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Gonarthrosis

knee osteoarthritis pain

Most often, the disease occurs in elderly patients (especially women). Pain in the joints with gonarthrosis is caused by dystrophic changes in the cartilage, which covers the intra-articular surfaces of the bones. First, the blood circulation in the vessels that feed the cartilage deteriorates. Then the cartilaginous coating begins to thin, it is completely erased. The bones inside the knee joint are exposed. As a result, while walking, they rub against each other, severe pain occurs.

Over the years, bony growths begin to appear in the joint. They cause the development of deformation, the leg is bent.

Causes of gonarthrosis

Gonarthrosis of the knee joint occurs for various reasons. It is common to distinguish two forms of it:

  • primary;
  • secondary.

Primary gonarthrosis usually develops in older people. Its occurrence is due to:

  • violation of metabolic processes;
  • obesity;
  • hereditary predisposition;
  • taking hormonal drugs.

The primary form affects two knee joints at once and is called bilateral gonarthrosis. But there are cases when the inflammatory process first covers one knee, and only after a few years it moves to the other.

Secondary gonarthrosis, on the contrary, is always unilateral. This is called:

  • heavy physical work and sports, putting a load on the right or left knee joint;
  • trauma (rupture of ligaments, dislocation, bleeding in the cavity of the knee joint, damage to the meniscus, intra-articular fracture, etc. ).
  • operations performed on the knee joint;
  • joint inflammation/swelling.

Symptoms of gonarthrosis

Among the common symptoms of gonarthrosis of the knee joints are:

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

Deformation (curvature) of the leg is also characteristic of the later stages of the disease.

In most cases, gonarthrosis develops slowly and goes through four consecutive stages.

Gonarthrosis of the knee joint of the first degree is characterized by the following features:

  • Unexpressed knee pain when climbing/descending stairs, during squats.
  • "Initial" pains at the beginning of the movement.
  • Limitation of mobility.
  • Disappearance of discomfort when the patient "breaks apart".
  • Pain in the knee after heavy physical exertion.
  • The knee looks healthy or slightly swollen.
  • Manifestations of synovitis (inflammation of the internal mucosa, which causes fluid to build up in the joint) may appear.

Bilateral gonarthrosis of the knee joint of the second degree has the following symptoms:

  • The pain becomes more intense.
  • Discomfort increases sharply during squatting, walking.
  • The pain is localized on the inside of the knee and gradually disappears during rest.
  • Creaking in the knees.
  • The joint expands, fluid begins to accumulate inside it (synovitis).
  • Intra-articular fluid can fill the popliteal fossa at the back of the joint (Baker's cyst).
  • To the touch, individual joint zones are hot.
  • After physical warming, the stiffness may disappear.
  • The shape of the legs in the area of the knees changes (there is curvature).

The following symptoms are characteristic of third-degree gonarthrosis:

  • Pain disturbs day and night, during rest and walking. The patient must seek a position to reduce the intensity of pain symptoms.
  • The joint has difficulty bending and bending. He is limited in movement. The leg cannot be fully straightened.
  • An O- or X-shaped deformity of the lower extremities may form.
  • The knee joint significantly increases in size, deforms. There is pronounced synovitis.
  • The patient's gait becomes unstable, shaky, he must use a cane / crutches, resort to external assistance during movement.

There is also the fourth degree of gonarthrosis of the knee joints. Clinically, orthopedists relate it to the third stage of the disease. It can only be determined by x-ray.

At the fourth stage, the articular surfaces of the bones are so deformed that there is almost no space between them, without which movement is impossible. The patient is in constant pain.

If you experience similar symptoms, contact your 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 examining the patient, examining the inflamed joint, checking its volume, assessing mobility. If gonarthrosis is suspected, the orthopedist prescribes instrumental methods:

  • Radiography. In gonarthrosis, radiography shows narrowing of cracks, thinning of bone tissue and its compaction under cartilage, ossification of articular cartilage. Perhaps the presence of osteophytes - bone growths that extend along the edges of the cartilage.
  • Ultrasound diagnostics 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 study area appears on the screen.
  • Magnetic resonance imaging (MRI). It enables the assessment of the degree of damage to the knee joints.
  • A blood test is an auxiliary diagnostic method and does not always give a complete picture of the clinical picture. The fact is that signs of inflammation in the blood cannot be determined in gonarthrosis.

Treatment of gonarthrosis of the knee joints

Medicines

The following groups of drugs are used in the treatment of gonarthrosis of the knee joint:

  • anti-inflammatory;
  • pain relievers;
  • hondoprotectors (ensures restoration of destroyed cartilage tissue).

The forms of their release are different - ointments, creams, gels, tablets, capsules, intra-articular and intramuscular injections.

Orthopedics

Orthopedic treatment of the pathology includes the use of special devices to reduce the load on the diseased joints:

  • orthopedic insoles for shoes
  • orthoses (special stiff knee pads that limit mobility in the diseased joint),
  • reeds.

Operation

In the treatment of gonarthrosis of the knee joint of the third degree, surgical methods are used. Indications for endoprosthetics are:

  • uncontrolled pain,
  • significant knee and hip joint dysfunction.

The time spent on implantation is 2-3 hours. Before installing the prosthesis, the destroyed part of the joint and the back of the patella are removed, the axis of the leg is aligned. If necessary, the ligaments are restored. When the endoprosthesis is implanted, the wound is sutured.

In the first hours after the operation, due to anesthesia, the patient does not feel the lower extremities. The rehabilitation period is long - 3-4 months.

Arthroplasty surgery is impossible if the patient suffers from osteoporosis (brittleness and fragility of bones).

