synovial fluid).
The cartilage in the knee allows the bony surfaces to slide and cushion them. If the nutrition of this tissue is disturbed, then dystrophic processes begin in it, it becomes thinner. If untreated, the cartilage disappears completely and the knee joint stops moving. The reason for the development of arthrosis can be different. For example, the following factors can provoke the appearance of a secondary form of pathology:
- Excessive stress on the knee joint. In this case, changes may occur that the person is not even aware of. Therefore, the load should be moderate, especially in old age. The greatest harm comes from squatting and running on hard surfaces (asphalt).
- Knee injury. This can include damage to the meniscus, dislocation of the joint, fracture. This reason contributes to the development of the disease in young people. After fixing the limb, blood circulation in it deteriorates. Damage or removal of menisci in 90% of cases leads to arthrosis.
- Too much body weight. Excessive weight can damage the menisci. The restoration of the knee joint is protracted and difficult. In obese people, bilateral arthrosis of the knee often occurs. An additional negative point is the presence of varicose veins. In this case, the patient develops the most severe form of knee gonarthrosis.
- Weakness of the ligamentous apparatus. Because of it, there is too high joint mobility. Despite the fact that a person can sit on the twine without any problems even without warm-up, at this time the joint receives microtrauma. If the knee is damaged enough, arthrosis begins to develop.
- Violation of metabolic processes. In this case, the knee joint does not receive enough nutrients.
- Articular pathologies. The presented pathology can be provoked by arthritis of the knee joint (reactive, rheumatoid). It is characterized by the development of inflammation and the accumulation of too much fluid in the articular cavity. The cartilage tissue in the knee begins to deteriorate.
- Stressful situation. Mood swings, the constant presence of the nervous system in a state of tension can provoke arthrosis of the knee joint.
- Congenital diseases of muscles, ligaments, and dysplasia.
- Chondrocalcinosis (premature deposition of calcium salts in the cartilage of the knee). Pathology is systemic.
- Osteomyelitis. This is an inflammation of the bone marrow, in which purulent masses are formed. They negatively affect the surrounding tissues. Over time, purulent masses go beyond the bone of the knee joint. Lack of treatment threatens the development of sepsis.
- Acromegaly. This is an endocrine disease in which the level of growth hormone increases. Most often, a benign tumor in the anterior pituitary gland contributes to an increase in its amount. If such a disease develops during adolescence, the child develops a specific physique. The excessive growth rate of cartilage tissue leads to deformation of the knee joint.
- Hypothyroidism. This disease is also endocrine. It occurs due to a lack of thyroid hormones. The mass of a person begins to increase, he moves little, and the cartilage of the knee joint wears out.
- Frostbite. In this case, ice crystals form in the soft tissues, which kill living cells.
- Synovitis (inflammation localized in the synovial bag of the joint).
All these reasons are capable of provoking knee gonarthrosis, while the person will not even notice when the disease began to develop.
What stages does arthrosis go through in its development?
The effectiveness of knee treatment depends on the degree of development of arthrosis diagnosed in the patient:
- First degree of knee arthrosis. The pain at this stage is not felt much. The patient can endure discomfort for years, while he is in no hurry to contact specialists or to carry out any kind of treatment. A person needs help during an exacerbation. A sharp onset of pain is not typical for arthrosis of the knee.
- Arthrosis of the knee joint of the 2nd degree. The intensity of the discomfort increases. Pain occurs not only after physical exertion on the knee joint, but also at rest. To get rid of unpleasant sensations, you have to rest more. In the area of the knee joint, swelling appears, the patient hears a crunch. The x-ray shows a narrowing of the joint space, a slight deformation of the knee joint.
- Arthrosis of the knee joint of the 3rd degree. In this case, knee mobility is severely limited, and sometimes the leg cannot fully straighten. The pain in the joint becomes severe and constant, it appears as a response to changing weather conditions. The discomfort is aching in nature, and it is difficult to get rid of it even at rest. Often the patient's sleep is disturbed, and in order to alleviate his condition a little, he uses NSAIDs. A person develops lameness, and the deformity of the joint is very noticeable.
Treatment of arthrosis should be started as early as possible, before the destruction of bone tissue becomes critical. In case of irreversible changes, only surgery will help the patient.
