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 affected more frequently. This insidious disease is characterized by rapid progression.
If treatment is not started on time, the knee joint may collapse completely. This leads to impaired musculoskeletal function. Movement is only possible with the aid of crutches, or the person is confined to a wheelchair.
The knee joint is the second largest, after the hip, and has the most complex structure. Allows you to bend and straighten the leg in different directions, promotes correct body position and coordination in space. This is a strong and stable joint that can support a person's weight. It consists of 3 bones: femur, tibia and fibula, in addition to the patella or kneecap. It includes osteochondral structures, muscles, ligaments and nerve fibers.
The disease begins with a violation of blood circulation and nutrition of articular tissues. First of all, cartilage suffers. The quality and quantity of synovial fluid, which is located in the joint capsule and contributes to the proper functioning of the knee, decreases. Friction occurs between the articulated parts. Gradually, the cartilage cracks and collapses. Unprotected bones begin to rub against each other. Pain occurs and a screeching sound is heard.
Causes of the disease
It mainly affects elderly people, especially overweight women. As a result of hormonal changes, the knee cartilage suffers a lot of wear. Gonarthrosis of varying degrees, after the age of 60, occurs in more than 80% of people.
There are other reasons for the appearance of knee osteoarthritis:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part of it;
- arthritis;
- lumbar spine diseases;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people who perform repetitive physical work. This group also includes athletes, people with a sedentary lifestyle and people with unfavorable environmental conditions. Patients are often people dependent on toxic substances (drugs, alcohol, tobacco).
The cause of joint deformation may be work associated with constant hypothermia. The provoking factor is the postmenopausal period, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Due to the lack of minerals and vitamins in the body, diet can be the trigger.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. According to the nature of the manifestations, the disease is divided into degrees:
- At this stage, there are no obvious clinical signs. There may be slight discomfort and pain after prolonged exercise, which disappears after rest. The pain is felt in the morning, when moving, it passes after some time. First-degree osteoarthritis is rarely diagnosed by chance during a routine examination.
- Knee pain and stiffness increase. The person spares the leg and tries to carry it less. As a result, the muscles atrophy, the joint becomes deformed, a formation can be 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. Partial or total loss of mobility develops. Cartilage is completely destroyed, friction between the bones of the joint increases with the formation of osteophytes.
In addition to pain in grades 2 and 3, a crunching sound is heard in the knee. Fluid and pieces of cartilaginous tissue can accumulate in the joint capsule, causing swelling. At a late stage, the inflammatory process is pronounced, the knee joint becomes deformed.
Diagnosis
If you experience knee pain, you can contact your local doctor, who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
To find out the causes and treatment of gonarthrosis, a comprehensive diagnosis is necessary:
- general and biochemical blood test;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
An X-ray allows you to see the condition of the cartilage and changes in the bones at 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, to remove pieces of cartilage or meniscus.
Knee osteoarthritis treatment
Therapy is long and sometimes painful. Having appeared once, the disease remembers for the rest of your life. The main medications used for treatment are non-steroidal anti-inflammatory drugs. Most often, these are drugs based on non-steroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. The medicines are relatively cheap, but they lead to the formation of ulcers and erosions in the stomach and duodenum. Modern medicines cause fewer side effects, but they are expensive.
Treatment measures for stage 1 include exercise-related preventive measures. Daily exercise, using a contrast shower, swimming twice a week and combating body weight gain are necessary.
Stage 2 requires fixation of the joint - use of an elastic bandage, bandage or brace. To relieve pain, NSAIDs are used in the form of creams and ointments. To reduce the degree of cartilage destruction, the patient is prescribed medications from the chondroprotector group.
Severe severity requires oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid activity and low mineralocorticosteroid activity. Additionally, pain relievers are prescribed.
A hyaluronic acid solution is injected into the joint. It is a substitute for intra-articular fluid and nourishes the cartilage. When moving, it acts as a shock absorber for the joint. The manipulation is painful, it is carried out by the doctor after the acute period has passed. If conservative treatment is unsuccessful, endoprosthesis is performed.
Along with drug therapy, exercises using simulators and special devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is for external use, administered through subcutaneous or intramuscular injections, ozone-based ointments, creams. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are in demand as an alternative to joint restoration medications. 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 cartilaginous tissue and deformed bones cannot be treated. In this situation, only surgery will help. No ointment or medication can restore cartilage. Drugs can only stop the process of destruction of cartilaginous tissue.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without adequate treatment, the patient's condition deteriorates rapidly. The knee does not work, serious complications arise:
- joint deformity;
- cosmetic defect - curvature of a limb;
- infection with blood or lymph flow from another source in 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 consult a doctor in time and the disease is advanced. Regular preventive examinations and timely treatment of general diseases of the body will help prevent the condition from worsening and maintain the motor function of the limb.