Such a disease, as arthrosis of the knee joint, is leading among other joint lesions in the frequency of occurrence, with the majority of patients being women. In medical circles, arthrosis of this localization is called gonarthrosis. Consider why this disease develops, how it manifests itself and is treated.
Osteoarthritis - causes
To understand the nature and causes of arthrosis, let us turn to anatomy. The knee joint is represented by a whole complex of structures - bone, tendon, ligament, vascular, nervous. The upper border of the joint is the distal end of the thigh, the lower border is represented by the superior section of the tibia, in front it is limited by the patella, and at the back - by the muscles.
The articulating surfaces are lined with cartilaginous tissue, the thickness of which is 5-6 mm. This structure performs damping functions and reduces friction in flexion-extensor movements. The cartilage is supplied by constantly flowing fluid produced by the synovial membrane, which lining the non-articular surface of the joint. With a shortage of food, the cartilaginous tissue becomes thinner, loses its elasticity, cracks and begins to gradually break down, losing its properties.
Non-functioning cartilage provokes an increase in the load on bone tissues, which begin to deform and grow as a protective reaction in the form of spines and protrusions. Degenerative processes also affect the synovial membrane, ligaments, muscle fibers. All this causes difficulty in the movement of the joint and the deviation of the limb axis from the correct position. This is the development of arthrosis of the knee joint.
Arthrosis pathological processes often arise due to several triggering factors, leading to a disruption in the supply of cartilaginous tissue, the main of which are as follows:
- congenital features ( joint dysplasia );
- traumatic joint damage affecting the structure of bones, ligaments, muscles, cartilaginous tissue (bruises, dislocations, fractures, sprains);
- pathology of the musculoskeletal system, in which the load on the joint is distributed unevenly ( scoliosis , kyphosis , flat feet);
- the transferred operations on the knee (for example, to remove the meniscus );
- excessive loads on the lower limbs associated with sports or work;
- too low physical activity, immobility;
- overweight;
- diseases accompanied by prolonged muscle spasms of muscles or vessels of the legs;
- inflammatory processes in the joint tissues (due to rheumatoid arthritis , arthritis with systemic lupus erythematosus, purulent infections);
- violation of metabolic processes in the body, endocrine pathologies;
- aging of the body.
Osteoarthritis of the knee - symptoms
The pathology develops relatively slowly, gradually, initially almost imperceptibly for the patient, then - causing minor discomfort, and subsequently leading to severe symptoms, and sometimes - to disability. Regardless of the causes of arthrosis of the knee joint, taking into account the intensity of pathological processes in the tissues, three degrees of gonarthrosis are distinguished, each of which can be characterized by a special clinical picture.
Osteoarthritis of the knee joint differs from other articular pathologies by the presence of specific types of pain:
- "Start pain" , which occurs after a long stay in a state of rest at the beginning of movement, and then soften or disappear against the background of motor activity (after about a quarter of an hour). This is due to the friction of the articular surfaces, on which small fragments of collapsing bones and cartilage settle. The movement of the joint leads to the expulsion of these destructive particles into the twists of the articular bag, in connection with which the soreness decreases.
- "Blockade of the joint" - a sudden developing pain syndrome due to the appearance of the "articular mouse", which is a sharp piece of cartilage or bone. The breakaway fragment is pinched between the articular surfaces or implanted into soft tissues, provoking hard-to-treat pain and the inability to make even a slight movement in the joint.
Gonarthrosis 1 degree
At the beginning of the disease, the knee is no different from healthy, no deformations. Gonarthrosis of the knee joint of the 1st degree is characterized by a blood circulation disorder in the intraosseous small vessels that feed the cartilage, so it begins to dry out and thin out. This is associated with periodic dull pain after motor activity, lifting weights or staying in a standing position for a long time. In addition, there may be a slight swelling in the patella.
Gonarthrosis of 2nd degree
As the pathology progresses, bone structures, the synovial membrane, are affected, and the cartilage nutrition impairment is aggravated. There is a degeneration of the capsule of the joint, the appearance of osteophytes. Gonarthrosis of the knee joint of the 2nd degree is characterized by increased symptomatology, with pains appearing more and more often, lasting longer, being felt with unessential loads. Patients can note the stiffness of the movements, the appearance of a crunch. Osteoarthritis of the knee joint of the 2nd degree is often manifested by the frequent appearance of edema and some deformity of the knee.
Gonarthrosis of 3rd degree
When arthrosis of the knee arises, the symptoms leave no doubt in the diagnosis. At this stage, the cartilage is practically absent, the ligament and muscle function is disrupted, the joint and limbs are severely deformed (the affected leg becomes O-shaped or X-shaped). Pains disturb the patient constantly, there is a significant restriction of mobility in the knee. Gait is characterized by instability, overtaking, patients need a cane or crutches.
Bilateral gonarthrosis
Often the disease begins with one knee joint, but later the second, getting an increased load, is involved in pathological processes. In some cases, arthrosis with bilateral knee joint damage is associated with innate characteristics, then the lesions develop symmetrically. With a severe degree of bilateral gonarthrosis, the symptoms of which primarily affect older people, can lead to a complete loss of the ability to move.
