Such a disease as gonarthrosis of the knee joint, without proper treatment, can lead to the disability of a person. 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 pathology, located 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 progressive implication in the pathological process of the bone tissue.
Why and how does it develop?
What is knee gonarthrosis? This is a violation of all functions of the knee, which occurs due to pathological changes in the cartilage tissue. This disease occurs in middle-aged people, that is, after 40-45 years (primary). However, there are also cases of the disease in younger patients; often it is post-traumatic (secondary) gonarthrosis.
Bilateral gonarthrosis of the knee joints 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 gradually begins to wear out and loses its physiological properties.
This disease refers to polyetiological. What does this mean? Such diseases develop under the influence of several factors at once. What can directly cause gonarthrosis, a disease of the knee joint?
Desk. Causes and mechanisms of the development of pathology:
| Cause | What's happening |
|---|---|
| The mechanical factor is of the greatest importance. | Degenerative changes begin, which occur due to daily microtrauma or some kind of major injury. As a result, the cartilage is destroyed in different parts of the cartilage. |
| Violation of microcirculation. | Impairment of nutrition of cartilage tissue leads to loss of elasticity and shrinkage. |
| Metabolic alterations in cartilage tissue. | There is a decrease in the amount of the main components of cartilage - glucosamine and chondroitin. |
| Changes in the structure of 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 gonarthrosis of the knee joint?
The main distinguishing feature of arthritis is the gradual and slow development of symptoms:
- The first manifestation of osteoarthritis is pain. At first, the patient feels the pain 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 early sensation of pain. In the later stages, the patient cannot even stand.
- Another characteristic symptom is initial pain. What it is? This is the pain that appears at the beginning of the movement. At the first stage, such pains appear in the morning, after getting out of bed. They then appear at the start of each move.
- The opposite symptom is night pain. It develops during sleep due to pressure within the bones. Such feelings pass during walking.
- In the second stage, reactive synovitis usually develops. This is an inflammation of the joint bag that occurs due to the destruction of cartilage. What does the knee joint look like with gonarthrosis and synovitis? The knee swells, the skin is hot to the touch. Sometimes there is bulging of the patella.
- The next typical symptom is crepitus. This term is called a crunch that is heard at a distance when performing movements in the joint. At first it is almost inaudible, but in the later stages it becomes quite loud. It is heard throughout the movement.
- At 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 a deforming osteoarthritis. As a result, an axial displacement of the bones develops, the leg is shortened, 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 made on the basis of 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 taken 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, at the third stage the gap is practically absent;
- in the second stage, osteophytes can be detected;
- subchondral sclerosis is also a specific sign, consisting of compaction of the ends of the bone adjacent to the cartilage.
If the diagnosis is in doubt, an MRI or CT scan is performed. The doctor evaluates the results and establishes one or another degree of gonarthrosis. The specialist in the video in this article will tell you more about the diagnostic methods and the results.
Types of treatment
It is necessary to treat gonarthrosis comprehensively. The combination of different approaches can significantly slow down the process of cartilage degeneration.
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 surgery.
Diet
First of all, the patient is prescribed a certain diet. With the help of food, you can improve the condition of cartilage tissue. And the rejection of certain 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 that contain a lot of protein and collagen. These include sea fish, meat, jelly. They need to be consumed daily.
- Products that contain fiber. These are fruits and vegetables. Also recommended for daily 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 get rid of excess weight.
medicines
The basis of conservative treatment is taking medication. The action of drugs is aimed at eliminating the pathological process and the symptoms that are manifested.
All medicines can be bought at the pharmacy. The price for them is quite high, but the drugs need to be taken for a long time.
Medicines are prescribed by a professional, self-medication is unacceptable.
Physiotherapy
At all stages of osteoarthritis, the use of physiotherapy procedures is indicated. Their goal is to reduce pain, restore blood circulation in the joint area and slow down dystrophic processes.
The most used methods are:
- ultra high frequencies;
- magnet therapy;
- ozone therapy;
- baths - radon, hydrogen sulfide.
Such treatment is carried out in a clinic or in sanatoriums.
Physiotherapy
Initially, the patient is prescribed measures to reduce the load on the affected knee. This is accomplished through the use of a cane and compression stockings and bandages. With severe pain syndrome, knee immobilization is required for several days.
As the condition improves, therapeutic exercises are prescribed. It is first carried out under the guidance of a specialist in exercise therapy, then you can do gymnastics at home.
surgical treatment
Gonarthrosis is the most common pathology that requires surgical intervention.
Depending on the state of the joint and the degree of its destruction, different types of operations are used:
- Denervation. Such an operation is used very rarely, mainly in elderly patients with severe pain. The essence of the intervention is to cut the nerve leading to the joint. The effect of such an intervention persists for several years.
- intraosseous decompression. It is most often carried out 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 drilling.
- osteotomyIt also aims to reduce the load on the joint. The effect is achieved by dissecting the bone directly at the articular head.
- endoprosthesisIt is used for the complete destruction of cartilage tissue. The gasket is replaced with a metal one.
After each type of surgery, restorative therapy is required. Gonarthrosis of the knee joint can disable a person, in the absence of timely diagnosis and proper treatment.