Knee arthrosis symptoms
The development of arthrosis does not occur overnight. With its progression, the symptoms become more intense. For gonarthrosis, the following manifestations are characteristic:
- Crunching and clicking that is heard with a certain movement. The patient may notice this symptom quite late. However, he says that the articular surfaces are damaged, grooves and bone growths have appeared on them.
- Swelling and enlargement of the knee.
- Painful sensations. At the first stage of the development of arthrosis, they are invisible and can appear only after a serious static load on the knee joint. Dynamic exercise, in turn, improves the condition of the joint, its nutrition, and subsequent prognosis. Since the top layer of cartilage is erased during arthrosis, the nerve endings are exposed. After some time (after rest), the fibers become covered with a small layer of fibrin and become less sensitive - the pain in the knee goes away. If the knee joint continues to collapse, then the discomfort does not leave the person even at rest. Edema appears in the bursa, which compresses the nerves even more. The inflammatory process begins.
- Restricted mobility. This symptom allows you to differentiate arthrosis from other pathologies of the knee joint. Stiffness appears in the morning after sleep and disappears after half an hour. If this condition lasts longer, then this indicates the presence of an inflammatory process.
- Decreased range of motion. The patient is not able to straighten the limb to the end. Since the patient constantly feels pain, he tries to reduce the range of motion, and the ligaments adapt to this. That is, they are shortened and do not allow the knee joint to fully fulfill its function.
- Joint jamming. It arises as a result of a strong change in the articular surfaces.
- Dislocations and subluxations. They appear at the last stage of the development of arthrosis, when the joint is severely deformed.
Over time, a person experiences muscle atrophy, proliferation of osteophytes, and weakening of the lateral ligaments. The consequences of arthrosis are severe, as a person becomes disabled.
How to define arthrosis correctly?
In order to begin the correct treatment of arthrosis, the patient needs to undergo a thorough examination. Diagnostics should be differential, and includes the following studies:
- X-ray of the knee joint. With gonarthrosis, it is carried out in two projections. The specialist needs an X-ray of both the damaged and the healthy knee. Radiography allows you to determine the following signs of arthrosis: narrowing of the joint space, osteophytes, subchondral sclerosis. Also, the presented study of the knee joint reveals subluxation, places of ossification of the cartilaginous tissue.
- Arthroscopy. This is a minimally invasive procedure that is used not only to diagnose arthrosis, but also to treat it. It provides for the use of a special LED conductor with a camera at the end. It is inserted through a small opening on the side of the knee. The whole picture of the internal state of the joint is reflected on the monitor. However, the procedure has a drawback: the joint is depressurized and pathogenic microorganisms can enter it.
- Ultrasound. This diagnostic method is absolutely safe. The procedure helps to examine the soft tissues of the knee, as well as cartilage, synovium, blood vessels.
- CT. This is an X-ray examination method, however, it allows you to see not only bone structures, but also soft tissues. Thanks to the computer equipment, the specialist can build a three-dimensional model of the knee. However, to obtain accurate information, the patient must receive a significant dose of radiation.
- Scintigraphy. This is an x-ray examination using a contrast agent.
- MRI. In this case, magnetic beams are used to obtain information. The picture shows soft tissues more clearly.
- Thermography. The procedure is based on the registration of thermal radiation from the surface of the patient's body. So you can identify tumors, foci of inflammation. A study is assigned for the purpose of differential diagnosis.
- General blood analysis. It helps to determine the severity of inflammation, to determine its nature.
- General urine test. Thanks to him, it is possible to determine the systemic nature of the pathology.
- Blood chemistry.
Thanks to these diagnostic measures, specialists can accurately identify arthrosis of the knee, and prescribe a truly effective treatment.
Knee arthrosis treatment
Treatment of arthrosis must be versatile and long-term. Since it will not be possible to completely stop the destruction of the joint, therapy will have to be carried out constantly in order to improve the patient's quality of life.
