Gonarthrosis

pain in osteoarthritis of the knee

Most often, the disease occurs in elderly patients (especially women). Joint pain with gonarthrosis is due to 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 worsens. Then the cartilage lining begins to thin out, completely cleared. The bones inside the knee joint are exposed. As a result, as they walk, they rub against each other, severe pain occurs.

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

Causes of gonarthrosis

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

  • primary;
  • secondary.

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

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

The primary form affects two knee joints at the same time and is called bilateral gonarthrosis. But there are cases when the inflammatory process first covers one knee and only after a few years passes to the second.

Secondary gonarthrosis, on the other hand, is always one-sided. Is called:

  • heavy physical work and sports, which strain the right or left knee joint;
  • trauma (rupture of ligaments, dislocation, hemorrhage 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

Common symptoms of knee joint gonarthrosis include:

  • severe pain in the knee when moving;
  • knee dysfunction;
  • swelling of the knee joint;
  • lameness
  • joint stiffness;
  • instability of 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 proceeds through four successive stages.

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

  • Unexpressed pain in the knee when climbing / descending stairs, during squats.
  • "Starting" pains at the beginning of the movement.
  • Mobility limitation.
  • Discomfort disappears when the patient "diverges".
  • Knee pain after intense physical exertion.
  • The knee looks healthy or slightly swollen.
  • There may be manifestations of synovitis (inflammation of the inner lining, as a result of which fluid begins to form in the joint).

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

  • The pain becomes more intense.
  • Discomfort greatly increases during squats, walking.
  • The pain is localized on the inside of the knees and gradually disappears during rest.
  • Knee crunch.
  • 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, the individual joint areas are warm.
  • After a physical warm-up, the stiffness can disappear.
  • The shape of the legs in the knee area changes (there is a curvature).

For third-degree gonarthrosis, the following symptoms are characteristic:

  • The pains disturb day and night, during rest and while walking. The patient should seek a position to reduce the severity of the pain symptom.
  • The joint is difficult to bend and bend. He is limited in his movements. The leg cannot be fully straightened.
  • An O- or X-shaped deformity of the lower limbs may form.
  • The knee joint significantly increases in size, deforms. There is marked synovitis.
  • The patient's gait becomes unstable, shaky, he has to use a cane / crutches, resort to external help during movement.

There is also a fourth degree of gonarthrosis of the knee joints. Clinically, orthopedists refer it to the third stage of the disease. It can only be determined by taking X-rays.

At the fourth degree, the articular surfaces of the bones are so deformed that there is almost no space between them, without which movement is impossible. The patient suffers constantly.

If similar symptoms occur, contact your doctor immediately. It is easier to prevent a disease than to deal with its consequences.

Diagnosis of gonarthrosis of the knee joints

Diagnosis of the disease includes questioning the patient, examining the inflamed joint, checking its volume, assessing mobility. If gonarthrosis is suspected, the orthopedist prescribes instrumental methods:

  • X-ray. With gonarthrosis, x-ray shows narrowing of cracks, rarefaction of bone tissue and its compaction under the cartilage, ossification of the articular cartilage. Perhaps the presence of osteophytes - bone growths that run along the edges of the cartilage.
  • Ultrasound diagnostics of the knee joint.
  • arthroscopy. During the study, the surgeon inserts a special micro-camera connected to the arthroscope into the joint through punctures. An image of all parts of the study area appears on the screen.
  • Magnetic resonance imaging (MRI). Allows you to assess the degree of damage to the knee joints.
  • A blood test is an auxiliary diagnostic method and does not always provide a complete picture of the clinical picture. The fact is that with gonarthrosis, the signs of inflammation in the blood may not be determined.

Treatment of gonarthrosis of the knee joints

Medicines

In the treatment of gonarthrosis of the knee joint, the following groups of drugs are used:

  • anti-inflammatory;
  • pain relievers;
  • condoprotectors (ensure the 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 pathology involves the use of special devices to minimize the load on diseased joints:

  • orthopedic insoles for shoes
  • orthoses (special rigid knee pads that restrict mobility in a diseased joint),
  • reeds.

Surgery

Surgical methods are used in the treatment of gonarthrosis of the third degree knee joint. The indications for endoprosthesis are:

  • uncontrollable pain,
  • significant dysfunction of the knee and hip joints.

The time taken for the implant 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. Ligaments are restored if necessary. When the endoprosthesis installation is performed, the wound is sutured.

