Osteoarthritis of the knee joint: symptoms and treatment

Causes, symptoms of knee arthrosis, effective treatment and prevention

articles:

• Types and causes of the disease
• Symptoms
• Treatment
• Prevention

Pain in the knees is a common complaint, which is addressed to the doctors.

What causes pain, and how to help yourself in case of its appearance? There is no unambiguous answer, because knee joints can suffer from different types of lesions that arise for many reasons.

One of these reasons (and very common) is the beginning arthrosis. Today we will tell you in detail about arthrosis of the knee joint: what are its causes, types, symptoms and signs, we will talk about methods of treatment and prevention.

On the photo, the knee joint affected by arthrosis

Types and causes of the disease

Osteoarthritis of the knee joint or gonarthrosis is a predominantly non-inflammatory lesion, which eventually leads to the destruction of articular cartilage, knee deformation and the limitation of the volume of movements in him. The disease has two main forms:

• primary - is due to a congenital joint defect;
• secondary - occurs as a consequence of other diseases or injuries.

The primary form begins to develop in childhood or young age and is caused by the incorrect formation of articular surfaces or ligamentous apparatus. Such a joint when walking is subjected to a disproportionate load, which provokes degenerative changes in it.

The development of a secondary form of pathology can lead to:

• Injuries: fractures of the bones of the legs, bruises and dislocations of the knee, accompanied by damage to the bony and cartilaginous parts of the joint, its ligament apparatus. In this case, posttraumatic arthrosis of the knee joint develops.
• Operations to remove the meniscus, as they lead to a violation of the integral structure of the knee and its rapid wear.
• Disproportionately high load on the feet, which often expose themselves athletes.
• Excessive fullness also provokes arthrosis, because it leads to excessive pressure of the body weight on articular cartilage of the knee.
• Arthritis - inflammation of the joints. Long-flowing arthritis is accompanied by the formation of fluid in the joint cavity and with time can be complicated by arthrosis.
• Metabolic disorders leading to the deposition of salts in joint cavities.
• Other factors and diseases are long accompanied by spasm of the muscles of the legs or blood vessels.
• Postponed operations.

The pathological process can be one- or two-sided. As a result of the injury, most likely, one-sided arthrosis (for example, the right knee) will develop, and from obesity - bilateral.

Symptoms

Osteoarthritis of the knee joint develops gradually, sometimes it is preceded by months and years of the initial period, when the apparent Symptoms (such as severe pain and visible deformity) are not yet there, but from time to time there is a feeling of discomfort in lap.

Most often, women over 40 who are overweight, especially as an aggravating factor, suffer from varicose veins.

The development of gonarthrosis passes through several stages:

1. The initial stage can last for months and sometimes for years.A person is worried about periodic knee pains, especially at the first steps after getting up in the morning from bed, as well as when climbing and descending the stairs.

2. In the second stage, the pain becomes stronger and arises even with any movements that are accompanied by a characteristic crunch. In the articular cavity fluid accumulation is possible, and on examination it is possible to notice the beginning deformation. The volume of movements in the diseased knee begins to decrease.

3. The third stage is characterized by pain, which does not pass even at rest. Often the discomfort is aggravated before the weather changes.

   Joints by this time largely lose their functions: the legs can almost not bend at the knees or do not unbend to the end. The gait changes: it becomes "waddling" or on half-bent legs.

   Deformation of the knees is strongly pronounced: the legs are bent and take O-or X-shape.

Such pain constantly accompanies the person and is strengthened after physical exertion. Gradually, she is joined by a feeling of tightness and stiffness in her knee.

Sometimes this form of the disease from the initial signs to irreversible changes takes only a few months.

Left - X-shaped form of legs, right - norm

Treatment of gonarthrosis

The amount of treatment depends on the stage of the disease and the severity of the lesion.

But since the disease is chronic, the only thing that can be achieved is a long-term remission (rest phase, when manifestations of pathology are minimal or absent).

At the same time, if at the early stages it is possible to eliminate the cause of arthrosis of the knee joint (for example, to reduce body weight), then almost complete recovery is possible.

Goals of treatment of gonarthrosis:

• eliminate pain,
• if possible, to restore the destroyed cartilage and ligamentous apparatus,
• increase the amount of movement in the joint.

