A disease such as gonarthrosis of the knee joint, without proper treatment, can lead to a person's disability. This is due to a violation of the motor function of the joint and the leg as a whole. To prevent this from happening, you should see a doctor as soon as possible when symptoms of the disease appear.
What is this disease
Gonarthrosis is osteoarthritis of the knee joint. This is one of the subtypes of joint disease, localized in one or both knees. This pathology is a degenerative-dystrophic process. This means that in the joint there is a destruction of the cartilage tissue with a gradual involvement in the pathological process of the bone tissue.
Why and how it develops
What is knee osteoarthritis? This is a violation of all functions of the knee, which occurs due to pathological changes in the cartilage tissue. This disease occurs in people of middle age, that is, after 40-45 years (primary). However, there are also cases of the disease in younger patients: it is often post-traumatic (secondary) gonarthrosis.
Bilateral knee joint osteoarthritis is the most common pathology in the elderly. This is due to the fact that these joints are subjected to a large daily load. As a result, the cartilage begins to wear out gradually and loses its physiological properties.
This disease refers to the polyetiological. What does this mean? Such diseases develop under the influence of several factors at once. What can directly cause knee arthrosis, a disease of the knee joint?
Table. Causes and mechanisms of development of pathology:
| Cause | What is going on |
|---|---|
| The mechanical factor is of the utmost importance. | Degenerative changes begin, which occur due to daily microtrauma or some type of severe injury. As a result, the cartilage is destroyed in different parts of the cartilage. |
| Violation of the microcirculation. | The deterioration of the nutrition of the cartilage tissue leads to loss of elasticity and shrinkage. |
| Metabolic disorders in the cartilage tissue. | There is a decrease in the amount of the main components of cartilage - glucosamine and chondroitin. |
| Changes in the structure of the joint fluid. | Its lubricating function is lost, the cartilage rubs against the bone and collapses. |
All this together leads to the development of joint pathology.
Main manifestations
What are the main symptoms of knee joint gonarthrosis?
The main distinguishing feature of arthritis is the gradual and slow development of symptoms:
- The first manifestation of osteoarthritis is pain. At first, the pain is felt by the patient only after a long load - a long walk. In a calm state, the pain quickly disappears. The progression of the disease leads to an increasingly premature sensation of pain. In the latter stages, the patient cannot even stand up.
- Another characteristic symptom is the onset of pain. What's this? This is the pain that appears at the very beginning of the movement. At the first stage, such pains appear in the morning, after getting out of bed. They therefore appear at the beginning of each movement.
- The opposite symptom is night pain. It develops during sleep due to the pressure inside the bones. Such sensations pass during walking.
- In the second stage, reactive synovitis usually develops. This is inflammation of the joint bag that occurs due to the destruction of the cartilage. What does the knee joint look like with gonarthrosis and synovitis? The knee swells, the skin feels warm to the touch. Sometimes there is swelling of the patella.
- The next typical symptom is crepitus. This term is called a crunch felt at a distance when making movements in the joint. It is almost inaudible at first, but in the later stages it gets quite noisy. It is felt during the entire movement.
- In the last stage, a deformity of the knee joint is formed. This is due to the involvement of the bone structures of the joint in the pathological process. Growths appear on the bones, which deform the knee: this is already deforming osteoarthritis. As a result, an axial displacement of the bones develops, the leg shortens and the knee turns to the side (photo).
A complication of gonarthrosis is the development of contractures. This is a complete cessation of movement in the joint due to bone fusion or muscle compaction. As a result, muscular dystrophy is formed, due to the small volume of movements.
Diagnostic methods
The diagnosis of gonarthrosis is based on several facts:
- anamnesis of the disease: how the symptoms developed, the dynamics of the patient's complaints;
- characteristic symptoms;
- X-ray study
With gonarthrosis, an x-ray is done in three projections.
Osteoarthritis is characterized by the following changes:
- a decrease in the lumen of the joint space is the first sign of the disease, in the third stage the gap is practically absent;
- in the second phase, osteophytes can be detected;
- Subchondral sclerosis is also a specific sign, consisting in the compaction of the ends of the bone adjacent to the cartilage.
If the diagnosis is in doubt, MRI or computerized resonance imaging is done. The doctor evaluates the results and sets one or another degree of gonarthrosis. The specialist in the video in this article will tell you more about the diagnostic methods and results.
Types of treatment
It is necessary to treat gonarthrosis comprehensively. The combination of different approaches can significantly slow down the cartilage degeneration process.
Conservative therapy can be performed on an outpatient basis. If surgical treatment is required, the patient is admitted to a hospital where a medical history is taken. Record the course and results of the surgery.
Diet
First of all, the patient is prescribed a certain diet. With the help of food, you can improve the condition of the cartilage tissue. And the refusal of some products will restore blood circulation in the joint area.
What is recommended to include in the diet of patients with gonarthrosis:
- First of all, these are products containing a lot of protein and collagen. These include sea fish, meat, jelly. They must be consumed daily.
- Products containing fiber. These are fruits and vegetables. Also recommended for everyday use.
Fatty meat and fish, pastries, sweets, alcoholic and carbonated drinks should be excluded from the diet. This not only improves blood circulation, but also allows you to shed excess weight.
Medicines
The basis of conservative treatment is the intake of drugs. The action of drugs is aimed at eliminating the pathological process and the symptoms that arise.
All medicines can be purchased at the pharmacy. The price for them is quite high, but the drugs have to be taken for a long time.
Drugs are prescribed by a professional, self-medication is unacceptable.
Physiotherapy
The use of physiotherapy procedures is indicated in all stages of osteoarthritis. They are aimed at reducing pain, restoring blood circulation in the joint area and slowing down dystrophic processes.
The most commonly used methods are:
- ultra high frequencies;
- magnetotherapy;
- ozone therapy;
- baths - radon, hydrogen sulfide.
Such treatment is carried out in a clinic or sanatoriums.
Physiotherapy
Initially, the patient is prescribed measures to reduce the load on the affected knee. This is achieved through the use of a cane and compression stockings and bandages. With severe pain syndrome, immobilization of the knee is required for several days.
As the condition improves, therapeutic exercises are prescribed. It is first performed under the guidance of a physical therapy specialist, then you can do gymnastics at home.
Surgical treatment
Gonarthrosis is the most common pathology that requires surgery.
Depending on the condition of the joint and the degree of its destruction, different types of operations are used:
- Denervation. Such an operation is used quite rarely, mainly in elderly patients with severe pain. The essence of the surgery is to cut the nerve leading to the joint. The effect of such an intervention persists for several years.
- intraosseous decompression. It is performed most often with gonarthrosis. Its essence is to reduce the load on the diseased joint. The spongy substance of the bone adjacent to the cartilage is destroyed by perforation.
- Osteotomy. It is also intended to reduce the load on the joint. The effect is achieved by dissecting the bone directly on the joint head.
- Endoprosthesis. It is used for the complete destruction of cartilage tissue. The joint is replaced with a metal one.
After any type of surgery, restorative therapy is required. Gonarthrosis of the knee joint can render a person disabled in the absence of timely diagnosis and adequate treatment.