Osteoarthritis - diagnosis
Patients who develop knee joint gonarthrosis are assigned a complex of examinations to confirm the diagnosis, identify possible causes and severity of the lesion, which may include:
- X-ray imaging - displays the state of menisci and cartilage (along the width of the joint gap), the presence or absence of bone growths, signs of bone destruction;
- Ultrasound and MRI of knee joints - to detect changes in soft tissues, the amount of intra-articular fluid;
- CT of knee joints - for detailed study of changes in bone structures;
- analysis of synovial fluid - is prescribed for swelling of the joint to assess the development of inflammatory and dystrophic processes;
- arthroscopy - a method of direct visual examination, in which a video camera is inserted into the joint cavity;
- blood and urine tests.
Osteoarthritis of the knee joint - treatment
On how to treat arthrosis of the knee joint in each case, the doctor should tell after performing diagnostic measures. In any case, you need to tune in for a long treatment with full compliance with medical recommendations - only in this way you can achieve positive results. The main principles of treatment include:
- therapeutic gymnastics;
- massage;
- physiotherapy techniques (UHF, electrophoresis, phonophoresis , diadynamic currents, magneto- and laser therapy);
- drug therapy;
- application of orthopedic adaptations.
In addition, it may be necessary to carry out treatment of the main pathologies that cause arthrosis of the knee, normalization of body weight, selection of comfortable shoes. Patients should correctly organize their daily regimen, alternating physical activity and rest, so that the load on the joints is dosed. With pronounced destructive changes, when conservative therapy is ineffective, resort to surgical intervention - knee arthroplasty.
How to remove the swelling of the knee with arthrosis?
Since the deforming arthrosis of the knee joint is accompanied by periodic swelling of the knee, it is important to learn to eliminate this symptom, which hinders daily life. Patients, first of all, should adjust the diet so that the body does not occur fluid retention. To do this, you need to limit the consumption of salt, sugar, semi-finished products, meat, fatty foods.
Directly for the removal of edema specialists often recommend to do compresses with Dimexide, which acts due to the ability to improve metabolic processes in the lesion. It is necessary to moisten a piece of gauze, folded several times, in a dilute Dimexide solution diluted in water with water, squeeze slightly and attach to the diseased knee. Covering the top with a plastic wrap, hold for 20-40 minutes. The procedures can be conducted daily for the night with a course of 10-15 sessions.
Ointments for arthrosis of the knee joint
When arthrosis of the knee is diagnosed, treatment at home is done in most cases using local preparations in the form of ointments, gels, creams. These funds can be divided into several categories:
- non-steroidal anti-inflammatory drugs (Diclofenac, Naise, Ketonal, Indomethacin, Voltaren, Dolobene) - reduce inflammation, anesthetize;
- warming (Apizartron, Gavkamen, Espol, Viprosal, Kapsikam, Finalgon) - have analgesic effect due to stimulation of blood flow, improve trophic cartilage and soft tissues;
- chondroprotectors (Chondroxide, Chondroart, Aflutop, Teraflex) - restore cartilaginous tissue, activate the synthesis of intraarticular fluid, reduce the severity of symptoms.
Injections in the knee joint with arthrosis - drugs
In some cases, for example, if joint effusions are present or severe pain is noted, injections are given in the knee for arthrosis of the knee joint. Intra-articular preparations of the following groups are used for injections:
- corticosteroids (Diprospan, Hydrocortisone, Triamcinolone);
- preparations of hyaluronic acid (Hyalurum, Synocrome, Fermatron);
- chondroprotectors (Aflutop, Dona, Hondrolon);
- anesthetic Novocaine.
Gonarthrosis tablets
Let's consider what tablets can be administered to patients who have arthrosis of the knee:
- non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, Ketoprofen, Analgin);
- chondroprotectors (Glucosamine, Chondroitin sulfate, Dona, Teraflex, Piascladin).
Osteoarthritis of the knee joint - treatment with folk remedies
If the beginning gonarthrosis is diagnosed, treatment can be supplemented with non-traditional methods, many of which show high effectiveness. For example, garlic grind helps to improve blood circulation of surrounding tissues, normalize cartilage nutrition, reduce pain and inflammation.
Prescription means
Ingredients:
- garlic - 1 head;
- vegetable oil - 200 mg.
Preparation and use
- Garlic chop, pour oil.
- Put the container with the oil tincture in a dark place for a week, periodically shaking.
- Rub a sick joint for the night.
Gymnastics for arthrosis of the knee joint
LFK with arthrosis of the knee joint is performed after removal of acute inflammation and elimination of severe pain. Gymnastics should be performed regularly, with a day should be allocated to it for 30-40 minutes, dividing this time into 10-minute periods. Correctly chosen exercises for arthrosis of the knee joint help restore blood circulation, strengthen muscles and ligaments, normalize the functions of the joint structures. In addition, patients are useful walking, swimming, cycling, pilates.
Bandage on the knee with arthrosis
Physicians recommend wearing special knee joints for knee arthrosis, which help to ensure the correct anatomical position, to facilitate walking, to prevent swelling. Wear such products should be from 2 to 8 hours a day, putting on before physical activity. It is important to know how to choose the knee joints for arthrosis of the knee joint correctly, for which you need to consult a specialist. Products can be open, closed and hinged, made of different materials, have a different degree of rigidity.