Methods of treatment:

• therapy with medicinal products,
• massage and manual therapy,
• surgical intervention,
• Restorative therapy (exercise therapy, physiotherapy and other methods).

Medicines can be chosen correctly only by a doctor, in no case should you prescribe them yourself. Their main action is aimed at:

• Elimination of symptoms of arthrosis of the knee joint: pain and inflammation removal. For this purpose, appropriate drugs are prescribed, including hormones, which are injected into the joint cavity.
• Improve blood supply in the affected area. It is provided by means that relieve spasms of the vessels and relaxing muscles.
• Restoration of cartilaginous tissue. To do this, prescribe drugs that nourish and repair cartilage.

Manipulation and massage reduce pain, relax the spasms of the muscles near injured knee, help to increase the volume of movements, correct the position of bones, strengthen circulation.

With far-reaching, irreversible lesions, the knee arthrosis is treated with a radical method - prosthetics, that is, implantation of a metal prosthesis instead of a damaged joint.

This is still the only way that gives a chance for a full recovery, but endoprostheses have a limited lifespan, after which they must be replaced.

Since the price of such operations is very high, this method of treatment has not yet become widespread.

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Restorative therapy includes physiotherapy exercises, kinesitherapy (exercises with special loads and simulators), physiotherapy and sanatorium treatment.

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Orthopedic methods are aimed at unloading the diseased knee - these are walking sticks, braces and other, which facilitates walking (used if necessary).

There are a lot of folk recipes for various ointments and compresses based on herbs, medical bile, apply warming dressings from natural wool. In general, the action of these methods is aimed at relieving pain and eliminating the main symptoms.

, how to do self-massage:

Preventive measures

Prevention of knee arthrosis involves many factors:

• Balanced diet: in the diet should be a sufficient amount of protein, vitamins and trace elements.
• Fighting the wrong way of life and getting rid of bad habits.
• Weight normalization.
• Adequate physical activity.
• Prevention of injuries in sports, weight lifting.

The most important in detecting such a pathology as knee arthrosis is not to start the disease, because the far-reaching stages of it lead to disability.

But if in time to direct all the forces for treatment and prevention - while time is not lost and the symptoms are insignificant - there is a chance for complete recovery from the disease.

It is important to read: arthritis of the knee joint.

A source: http://SustavZdorov.ru/artroz/kolennogo-2.html

Osteoarthritis of the knee joint - symptoms, treatment. Deforming arthrosis of the knee:

Osteoarthritis of the knee joint is a slowly progressing inflammatory-degenerative joint disease.

Most often, this ailment is observed in middle-aged and elderly people and is the most common cause of musculoskeletal pain in the knee joint and disability zone.

From this publication you will learn how to treat arthrosis of the knee joint.

general description

In the knee joint, the femoral and tibia are covered with articular cartilage. There is also a second type of cartilaginous tissue, forming the so-called menisci, which act as interlayers or shock absorbers.

Additional protection and smooth movement adds joint fluid.

Osteoarthritis begins to develop if the cartilaginous tissue protecting the bones is damaged and damaged in As a result, the surface of the bones is bare, and the joint lubricant ceases to be produced in the necessary quantity.

In this case, both complete and partial loss of cartilage can be observed. This process is often isolated by a certain site in the joint, in such cases it can be caused by trauma and chronic wear of the joint.

Deforming arthrosis of the knee joint is characterized by the process of destruction of its cartilaginous membranes. In the future, the process can include the nearest tissues, for example, ligaments and bones.

Gonarthrosis, or arthrosis of the knee joint, due to loss of cartilage is accompanied by increased stiffness and deformation of the joint. Bone spurs (osteophytes), which are a pathological growth of the bones, can sometimes even be probed outside.

The surfaces of the bones are deformed and no longer close and do not fit together, as in healthy joints. As a result, the limitation of movements increases.

Stress can also provoke painful sensations in the area of ​​the affected joint.

Indirect sign of pathological changes in cartilage is the visible narrowing of the joint cavity between the femur and the tibia on an X-ray.

Causes

The causes of arthrosis are several: this is the process of aging and wear of cartilage, overweight, trauma, autoimmune diseases in which immunity attacks its own articular tissue, causing inflammation and its subsequent destruction.

