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Gonarthrosis

knee osteoarthritis pain

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

Over the years, bony 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;
  • second.

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

  • disorders 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. Is called:

  • heavy physical work and sports that put a load on the right or left knee joint;
  • trauma (tear 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 frequent symptoms of gonarthrosis of the knee joints are:

  • severe pain in the knee during movement;
  • knee dysfunction;
  • swelling in the area of 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 proceeds in four consecutive 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.
  • Limitation of mobility.
  • Disappearance of discomfort when the patient "disappears".
  • Knee pain after heavy physical exertion.
  • The knee appears firm 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 more intense.
  • Discomfort increases sharply during squatting, walking.
  • The pain is localized on the inside of the knees and gradually disappears at 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).
  • Individual joint areas are hot to the touch.
  • After physical warm-up, the stiffness may disappear.
  • The shape of the legs in the area of the knee changes (there is a curvature).

The following symptoms are characteristic of gonarthrosis of the third degree:

  • The pains disturb during the day and night, during rest and when walking. The patient should seek a position to reduce the severity of the pain symptom.
  • The joint is difficult to extend and bend. He is limited in movement. 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 pronounced synovitis.
  • The patient's gait becomes unstable, unsteady, he must use a stick / crutches, resort to external assistance during movement.

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

In the fourth degree, the articular surfaces of the bones are so deformed that there is almost no gap between them, without which movement is impossible. The patient experiences 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 questioning the patient, examining the inflamed joint, checking its volume, assessing mobility. If gonarthrosis is suspected, the orthopedist prescribes instrumental methods:

  • Radiography. In gonarthrosis, the X-ray shows narrowing of the cracks, thinning of the bone tissue and its compaction under the cartilage, ossification of the articular cartilage. Perhaps the presence of osteophytes - bone growths passing along the edges of the cartilage.
  • Ultrasound diagnosis of the knee joint.
  • arthroscopy. During the examination, the surgeon inserts a special micro video camera connected to the arthroscope into the joint through punctures. An image of all parts of the examined area appears on the screen.
  • Magnetic resonance imaging (MRI). Allows 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

Medicines

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

  • anti-inflammatory;
  • pain relievers;
  • chondroprotectors (ensure restoration of damaged cartilage tissue).

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

Orthopedics

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

  • orthopedic insoles for shoes
  • orthoses (special hard knee braces that limit mobility in a diseased joint),
  • walking sticks.

surgery

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

  • uncontrollable pain
  • significant knee and hip dysfunction.

Implantation time 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 repaired if necessary. When the endoprosthesis installation is done, the wound is sutured.

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

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

Additional methods for the treatment of gonarthrosis

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

  • manual therapy;
  • massage;
  • acupuncture;
  • hirudotherapy;
  • physical therapy;
  • 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 that surround 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 take more than 10 minutes. Gradually, the time of classes should be brought to half an hour. It is important that all movements are performed smoothly to ensure that the pain does not increase.

Common exercises include:

  • Raising a straight leg at a height of 15-20 cm from the floor and holding it in this position for the maximum time.
  • Raising the straight leg to a height of 15-20 cm and gradually lowering it to its original position.
  • Flexion and extension of the legs, sitting in a chair.

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

Features of the 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 prescribed:

  • 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 the pathology includes:

  • Perform exercises recommended by the therapist.
  • Taking anti-inflammatory and analgesic drugs, chondroprotectors, introduction of hyaluronic acid into the joint.
  • Phytotherapeutic 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 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 examines how pronounced the problem is.

If areas of healthy tissue are preserved, a corrective osteotomy is indicated. During this surgery, the doctor corrects the shape of the bone through 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 endoprosthesis - an operation to replace the entire knee joint or individual parts of it with prostheses.

Treatment of gonarthrosis of the knee joints with folk remedies

Folk recipes help to achieve good results only in the 1st and 2nd stages 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 following recipe:

  • Pass the ficus leaves 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 finished liquid in the refrigerator. Rub the joints with tincture once a day for 10 days.

Compresses with clay

  • Place the blue/red clay in a glass container.
  • Dilute with water to the consistency of sour cream.
  • Apply 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 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, 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.
  • Cabbage leaves are arranged on top.
  • Wrap with plastic wrap and a scarf.
  • It is best to apply a compress 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, chop 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, since there is less load on the joints. In this case, you should not starve or resort to the help of monodiets. Nutrition should be balanced.

Proteins support the repair of intra-articular cartilage. Their patient can get from lean meat, cheese, cottage cheese, fish, lentils, beans, buckwheat. Useful for gonarthrosis bone broth jelly, as it contains a lot of collagen.

Carbohydrates should be obtained through the consumption of vegetables and fruits. Fats should be mostly vegetable. A small amount of oil is allowed. Vitamins, especially from group B, are of great importance for improving the patient's condition. They are contained 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 danger 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 the functions of the joints 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 is necessary.

Risk group for gonarthrosis

The risk group for gonarthrosis includes:

  • professional dancers;
  • athletes;
  • builders, loaders, miners;
  • people with a hereditary predisposition;
  • obese persons;
  • 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 followed:

  • do physical education;
  • avoid excessive physical activity;
  • weight control;
  • 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 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.