Additional methods of treatment of gonarthrosis

In gonarthrosis, the following 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. Their regular use allows you to strengthen the muscles surrounding the inflamed joint, improve blood circulation in the area of pathology. They should be performed lying on your back or sitting.

In the first days, therapeutic exercises for gonarthrosis of the knee joint should not last longer than 10 minutes. Gradually, the class time should be increased to half an hour. It is important that you do all the movements smoothly, so that the pain does not increase.

General exercises include:

  • Raising the straightened leg to a height of 15-20 cm from the floor and staying in that position for as long as possible.
  • Raising the straightened leg to a height of 15-20 cm and gradually lowering it to the original position.
  • Flexion and extension of legs, sitting on a chair.

Any squatting and long walking are contraindicated without prior consultation with an orthopedist.

Features of treatment of gonarthrosis depending on the degree of the disease

Treatment of gonarthrosis of the knee joint of the first degree

The first stage of the disease is the easiest. The patient is assigned:

  • Massage.
  • Physiotherapy.
  • Physiotherapy procedures.

In the presence of obesity, weight loss is necessary. A special diet is followed for this.

Treatment of gonarthrosis of the knee joint of the second degree

Comprehensive treatment of pathology includes:

  • Perform the exercises recommended by the therapist.
  • Taking anti-inflammatory and analgesics, chondroprotectors, injecting hyaluronic acid into the joint.
  • Phytotherapy procedures (if there is no pronounced inflammatory process).
  • Weight normalization.

Treatment of gonarthrosis of the third degree

Therapeutic treatment of pathology of the third degree is similar to the measures used in the second stage of the disease. However, in the absence of the expected effect, a surgical method is recommended to the patient.

If it is the beginning of the third degree, it is possible to remove part of the damaged cartilage and bone growths. Using an arthroscope, the doctor examines the cavity of the knee joint and studies how severe the problem is.

If areas of healthy tissue are preserved, corrective osteotomy is indicated. During this operation, the doctor corrects the shape of the bone through the fracture. Then he installs a special plate that allows you to fix the limb in the correct position.

Another method of surgical treatment is endoprosthetics - surgery to replace the entire knee joint or its individual parts with prostheses.

Treatment of gonarthrosis of knee joints with folk remedies

Folk recipes help to achieve good results only in stage 1 and 2 of the disease. When the cartilage tissue is destroyed and the joint is severely deformed, they are powerless.

ficus tincture

The solution is prepared according to the recipe:

  • Skip the ficus leaf through a meat grinder.
  • Place in a glass container.
  • Add 100 ml of vodka.
  • Close the lid and let it stand for 3 weeks.
  • Store the prepared liquid in the refrigerator. Rub the tincture on your joints once a day for 10 days.

Clay compresses

  • Place the blue/red clay in a glass container.
  • Dilute with water to the consistency of sour cream.
  • Apply the clay to a linen/cotton fabric about 1. 5-2 cm thick.
  • Apply to the affected joint.
  • Secure with a bandage and wrap with a towel.
  • Make poultices 2-3 times a day. Duration of treatment is 1. 5 weeks.

Dandelion tincture

  • Fill a glass bottle with dandelion flowers.
  • Top with triple cologne.
  • Close the lid.
  • Put for a month in a dark place.
  • After the specified time, strain the tincture. Rub her knees twice a day.

apple cider vinegar for knee arthritis

  • Mix 6 tablespoons of apple cider vinegar with 2 tablespoons of natural honey.
  • Apply the mixture to the joint area.
  • Place cabbage leaves on top.
  • Wrap with plastic wrap and a scarf.
  • The compress is best applied 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, minced 3 lemons, mix. Transfer to a three-liter jar, cover with boiling water.
  • Cover with a warm blanket.
  • After cooling, the agent should be consumed 70 ml before meals, first 1 time 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, fighting obesity and saturating the body with nutrients. If the patient manages to lose weight, the pain becomes less pronounced, because the load on the joints is less. In this case, you should not starve or resort to mono-diets. The diet must be balanced.

Proteins help restore intra-articular cartilage. Their patient can get from lean meat, cheeses, cottage cheese, fish, lentils, beans, buckwheat. Jelly made from bone broth is useful for gonarthrosis, as it contains a lot of collagen.

Carbohydrates should be consumed by eating vegetables and fruits. Fats should be predominantly vegetable. A small amount of butter is allowed. Vitamins, especially group B, which are found in eggs, legumes, bananas, dairy products, cabbage, nuts, and lentils, are of great importance for improving the patient's condition.

Alcohol with gonarthrosis of the knee joints is prohibited. Not only does it have a negative effect on the body as a whole, but it also increases appetite, which is undesirable.

Danger of gonarthrosis

With gonarthrosis of the first and second degree, we are not talking about disability. The third stage of the disease can lead to the patient's disability, when joint functions are completely lost and movement without assistance becomes impossible.

It should be understood that gonarthrosis is a chronic pathology that is constantly progressing. In order for the prognosis to be favorable, a competent selection of drugs and regular exercise are necessary.

Risk group for gonarthrosis

The risk group for gonarthrosis includes:

  • professional dancers;
  • athletes;
  • builders, loaders, miners;
  • persons with a hereditary predisposition;
  • people with obesity;
  • with posture disorders;
  • suffered fractures;
  • with malformations of the ligamentous-articular apparatus;
  • who suffer from hormonal, rheumatoid and metabolic diseases.

Prevention of gonarthrosis

To reduce the risk of developing gonarthrosis of the knee joints, it is necessary to adhere to the following recommendations:

  • engage in physical education;
  • avoid excessive physical activity;
  • weight control;
  • seek qualified medical help for injuries, inflammatory joint diseases;
  • do not get cold (if there is a problem, it is recommended to wear warm knee pads);
  • drink 2 liters of water a 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.