An example is rheumatoid arthritis, in which both joints are affected simultaneously and disability develops.

Some experts combine such concepts as arthritis and arthrosis of the knee joint, the symptoms of these ailments are similar and are often caused by the same reason.

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Reduction of the blood supply to the head of the femur can also cause cartilage deformation, in this case they speak of aseptic necrosis.

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To the displacement of the mechanical axis and degeneration of the knee joint may result in inadequate formation of the knee joint in early childhood.

Post-traumatic arthrosis is secondary and develops as a result of damage to the meniscus, anterior or posterior cruciate ligament.

Symptoms

There are three degrees of arthrosis of the knee joint, each of which has its own signs. At the first stage, mild pain, discomfort in a sore spot and occasional swelling occur.

The second degree is accompanied by an increase in symptoms, the appearance of a crunch and a restriction of mobility.

When the painful sensations practically do not leave the person, and the cartilage tissue is thoroughly destroyed, the ailment passes into arthrosis of the knee joint of the third degree.

Knees can hurt when walking on the stairs, or when you have to get up on your knee, and often painful sensations arise just during your walking.

For weather-sensitive people, weather changes can also cause joint pain.

Puffiness is a consequence of inflammation, which is periodically aggravated by arthrosis. Edema can also be associated with the formation of bone spurs or the accumulation of excess fluid in the knee.

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They can be more pronounced after a long period of inactivity, for example in the morning or after a long stay at the desk. The skin can become reddish and hot when touched.

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If there is a chronic inflammation of the joint, the removal of pain and swelling is usually achieved by taking anti-inflammatory drugs.

Loss of stability develops over time due to muscle weakness and instability of the entire system. From time to time, there are situations when a person simply can not bend or fully unbend his leg in the knee.

This symptom usually accompanies arthrosis of the knee joint of the 2nd degree. The crunch is felt during movement because the cartilaginous surface has lost its original smoothness and the necessary amount of synovial lubricant.

In later stages, the creaking sound can be caused by the bone spurs rubbing against each other during movement.

Deformation of the knee joint is perhaps the most terrible symptom of arthrosis, as it indicates irreversible changes in the joint, turning a person into an invalid. Knees can be facing towards each other, as well as outwards.

Deformation of the knee is from barely noticeable to significant.

Diagnostics

The definition of osteoarthritis of the knee begins with a physical examination of the doctor, study of the medical history and conversation with the patient. Be sure to pay attention to the doctor that often causes pain, and tell about cases of the disease in the family, if any.

Additional diagnostics are carried out with the help of:

• X-rays, which can show the presence of bone spurs and changes in cartilage;
• magnetic resonance imaging;
• blood tests can identify autoimmune disorders.

How to treat arthrosis of the knee joint, what preparations are needed for this? The answers to these questions are sought further.

Principles of treatment

The standard treatment of such an ailment as arthrosis of the knee joint is aimed primarily at the elimination of pain and the removal of functional limitations.

It is worth knowing that pain medication only weakens the symptoms, but can not affect the course of the disease and repair the damaged cartilage.

For the treatment use narcotic analgesics, non-steroidal anti-inflammatory drugs, slow-acting preparations of gold, corticosteroids, methotrexate, etc.

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In addition, surgical intervention, as well as physiotherapy and physical therapy procedures may be necessary. Gymnastics with arthrosis of the knee joint can be helpful in the treatment, the exercises are selected by the attending physician.

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Despite the fact that in modern pharmacology, active research and development of the most effective and at the same time safe drugs for treatment of arthrosis, most drugs still have their side effects and with prolonged use disrupt the normal functioning of the systems and bodies.

Treatment with drugs

Medicamentous therapy of arthrosis of the knee joint provides for three main directions:

• use of non-steroidal anti-inflammatory drugs that are needed to relieve pain and reduce the intensity of the inflammatory process in tissues;
• taking medications to restore cartilage, which include chondroprotectors: glucosamine and chondroitin;
• use of creams and ointments in complex therapy of deforming arthrosis.

In combination with exercise therapy, manual therapy, taking medications allows you to slow down the process destruction of articular cartilage, accelerate the regeneration of cartilaginous tissue and restore normal functioning extremities.

