Gonarthrosis

More 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, blood circulation in the vessels that feed the cartilage deteriorates. Then the cartilaginous coating begins to thin, completely disappears. 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 joints. 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 appearance is due to:

• violation 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 it moves to the second.

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

• heavy physical work and sports, giving a load on 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

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
• joint stiffness;
• 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 passes through four consecutive stages.

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

• Unexplained pain in the knee when going up/down the stairs, during squats.
• "Starting" pains at the beginning of the movement.
• Restriction of mobility.
• Disappearance of discomfort when the patient "diverges".
• Pain in the knee after a heavy physical strain.
• The knee looks healthy or slightly swollen.
• There may be manifestations of synovitis (inflammation of the inner lining, due to which fluid begins to form in the joint).

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

• The pain becomes stronger.
• Discomfort increases significantly during meetings, walking.
• The pain is localized on the inside of the knees and gradually disappears during rest.
• Jump on the knees.
• This joint expands, fluid begins to accumulate within it (synovitis).
• Intra-articular fluid can fill the popliteal fossa at the back of the joint (Baker's cyst).
• To the touch, individual articular areas are hot.
• After a physical warm-up, the stiffness may go away.
• The shape of the legs in the knee area changes (there is a curve).

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

• Pain disturbs day and night, while resting and while walking. The patient should seek a position to reduce the severity of pain symptoms.
• The binding is difficult to undo and bend. He is limited in movement. The leg cannot be fully straightened.
• O- or X-shaped deformity of the lower extremities may form.
• The knee joint increases significantly in size, deforms. There is pronounced synovitis.
• The patient's gait becomes unstable, wobbly, he must use a stick / crutches, use external assistance 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.

In the fourth degree, the articular surfaces of the bones are deformed so much that there is almost no gap between them, without which movement is impossible. The patient has constant pain.

If you have 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 questioning the patient, examining the inflamed joint, checking its volume, assessing mobility. If gonarthrosis is suspected, the orthopedist prescribes instrumental methods:

• Radiography. With gonarthrosis, narrowing of the cracks, thinning of the bone tissue and its compression under the cartilage, ossification of the articular cartilage can be observed on the radiograph. Perhaps the presence of osteophytes - bone growths running along the edges of the cartilage.
• Ultrasound diagnosis of the knee joint.
• arthroscopy. During the study, the surgeon inserts a special microvideo camera connected to the arthroscope into the joint through the holes. An image of all parts of the study area is displayed on the screen.
• Magnetic resonance imaging (MRI). It makes it possible to assess the degree of damage to the knee joints.
• The blood test is an auxiliary diagnostic method and does not always give a complete picture of the clinical picture. The fact is that with gonarthrosis, signs of inflammation in the blood may not be determined.

Treatment of gonarthrosis of the knee joints

medicaments

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

• anti-inflammatory;
• pain relievers;
• chondroprotectors (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 the pathology includes the use of special equipment to minimize the load on the diseased joints:

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

Surgery

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

• uncontrollable 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 is removed, the shaft of the leg is aligned. Ligaments are restored if necessary. When the endoprosthesis is installed, 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.

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

Additional methods of treatment of gonarthrosis

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

• manual therapy;
• massage;
• acupuncture;
• hirudotherapy;
• physiotherapy;
• exercise therapy.

Exercise therapy for gonarthrosis

Exercises for gonarthrosis of the knee joint are selected individually. Their regular application 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 last no more than 10 minutes. Gradually, the time of the lessons should be increased to half an hour. It is important that all movements are made smoothly, to ensure that the pain does not increase.

General exercises include:

• Raising the straight leg up to a height of 15-20 cm from the floor and holding it in this position for the maximum time.
• Raising the straightened leg to a height of 15-20 cm and gradually lowering it to its original position.
• Bending and stretching the legs, sitting in 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. For this, a special diet is observed.

Treatment of gonarthrosis of the knee joint of the second degree

Comprehensive treatment of the pathology includes:

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

Treatment of gonarthrosis of the third degree

The therapeutic treatment of the 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 we are talking 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 he installs a special plate that allows you to fix the limb in the right position.

The second method of surgical treatment is endoprosthetics - 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 the cartilage tissue is destroyed and the joint is severely deformed, they are powerless.

ficus tincture

The solution is prepared according to the recipe:

• Pass the ficus leaf through a meat grinder.
• Place in a glass container.
• Add 100 ml of vodka.
• Close the lid and let it infuse for 3 weeks.
• Store the prepared juice in the refrigerator. Rub the joints with the solution once a day for 10 days.

Mud compress

• 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 cloth about 1. 5-2 cm thick.
• Apply to the affected joint.
• Cover with a bandage and wrap with a towel.
• Make compresses 2-3 times a day. The duration of treatment is 1. 5 weeks.

Dandelion tincture

• Fill a glass bottle with dandelion flowers.
• Triple column top.
• Close the lid.
• Put it for a month in a dark place.
• After the specified period of time, strain the solution. Rub her 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 to the joint area.
• Put the cabbage leaves on top.
• Wrap in plastic wrap and a scarf.
• It is best to apply a compress at night. Remove the leaves after complete drying. The course of treatment is about 4 weeks.

Garlic with celery and lemon

• 250 g of celery, 120 g of garlic, grate 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

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, as there is less stress on the joints. In this case, you should not starve or turn to the help of mono-diets. Food should be balanced.

Proteins help restore intra-articular cartilage. Their patient can take from lean meat, cheese, cottage cheese, fish, lentils, beans, buckwheat. Useful for gonarthrosis made of bone fluid, as it contains a lot of collagen.

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

With gonarthrosis of the first and second degree, we are not talking about disability. The third stage of the disease can make the patient disabled, 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 exercises are necessary.

Risk group for gonarthrosis

The risk group for gonarthrosis includes:

• professional dancers;
• athletes;
• builders, loaders, miners;
• people with a hereditary predisposition;
• people with obesity;
• with posture disorders;
• suffered fractures;
• with malformations of the ligamento-articular apparatus;
• suffer 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 followed:

• to do physical education;
• avoid excessive physical activity;
• control weight;
• seek qualified medical help for injuries, inflammatory joint diseases;
• do not get too 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 posted for educational purposes only and does not constitute scientific material or professional medical advice.