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gonarthrosis

knee osteoarthritis pain

Most 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 of all, it worsens blood circulation in the vessels that feed the cartilage. Then the cartilaginous layer begins to thin, it is completely erased. The bones within the knee joint are exposed. As a result, when walking, they rub against each other and 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;
  • secondary.

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

  • violations of metabolic processes;
  • obesity;
  • hereditary predisposition;
  • take 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 passes to the second.

Secondary gonarthrosis, on the other hand, is always unilateral. Is named:

  • heavy physical work and sports, giving a load on the right or left knee joint;
  • trauma (torn ligaments, dislocation, hemorrhage into the cavity of the knee joint, meniscus damage, intra-articular fracture, etc. ).
  • operations performed on the knee joint;
  • inflammation/swelling of the joints.

Symptoms of gonarthrosis

Common symptoms of gonarthrosis of the knee joints include:

  • severe knee pain when moving;
  • knee dysfunction;
  • swelling in the knee joint;
  • limp
  • 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 goes through four successive stages.

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

  • Unexpressed pain in the knee when going up/down stairs, during squats.
  • "Starting" pains at the beginning of movement.
  • Mobility restriction.
  • Disappearance of discomfort when the patient "diverges".
  • Knee pain after great physical exertion.
  • 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 more intense.
  • Discomfort increases sharply during squats, walking.
  • The pain is localized to the inside of the knees and gradually disappears during rest.
  • Cracking 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).
  • To the touch, individual joint areas are warm.
  • After a physical warm-up, the stiffness may disappear.
  • The shape of the legs in the knee area changes (there is a curvature).

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

  • Pains bother day and night, during rest and when walking. The patient has to find a position to reduce the severity of the pain symptom.
  • The joint is difficult to bend and bend. It has limited movement. The leg cannot be fully stretched.
  • An O- or X-shaped deformity of the lower extremities may form.
  • The knee joint significantly increases in size, deforms. There is marked synovitis.
  • The patient's gait becomes unsteady, trembling, he has to use a cane / crutches, resort to outside help during movement.

There is also a fourth degree of gonarthrosis of the knee joints. Clinically, orthopedists refer to it as 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 so deformed that there is almost no gap between them, without which movement is impossible. The patient has 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 swollen joint, checking its volume, and assessing mobility. If gonarthrosis is suspected, the orthopedist prescribes instrumental methods:

  • Bone scan. With gonarthrosis, the radiograph shows narrowing of the cracks, rarefaction of bone tissue and its compaction under the cartilage, ossification of articular cartilage. Perhaps the presence of osteophytes - bone growths that extend along the edges of the cartilage.
  • Ultrasound diagnosis of the knee joint.
  • arthroscopyDuring the study, the surgeon inserts a special video microcamera connected to the arthroscope into the joint through punctures. An image of all parts of the study area appears on the screen.
  • Magnetic resonance imaging (MRI). It allows to assess the degree of damage to the knee joints.
  • A 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;
  • analgesics;
  • chondoprotectors (ensure the restoration of destroyed cartilaginous tissue).

The forms of its release are different: ointments, creams, gels, tablets, capsules, intraarticular and intramuscular injections.

Orthopedics

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

  • orthopedic insoles for shoes
  • orthoses (special rigid knee braces that limit mobility in a diseased joint),
  • Canes

Surgery

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

  • uncontrollable pain,
  • significant dysfunction of the knee and hip joints.

The 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 restored if necessary. When the installation of the endoprosthesis is performed, the wound is sutured.

In the first hours after surgery, 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 (fragility and fragility of the bones).

Additional methods of treatment of gonarthrosis.

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

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

Exercise therapy for gonarthrosis

Exercises for gonarthrosis of the knee joint are selected individually. Its regular implementation allows you to strengthen the muscles surrounding the inflamed joint, improve blood circulation in the area of pathology. They should be done lying on your back or sitting down.

In the first days, therapeutic exercises for gonarthrosis of the knee joint should last no more than 10 minutes. Gradually, class time should be brought up to half an hour. It is important to do all movements smoothly, to ensure that the pain does not increase.

General exercises include:

  • Raise the stretched leg to a height of 15-20 cm from the ground and keep it in this position for as long as possible.
  • Raise the straight leg to a height of 15-20 cm and gradually lower it to its original position.
  • Flexion and extension of the legs, sitting on a chair.

Squats and long walks are contraindicated without prior consultation with an orthopedist.

Features of the treatment of gonarthrosis according to the degree of the disease.

Treatment of gonarthrosis of the knee joint of the first degree.

The first degree 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.

The comprehensive treatment of the pathology includes:

  • Do the exercises recommended by the therapist.
  • Taking anti-inflammatories and analgesics, condoprotectors, introducing hyaluronic acid into the joint.
  • Phytotherapeutic procedures (if there is no pronounced inflammatory process).
  • Weight normalization.

Treatment of third degree gonarthrosis.

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 outgrowths. 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 breaking it. Then he installs a special plate that allows you to fix the limb in the correct position.

The second method of surgical treatment is endoprosthesis - an operation to replace the entire knee joint or its individual parts with prosthetics.

Treatment of gonarthrosis of the knee joints with folk remedies.

Folk recipes help to achieve good results only at 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:

  • Sauté the ficus leaf through a meat grinder.
  • Place in a glass dish.
  • Add 100 ml of vodka.
  • Close the lid and leave to infuse for 3 weeks.
  • Store the prepared liquid in the refrigerator. Rub the joints with tincture once a day for 10 days.

clay compresses

  • Place the blue/red clay in a glass dish.
  • Dilute with water to the consistency of sour cream.
  • Apply clay on a linen/cotton fabric about 1. 5-2 cm thick.
  • Apply on the affected joint.
  • Secure it with a bandage and wrap it 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.
  • Cover with triple cologne.
  • Close the lid.
  • Put for a month in a dark place.
  • After the specified period of time, strain the tincture. Rub your 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.
  • Top with cabbage leaves.
  • Wrap it with plastic wrap and a scarf.
  • It is best to apply a compress at night. Remove after complete drying of the leaves. 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, 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, combating obesity and saturating the body with nutrients. If the patient manages to lose weight, the pain becomes less pronounced, since there is less stress on the joints. In this case, you should not go hungry or resort to the help of monodiets. The diet must be balanced.

Proteins help restore intra-articular cartilage. Your patient can get from lean meats, cheeses, cottage cheese, fish, lentils, beans, buckwheat. Useful for gonarthrosis jelly made from bone broth, as it contains a large amount of collagen.

Carbohydrates should be obtained by eating vegetables and fruits. Fats should be predominantly vegetable. A small amount of butter is allowed. Vitamins, especially group B, are of great importance to improve the patient's condition and are found in eggs, legumes, bananas, dairy products, cabbage, nuts and 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 incapacitate the patient, when the functions of the joints are completely lost, and unaided movement 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 are needed.

Gonarthrosis risk group

The risk group for gonarthrosis includes:

  • professional dancers;
  • athletes;
  • builders, loaders, miners;
  • people with hereditary predisposition;
  • people with obesity;
  • 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 observed:

  • do physical education;
  • avoid excessive physical activity;
  • control weight;
  • seek qualified medical assistance for injuries, inflammatory diseases of the joints;
  • do not cool too much (if there is a problem, it is recommended to use 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.