The main goal of drug treatment is to eliminate pain syndrome, improve cartilage nutrition, activation of recovery processes, increase of joint mobility and normalization of blood circulation in the knee.

Nonsteroid preparations

The most common for the treatment of arthrosis are non-steroidal anti-inflammatory drugs such as Diclofenac, Indomethacin, Piroxicam, Ketoprofen and others.

They are used to relieve pain and reduce inflammation, but long-term treatment with these drugs is not recommended, as the drugs of this group have undesirable side effects, including negative effects on the gastric mucosa and intestines, the effect on the kidneys, liver and cardiovascular system. However, each drug has its own characteristics. And recently, funds have been developed with minimal risk to the patient's health.

Of the modern NSAIDs, you can call the funds "Celebrex "Nimesulide "Naproxen "Meloksikam." Most non-steroidal anti-inflammatory drugs are available in various forms: in the form of capsules or tablets, as a solution for injections and ointments or gels for topical external application.

Means for restoration of cartilage

To feed and regenerate the cartilage to its tissues, constant intake of such compounds as chondroprotectors - glucosamine and chondroitin - is necessary. These are the most useful substances for people suffering from knee osteoarthritis.

Their reception should be carried out for a very long time, from six months or more, only in this case one can count on a positive therapeutic effect.

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Chondroprotectors improve the quality and quantity of synovial fluid, unlike NSAIDs, they increase the synthesis of proteoglycans and promote the regeneration of the cartilaginous plate. However, due to such useful properties of these compounds, it is not necessary to consider them as the main treatment for arthrosis.

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Deforming arthrosis of the knee requires the use of drugs chondroitin and glucosamine for at least, years. It is also taken into account that they are not able to restore the completely destroyed cartilage.

Ointments and creams

Treatment of a disease such as arthrosis of the knee joint, should include the local use of gels and ointments.

These forms of drugs should not be relied on as the only option of therapy, their use should be considered as a necessary supplement to the intake of NSAIDs and chondroprotectors.

Such drugs significantly reduce discomfort, pain, swelling, improve the mobility of joints.

This effect is explained by the fact that penetrating the blood through the skin, ointments and creams improve blood circulation in the joint, accelerate the metabolism in the cartilage and, consequently, its regeneration. Among these funds, it is possible to isolate ointments "Indomethacin "Voltaren "Fastum-gel etc.

Compresses

Applications for osteoarthritis have a greater effect than ointment.

For medical compresses, the "Dimexide" remedy is often prescribed, which has a good anti-inflammatory and analgesic effect, it penetrates well into tissues. Bischofite is also effective, which accelerates metabolic processes in the cartilage.

Injections

Within the knee joint synovial fluid is very viscous, this ensures the absence of friction of the tissues.

An important part of this lubricant is hyaluronic acid, which binds proteoglycans to stabilize the structure of the cartilaginous tissue.

Injections in the knee of preparations based on hyaluronic acid can slow the progression of osteoarthritis, but only half of people with this diagnosis get symptomatic relief. The course of injections is usually three weeks, with one injection every seven days. After six months, the procedure is recommended to be repeated.

Folk remedies

Osteoarthritis of the knee joint provides for an integrated approach to treatment, and recipes of traditional medicine act as additional therapy.

Noteworthy are such means as decoction of onion husk, infusion of dandelion leaves, a mixture of aloe, vodka and honey in equal volumes, night compresses from salt with honey and many others.

It is also recommended to eat more jellies and jellies.

Joint replacement

If all listed methods of treatment did not work, then surgery to replace the joint on the endoprosthesis is indicated.

The main purpose of the operation is to restore the natural mechanical axis of the leg and complete relief from pain and discomfort. In this case, either part of the joint or the entire joint can be replaced.

The constant improvement of surgical equipment and the quality of implants made this procedure quite successful and widespread.

A source: https://www.syl.ru/article/159670/new_artroz-kolennogo-sustavasimptomyi-lechenie-deformiruyuschiy-artroz-kolennogo-sustava

Symptoms, degrees and treatment of gonarthrosis

Osteoarthritis of the knee, the symptoms and treatment of which depend on the stage, is a degenerative-deforming disease. Pathology progresses for a long time and is accompanied by destruction of the cartilaginous surface of the joint.

