The inflammatory-degenerative process in the knee joint, or gonarthrosis, occurs for various reasons. It has a very negative impact on a person's quality of life, sometimes leading to disability. How to treat arthritis of the knee joint and prevent complications?
What is arthritis
About 22% of the world's population suffers from gonarthrosis, and women are often affected. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint may collapse completely. This results in impaired musculoskeletal function. Movement is only possible with the help of crutches, otherwise the person becomes hostage to a wheelchair.
The knee joint is the second largest, after the hip, and the most complex in structure. It allows you to bend and point your leg in different directions, it promotes the correct position of the body and coordination in space. This is a strong and stable joint that can support a person's weight. Composed of 3 bones: the femur, tibia and fibula, as well as the patella or kneecap. It includes osteochondral structures, muscles, ligaments, and nerve fibers.
The disease begins with a violation of blood circulation and joint tissue nutrition. First, the cartilage suffers. The quality and quantity of synovial fluid, which is located in the joint capsule and contributes to the smooth functioning of the knee, decreases. Friction occurs between the joint parts. Gradually, the cartilage splits and falls. Unprotected bones begin to rub against each other. Pain occurs and a sharp sound is heard.
Causes of the disease
It mainly affects older people, especially overweight women. As a result of hormonal changes, the cartilage in the knees wears down significantly. Gonarthrosis to varying degrees, after 60 years, occurs in more than 80% of people.
There are other reasons for the appearance of knee arthritis:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part of it;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people engaged in repetitive physical work. This group also includes athletes, people leading a sedentary lifestyle, and people with unfavorable environmental conditions. Patients are often dependent on toxic substances (drugs, alcohol, smoking).
The cause of joint deformation can be work related to constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Due to the lack of minerals and vitamins in the body, diet can be a trigger.
Steps and signs
Gonarthrosis can be unilateral or bilateral. According to the nature of the manifestations, the disease is divided into stages:
- At this stage, there are no obvious clinical signs. There may be slight discomfort and pain after a long workout, which disappears after rest. The pain is felt in the morning, when moving, it disappears after some time. Stage 1 arthrosis is rarely diagnosed by chance during a routine examination.
- Increases pain and stiffness in the knees. One throws his leg and tries to charge less. As a result, the muscles atrophy, the joint is deformed, a formation can be felt, and the leg does not fully extend at the knee.
- The pain is constant. The leg does not straighten or bend, and it is difficult for the person to walk. A partial or total loss of mobility develops. The cartilage is completely destroyed, friction increases between the bones of the joint with the formation of osteophytes.
In addition to pain in grades 2 and 3, a crunching sound is heard in the knees. Fluid and pieces of cartilage tissue can accumulate in the joint cavity, causing swelling. At a late stage, the inflammatory process is pronounced, the knee joint is deformed.
Diagnostics
If you have knee pain, you can contact your local doctor, who will, if necessary, refer you to an orthopaedist, 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.
With X-rays the condition of the cartilage and bone changes in stages 2 and 3 can be seen. 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 in the treatment of the knee, to remove pieces of cartilage or meniscus.
Treatment of knee arthritis
The therapy is long and sometimes painful. Having appeared once, the disease reminds you of yourself for the rest of your life. The main drugs used for treatment are non-steroidal anti-inflammatory drugs. These drugs are often based on non-steroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. Medicines are relatively cheap, but lead to the formation of ulcers and erosions of the stomach and duodenum. Modern drugs cause fewer side effects, but are expensive.
Treatment measures for stage 1 include preventive measures involving exercise. Daily exercise, use of a contrast shower, swimming pool 2 times a week, and combating increased body weight are necessary.
Step 2 requires fixing the joint - using an elastic bandage, bandage or orthosis. To relieve pain, NSAIDs are used in the form of creams and ointments. To reduce the amount of cartilage destruction, the patient is prescribed medications from the group of chondroprotectors.
Severe severity requires oral administration of NSAIDs. Intra-articular injection of hormonal drugs is indicated — synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. In addition, painkillers are prescribed.
A solution of hyaluronic acid is injected into the joint. It is a substitute for intra-articular fluid and nourishes cartilage. When it moves, it acts as a shock absorber for the joint. The manipulation is painful, a doctor does it after the acute period has subsided. If conservative treatment is unsuccessful, endoprosthetics are performed.
Along with drug therapy, exercises are prescribed using simulators and special devices (kinesitherapy). Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered through subcutaneous or intramuscular injections, ozone-based ointments, creams. Manipulation stimulates blood circulation, improves the effect of chondroprotectors and glucocorticosteroids.
Modern nutritional supplements are in demand as an alternative to medications for joint restoration. Exercise therapy and massage are indicated. A series of special exercises improves blood circulation and nutrition of the cartilage cells, increases the elasticity of the ligaments.
Complications and prevention
Destroyed cartilage tissue and deformed bones cannot be treated. In this case, only surgery will help. No ointments or medicines can restore cartilage. Drugs can only stop the process of cartilage tissue destruction.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without proper treatment, the patient's condition deteriorates rapidly. The knees cannot work, serious difficulties appear:
- joint deformity;
- cosmetic defect - limb curvature;
- infection with blood or lymph flow from another source of the body;
- due to the weakness of the ligaments, dislocations and fractures are observed, even during normal walking;
- fusion of bone (ankylosis) occurs in the joint area, making movement impossible.
Complications develop if the patient does not see a doctor in time and the disease progresses. 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.