What is it – gonarthrosis is a disease of the knee joint that is not inflammatory in nature, in which the blood supply to the cartilage that covers the articular surfaces of the femoral and / or tibial bones is disturbed.
As a result, the cartilage is destroyed, the bone areas begin to rub against each other, as a result of which they become denser and expand. Inflammation is often associated with this.
Symptoms of the disease are caused only by the above processes; Calcium salts, if they are deposited in the joints, are not the cause of the pathology. Pathology most often develops in people 40 years and older, mainly women and people involved in professional sports or having injuries of the knee joints.
The articular cartilage does not regenerate, so the disease must be detected and started to be treated in its early stages.
Causes of gonarthrosis
The disease develops with a combination of several reasons:
- fractures of the shin bones with the involvement of the knee joint;
- injuries of the cartilaginous interlayers of the joint – menisci;
- rupture of the knee ligaments;
- increasing the load on the joint – running, squatting, lifting weights from an upright position of the body – after the age of 40, especially if the person does not exercise regularly;
- excess weight
The disease does not develop immediately after the action of the damaging factor, but after a few years. Gonarthrosis of the knee joint develops faster if a person has one or more risk factors for developing the disease.
The latter include:
- varicose disease of the lower extremities;
- joint inflammation (arthritis), having a different psoriatic, gouty, rheumatoid, or reactive etiology;
- genetically determined weakness of the ligamentous-capsular apparatus of the joint, due to which its loosening occurs;
- pathology of innervation of the joint, characteristic of cranial or spinal injuries;
- metabolic diseases.
Given the mechanism of disease development, there are two main types of gonarthrosis:
- 1) Primary. It occurs against the background of complete joint health (without prior injuries or inflammations). It is based on metabolic diseases, long-term use of hormonal drugs, genetic predisposition of articular cartilage. The process is usually two-way (although it can begin as one-sided). Develops more often in older people.
- 2) Secondary. It develops as a result of injuries, inflammations, tumors transferred on operations joint. It can develop at any age. The process is usually one-sided.
Symptoms of gonarthrosis of the knee
How the disease manifests itself will depend on how far the degenerative process has progressed. Depending on this, there are three stages of the disease, each of which is characterized by its own symptoms.
As a rule, the first degree of gonarthrosis of the knee joint manifests itself with certain symptoms that are worth paying attention to:
- feeling under the knee;
- stiffness in the knee, which manifests itself after sleep, prolonged sitting or prolonged immobility of the joint;
- joint pain:
- dull character;
- arising from long walking, squats, walking on stairs;
- aggravated after standing or physical exertion
- swelling of the joint may occur for a short time, passes on its own.
Second degree gonarthrosis of the knee. The following signs indicate that the disease has passed into this stage:
- joint pain becomes more intense, lasts longer. She disappears after a rest.
- pain is felt inside the joint or on the inside of the knee.
- there is a crunch in the knee when walking.
- in the morning it is impossible to straighten the knee.
- closer to the night and pains in the calves appear at night.
- leg to the end does not unbend.
- the joint swells, acquires signs of initial deformation.
The third degree of gonarthrosis of the knee. The symptoms of this degree of pathology are as follows:
- 1) Joint pain is constantly worried, regardless of a person’s physical activity.
- 2) Pain syndrome increases with changing weather.
- 3) The mobility of the joint is limited, because of which a person limps.
- 4) The knee is enlarged and deformed. As the process progresses, the joint becomes X-shaped or O-shaped.
If inflammation of the lining lining the joint (synovitis of the knee joint) joins gonarthrosis, the knee swells, its contours are smoothed, a prominent protrusion that has a soft consistency is noticeable on the anterolateral surfaces.
Diagnosis of gonarthrosis
It is possible to suspect the presence of gonarthrosis of the knee joint in a patient already on the basis of his complaints and objective examination data.
Confirmed diagnosis with the help of such instrumental studies:
- 1) X-ray. This method may be uninformative at stage I of the disease, but later on it visualizes the narrowing of the joint space, sealing of the bone area below the articular cartilage, sharpening the edges of the condyles.
- 2) Computed tomography of the joint. This is a more expensive, but more informative (even with stage I) method based on x-rays. Visualizes the joint itself and the surrounding tissue in more detail and in layers.
- 3) Magnetic reznansnoy tomography – a method based on non-radiological, considered to be harmless radiation, which can be used for contraindications to CT. It also displays layers in the joint in layers, but is more informative in relation to the soft tissues surrounding it.
- 4) Arthroscopy is an invasive technique for examining a joint when a fiber-optic device is inserted into a hole made under local anesthesia, which allows a specialist to inspect the joint from the inside.
- 5) Ultrasonography of the knee is informative for diagnosing such complications of gonarthrosis as synovitis.
Treatment of gonarthrosis of the knee
Physiotherapy for gonarthrosis
In the acute period, the person needs to provide complete rest for the sick knee. Next, proceed to the gradual introduction of physical activity in his day regimen.
Exercises are carried out in the position of the patient lying on his back, they consist mainly in raising the straightened legs, holding them in the raised position. It is important to perform the exercises smoothly, carefully, so that they do not cause pain.
Begin with 10 minutes, gradually, 2 minutes a day, increasing the duration of classes. They also increase the amplitude of movements, which experts must select individually for each.
- knee flexion;
- walking for a long time;
- movements in which there is pain in the knee.
Physiotherapy for gonarthrosis
In order to reduce inflammation in the joint, accelerate the regeneration of articular cartilage, relieve pain, in the treatment of gonarthrosis of the knee joint are used:
- electrophoresis with novocaine;
- diadynamic currents;
- magnetic therapy;
- phonophoresis using hydrocortisone;
- laser therapy;
- paraffin or ozocerite applications, mud therapy.
Subsequently, a person is sent to a sanatorium-resort treatment.
At the end of the acute period, the patient is allowed to get up, but he will need to walk with a cane. For the knee, special orthoses (knee pads made of rigid materials that restrict movement in the joint) or orthopedic insoles can be selected.
Surgical intervention. In gonarthrosis, joint endoprosthesis replacement is performed with prostheses from biologically intact materials in such cases:
- dysfunction of the joint;
- significant disability if the disease has developed at a young or middle age.
The operation is possible only in the case (not taking into account general contraindications), if the person does not suffer from concomitant osteoporosis.
In the future, for 3-6 months, carry out rehabilitation activities, including physiotherapy, exercise therapy, spa treatment.
Advanced methods, diet
In case of gonarthrosis, massage, acupuncture, pharmacopuncture, acupressure, treatment with leeches in combination with drug therapy, physiotherapy and physical therapy are effective.
You must also pay special attention to your diet, achieving weight loss. The menu should include an increased amount of animal and vegetable proteins: lean types of meat and fish, boiled, steamed and steamed, cheese, cottage cheese, bean products.
It is also recommended to use jelly more often. Most of the incoming fat should be of vegetable origin, you can eat a little butter. It is also important to eat foods rich in vitamins of group B.
Prevention of gonarthrosis
Which doctor to contact for treatment?
If, after reading the article, you assume that you have symptoms characteristic of this disease, then you should seek advice from an orthopedist.