Causes and mechanism of the disease

Gonarthrosis is most common in age patients - the risk of pathology increases after 40 years. The knee joint is the largest in the human bone system.

Increased mobility and high load lead to a risk of pathology when the degenerative processes associated with age changes increase. But gonarthrosis can also be found in young people.

Depending on the causes that caused the disease, and its appearance in different age groups depends.

Investigations of the causes of pathology confirm the vascular concept - deforming arthrosis of the knee arises from the violation of microcirculation in the articular ends of the joint bones. It was found that the disturbance of microcirculation is associated with prolonged dilatation of blood vessels, the appearance of thrombi and stasis of veins.

With arthrosis of the knee joint, the structural organization of tissues is gradually broken, cell cells die and metabolic disorders occur, osteonecrosis occurs. Pathological changes are primary and secondary. The development of primary gonarthrosis occurs against the background of:

• disorders of metabolic processes due to insufficient blood supply, obesity;
• genetic anomaly of collagen tissue formation;
• long-term therapy with hormonal drugs;
• degenerative processes associated with aging.

Primary gonarthrosis, as a rule, affects both joints, although the initial stage of pathology is one knee.

The disease that occurs in one knee joint can be associated with physical exertion, which affects one of the joints more.

The reasons for the emergence of a unilateral process can be related to sports or professional characteristics.

Secondary gonarthrosis causes:

• trauma of the meniscus, fractures of bones, hemorrhages in the cavity, dislocations and rupture of ligaments;
• surgical treatment;
• inflammatory process, arthrosis.

Manifestations of the pathological process

Deforming arthrosis of the knee joint is divided into 3 degrees (or stages), which are classified depending on the clinical manifestations. The disease manifests itself both subjectively and objectively. For example:

• gonarthrosis of the 1st degree of the knee joint (compensated stage) causes complaints of the patient for not very pronounced painful sensations during physical activity, which pass after rest. Drug dependence is absent. There are swelling of the knee; this symptom spontaneously disappears. Functional changes are not pronounced;
• arthrosis of the knee joint of the 2nd degree (the stage of subcompensation) causes growing pains, there is a relative drug dependence. Long physical activities, such as walking, require the use of a walking stick. A slight instability is noted, and the joint function is partially impaired;
• Gonarthrosis of the 3rd degree (stage of decompensation) is characterized by a constant pain syndrome, at which drug dependence is observed. The condition of the joint requires orthopedic relief - the use of crutches. It is unstable and requires orthopedic correction when loaded. Movement is severely limited.

If we consider the condition of the knee joint by means of radiography, then the changes in the X-ray pattern with the compensated stage of pathology are not noted.

Disturbances occur at the molecular level, and only with the progression of pathology, structural changes begin to occur. Thinning and defibration of the cartilage occurs.

Pain syndrome arises from the increase in intraosseous pressure, with increasing it increases and pain, from periodic to transforming into a constant.

Gonarthrosis of the 2nd degree of the knee joint is accompanied by a disturbance of biomechanics and the addition of secondary periarticular syndromes, such as bursitis or tenosynovitis. These pathologies contribute to an increase in pain.

Mediators of the inflammatory process appear in the early stages of the development of pathology in the intra-articular fluid. Gonarthrosis of the knee joint is characterized by a narrowing of the joint between the joints, which is caused by a decrease in the volume of the cartilaginous tissue.

In some foci the cartilage disappears and the parts of the bone are exposed.

At the third stage, bony outgrowths are formed-osteophytes. They grow on the areas where the cartilaginous tissue ceases to protect the bone.

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Under the influence of increasing mechanical load, bone tissue begins to form bone spines, causing severe pain during movement and limiting the mobility of the joint.

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Progression of the disease is accompanied by:

• pronounced knee deformation;
• decrease in the volume of the muscles in the thigh and lower leg;
• curvature of the limb;
• a violation of the gait.

Diagnostic methods of research

At the initial stages there are no expressed symptoms, arthrosis of the knee joint proceeds at the cellular level, therefore the diagnosis is established with delay. The main method of diagnosing gonarthrosis is still radiography. With the help of this method, the main objective symptoms of the disease are determined:

• degree of severity of the narrowing of the radiographic joint space;
• a sign of subchondral sclerosis;
• the presence of osteophytes.