Medicines in the treatment of arthrosis
The doctor may prescribe the following medications:
- Non-hormonal anti-inflammatory drugs. They are used in the form of tablets and ointments. However, in case of severe pain syndrome, which cannot be eliminated by standard methods, an injection is used. It helps to quickly calm pain, relieve swelling and reduce the intensity of inflammation. These remedies can only eliminate the symptom, but they cannot cure arthrosis. Only a doctor should prescribe these funds. The course of treatment lasts no more than 14 days, and relief comes already in 2-3 days.
- Chondroprotectors for arthrosis of the knee joint. Each such medicine contains useful substances that can regenerate cartilage. However, it will be effective only if its application is started on time. If the cartilage is completely erased, then the use of chondroprotectors will be useless. Treatment with such means will be long-term (at least 6 months). Pills and topical medications are most commonly used, although injections are possible.
- Vasodilators. They help relieve spasm and pain syndrome, restore normal blood circulation, and improve the nutrition of the knee joint.
- Glucocorticosteroids. Most often they are used in the most difficult cases, when other drugs do not give a positive effect. Intra-articular injections into the knee are used for arthrosis. They are allowed to be used only once a year.
- Enzymes. They provide the regeneration of the cartilage structure at the initial stages of knee arthrosis development. They are also prescribed for injection into the joint.
- Hyaluronic acid. It provides smooth movement of the knee joint, as it is able to replace synovial fluid.
- Local preparations - ointments, creams, gels. They also only relieve symptoms.
- Medication compresses. In this case, a drug is used that can penetrate the skin, helps to eliminate muscle clamps, and has a resorbing effect. The compress can be done using medical bile.
Drug therapy in the treatment of arthrosis is indispensable. However, drugs must be used strictly in the dosage prescribed by the doctor. It is impossible to independently increase or decrease the rate, change the daily rate without the knowledge of a specialist.
Features of physiotherapy treatment and exercise therapy
You can also treat arthrosis of the knee joint using physiotherapy procedures:
- Massage. It helps to restore normal blood circulation in tissues, eliminate muscle spasm.
- Electrophoresis with medications allows you to eliminate inflammation in the joint, and also produces an analgesic effect.
- Magnetic therapy. With the help of specific radiation, the tissues surrounding the affected right or left joint are stimulated. Metabolic processes in cells are improved.
- UHF. The waves promote the production of synovial fluid, which lubricates the knee.
- Phonophoresis with corticosteroids.
- Electrotherapy helps to eliminate not only pain, but also swelling.
- Mud therapy.
- Shock wave therapy.
- Heat treatment. This includes paraffin therapy. Thanks to this procedure, local blood circulation is improved.
- SMV therapy. This physiotherapy stimulates blood circulation, relieves swelling and helps to improve the nutrition of the cartilage tissue.
Physical therapy is extremely useful. It is necessary to restore the elasticity of muscle tissue and ligaments, improve the mobility of the knee joint. The following exercises will be useful:
- Lying on your stomach, you need to take turns raising your legs up. In this case, they should not be bent at the knee. The lifting height is approximately 20 cm.
- Lying on your left side, you need to bend your left leg and lift it up 30 degrees. It is necessary to hold the limb in this position for up to 30 seconds. The same exercise should be done with the right leg.
- Sitting on a chair, legs should be straightened and raised in turn as high as possible.
The set of exercises is selected individually by the attending physician. Gymnastics is best done after a small massage with medicinal ointments. Physiotherapy is an effective additional method of treating arthrosis, which enhances the effect of medications.
Is surgery necessary?
In the most difficult cases, when the joint is severely damaged by arthrosis, the patient is prescribed an operation. There are several types of interventions:
- Articulation traction. It involves stretching the joint damaged by arthrosis in order to increase the gap between the cartilages. This will make it possible to prevent further tissue destruction and its gradual recovery.
- Endoprosthetics is a complete replacement of a joint destroyed by arthrosis. It is carried out as a last resort. Replacement can be complete or partial. The prosthesis will have to be changed in 10-15 years.
- Osteotomy. Such treatment for arthrosis makes it possible to mechanically correct the deviations of severely deformed bones. In this case, solid elements break in a strictly defined place. Next, the bones are positioned correctly and fused.
- Arthroscopy. With its help, the restoration of the surface of the cartilage destroyed by arthrosis is performed. In addition, by means of an arthroscope, foreign bodies and bone fragments can be removed from the joint. Such an operation is used for hypermobility of the joint. Arthroscopy is considered a low-traumatic procedure, so rehabilitation after it does not last long.