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

It is impossible to perform an arthroplasty if the patient suffers from osteoporosis (fragility and fragility of the bones).

Additional methods of treatment of gonarthrosis

With gonarthrosis, as auxiliary methods of treatment, the following can be used:

  • manual therapy;
  • massage;
  • acupuncture;
  • hirudotherapy;
  • Physiotherapy;
  • physical therapy.

Physical therapy for gonarthrosis

Exercises for gonarthrosis of the knee joint are selected individually. Their regular implementation allows you to strengthen the muscles surrounding the inflamed joint, improve blood circulation in the area of pathology. They should be performed lying on the back or sitting.

In the first few days, therapeutic exercises for gonarthrosis of the knee joint should take no more than 10 minutes. Gradually, the time of classes should be brought to half an hour. It is important to perform all movements smoothly to ensure that the pain does not increase.

General exercises include:

  • Lift the straightened leg up to a height of 15-20 cm from the floor and hold it in this position for the maximum time.
  • Raise the straightened leg to a height of 15-20 cm and gradually lower it to the original position.
  • Flexion and extension of the legs, sitting on a chair.

Any squats and long walks are contraindicated without prior consultation with an orthopedist.

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

Treatment of first degree knee joint gonarthrosis

The first degree of the disease is the simplest. The patient is assigned:

  • Massage.
  • Physiotherapy.
  • Physiotherapy procedures.

In the presence of obesity, weight loss is necessary. For this, a special diet is observed.

Treatment of gonarthrosis of the second degree knee joint

Comprehensive treatment of the pathology includes:

  • Perform the exercises recommended by the therapist.
  • Taking anti-inflammatory and analgesic drugs, chondoprotectors, introducing hyaluronic acid into the joint.
  • Herbal procedures (if there is no pronounced inflammatory process).
  • Weight normalization.

Treatment of third degree gonarthrosis

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

If we talk about 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 pronounced 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 by means of a fracture. Then install a special plate that allows you to fix the limb in the correct position.

The second method of surgical treatment is endoprosthesis, an operation to replace the entire knee joint or its individual parts with prostheses.

Treatment of gonarthrosis of the knee joints with folk remedies

Folk recipes help to achieve good results only in stages 1 and 2 of the disease. When 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 dish.
  • Add 100 ml of vodka.
  • Close the lid and leave to infuse for 3 weeks.
  • Store the prepared liquid in the refrigerator. Rub the joints with the tincture once a day for 10 days.

Clay wraps

  • Put the blue / red clay in a glass dish.
  • Dilute with water to the consistency of sour cream.
  • Apply the clay to a linen / cotton fabric that is approximately 1. 5-2 cm thick.
  • Apply to the affected joint.
  • Secure with a bandage and wrap with a towel.
  • Do compresses 2-3 times a day. The 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 has elapsed, strain the tincture. Rub your knees 2 times a day.

apple cider vinegar for knee arthritis

  • Mix 6 tablespoons of apple cider vinegar with 2 tablespoons of natural honey.
  • Apply the mixture on the joint area.
  • Garnish with the cabbage leaves.
  • Wrap with cling film and a scarf.
  • It is best to apply a compress at night. Remove after complete drying of the leaves. The course of treatment is about 4 weeks.

Garlic with celery and lemon

  • 250 g of celery, 120 g of garlic, chop 3 lemons, mix. Transfer to a three-liter jar, pour 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

Diet for knee joint gonarthrosis 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, as there is less stress on the joints. In this case, you should not starve or resort to the help of mono diets. Nutrition must be balanced.

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

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

Alcohol with gonarthrosis of the knee joints is prohibited. It not only has a negative effect on the body as a whole, but also increases appetite, which is undesirable.

The danger of gonarthrosis

With first and second degree gonarthrosis there is no mention of disability. The third stage of the disease can make the patient disabled, when the functions of the joints are completely lost and movement without assistance becomes impossible.

It should be understood that gonarthrosis is a chronic pathology in constant progress. In order for the prognosis to be favorable, a competent selection of drugs and regular exercise are required.

Risk group for gonarthrosis

The risk group for gonarthrosis includes:

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

Prevention of gonarthrosis

To reduce the risk of developing gonarthrosis of the knee joints, the following recommendations should be observed:

  • do physical education;
  • avoid excessive physical activity;
  • check weight;
  • seek qualified medical assistance for injuries, inflammatory diseases of the joints;
  • do not overcool (if there is a problem, it is recommended to wear warm knee pads);
  • drink 2 liters of water per 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.