It is better not to bring it to the surgical intervention. Treatment should be started at the first stage of arthrosis development. Orthopedic devices will help to consolidate the result: a cane, an orthosis to reduce the load, knee braces with infrared radiation.
The use of folk remedies
It is impossible to completely cure arthrosis, since the degenerative process will gradually progress. However, you can eliminate the symptoms and stop the destruction of the knee joint in arthrosis. Folk remedies can be used during an exacerbation, as well as during a relative calm. But first you need a specialist consultation. The following recipes will be useful for arthrosis:
- Chopped horseradish root should be boiled in a small amount of water over low heat. After that, the gruel must be filtered and put around the knee affected by arthrosis. The compress must be fixed with a bandage. You need to do the procedure every day for a month. The compress improves blood circulation and tissue repair.
- Rubbing any vegetable oil into the area of the knee joint for arthrosis will help eliminate pain. However, it needs to be warmed up a little.
- The mummy provides a good effect. It is necessary to mix 3-4 g of raw materials with 100 g of honey and mix everything thoroughly. You need to rub the medicine into the sore spot in the evening, before bedtime. Next, wrap the affected area with a warm scarf. The reception of the mummy inside is also welcomed. You can use it at 0. 2 g per day.
- Fresh dandelion flowers can be washed thoroughly and consumed 5-6 pieces per day. Also dry raw materials in the amount of 1 tbsp. you should pour a glass of boiling water, insist and drink 1/3 cup three times a day.
- Rubbing aloe leaves. It is necessary to twist 10 sheets of the plant and squeeze through cheesecloth. The juice is mixed with half a glass of honey and 150 ml of red wine. The resulting product is poured into a dark glass container, and apply every day for a month.
Cabbage and burdock leaves will help relieve inflammation in arthrosis. Folk remedies cannot be considered a panacea, but they increase the effectiveness of other types of therapy.
Nutritional rules for arthrosis
Treatment of arthrosis does not require a particularly strict diet, but you still have to adhere to some nutritional rules:
- Reduce your salt intake. Its total amount per day should not exceed 2 g. It is better to salt the dish just before use, and not during cooking.
- The amount of spices used during the treatment of arthrosis should also be reduced. The same applies to fermented foods, pickles. Marinades and canned food are better, in general, to exclude from the diet.
- Animal fats are not recommended.
- The menu should not contain sweets, pastries and bread made from wheat flour.
- With arthrosis, alcohol and nicotine are strictly prohibited.
- Dishes with gelatin content are useful: aspic, jellied meat, beef bone broths.
- It is important for arthrosis to consume milk protein (products should not be fatty), fish, seafood.
- The diet should contain vegetable oils, vegetables and fruits, freshly squeezed juices.
- A person should consume a sufficient amount of fluids per day.
The correct diet for arthrosis should be developed by a specialist. You cannot go to extremes, even if the patient is overweight. Dramatic and improper weight loss will only aggravate your health. In this case, the treatment will be significantly delayed.
Prevention of arthrosis
To avoid the possibility of developing arthrosis, as well as not to lose the ability to walk, you need to follow the following expert advice:
- We must not forget about movement. Better to go to the pool, ride a bike, go hiking in the fresh air. You can also go to dances.
- It is advisable to avoid any lesions and hypothermia of the knee joint, as this provokes post-traumatic arthrosis.
- It is better to use protective knee pads or other orthopedic devices for prolonged exertion.
- It is advisable to wear comfortable shoes.
- It is important to eat right - arthrosis will not have a chance if all the necessary nutrients are regularly supplied to the joint.
- If you have excess weight, you should get rid of it.
- It is better to avoid stress, as well as to organize the work and rest routine correctly.
- It is necessary to strengthen the body's defenses.
- All inflammatory or infectious pathologies that can provoke the development of arthrosis should be eliminated in time.
Proper prevention can significantly delay joint destruction, which under normal conditions is a natural aging process in the body.
Arthrosis of the knee joint is an incurable disease, but its progression can be slowed down and even stopped by improving the quality of life.