Based on the analysis of X-ray images, the doctor can establish an accurate diagnosis and the stage of gonarthrosis. So on the roentgenogram look different stages of progression of the pathological process in the knee joint (see. a photo).

A photo. Gonarthrosis on an x-ray photograph

In the last decade, the methods of ultrasound diagnostics have become very popular.

At present, arthrosonography is the second most frequently used method of studying the state of soft tissues and the detection of joint fluid.

However, this method allows you to visualize the cartilage and the surface of bone structures.

Unlike expensive CT and MRI, ultrasound is economical and highly informative. With its help you can visualize small details of the bone surface, assess the condition of the ligamentous tendon apparatus, identify and control the inflammatory process in the knee.

Arthrosonography is an effective way of visualizing pathology.

Despite the fact that MRI is a highly informative method of diagnosis, the frequency of its use is extremely small in comparison with radiography and ultrasound, which is due to the high cost of the procedure.

Laboratory methods for diagnosing gonarthrosis are poorly informative, as in most patients there are no changes in the composition of blood and urine. The exception is when all kinds of arthrosis of the knee joint are accompanied by a synovitis.

Methods of therapy of pathology

Modern methods of treatment of arthrosis of the knee joint include:

• drug therapy;
• physiotherapy methods;
• surgical treatment.

The choice of the method of treatment is aimed at solving tactical and organizational problems:

• ensuring the normal function of the joint surface and creating a biomechanical interaction of all joint elements;
• increased microcirculation in the cartilaginous and bone tissues;
• decrease in the severity of the secondary inflammatory process in the envelope and synovia;
• an increase in the strength of cartilage, its resistance to mechanical stress and a decrease in its proteoglycan insufficiency.

Standard methods of therapy recommend starting the treatment process with non-pharmacological and pharmacological treatment.

Nepharmacological treatment consists of educational work with the patient, the selection of physical exercises, diet therapy and, if necessary, weight correction, lifestyle changes.

Drug therapy of disease

With arthrosis of the knee joint, treatment is recommended starting with the use of external NSAID preparations. When there is a restriction of movement and pronounced edema, systemic administration of NSAIDs is prescribed.

In clinical trials, the treatment of patients with gonarthrosis with drugs Aceklofenac and Diacerein from the NSAID group showed good results. These drugs were prescribed to patients as surface and systemic drugs.

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The group of subjects included patients with gonarthrosis 1 and 2 accompanied by pain and synovitis. These drugs had a positive effect on the synthesis of hyaluronic acid and proteoglycan.

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A positive effect was observed after 4 weeks of taking medications and increased by the end of the 16th week of regular intake.

Such popular with gonarthrosis NSAIDs as Meloksikam, Indomethacin, Ketoprofen, Butadion, Diclofenac, Piroxicam it is recommended to take, if necessary, and short courses, as they have contraindications and may have an adverse impact. List of drugs from the NSAID group for the treatment of arthrosis of the knee joint does not exist - they are selected in each case.

How to treat gonarthrosis with the help of medications, continue to explore the leading medical research institutes of our country and abroad.

Numerous clinical trials have shown the effectiveness of treatment with combined preparations-chondroprotectors, such as for example "Teraflex" - combinations of glucosamine hydrochloride and chondroitin sulfate.

If medicamentous treatment is used, then with knee arthrosis, the diagnosis of the effectiveness of therapy should be carried out regularly. This will stop the disease in the early stages and significantly reduce the number of its relapses in the later stages.

At 2 and 3 stages of the disease, intraocular administration of glucocorticoids is prescribed to reduce pain and chondroprotectors.

A long-term randomized study of the effectiveness of monotherapy with the help of a "liquid prosthesis" - the preparation "Synvisc" was carried out. In patients with stage 1 and 2 disease, a more rapid and persistent improvement in the condition was noted.

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Patients with stages 3 and 4 were less susceptible to treatment, as they had a significant degree of cartilage destruction, but they also had pain and stiffness in the joint.

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It was found that Synvisc has an analgesic, anti-inflammatory and chondroprotective effect. The attending physician develops an individual scheme for administering the drug taking into account the concomitant diseases.

To increase blood flow and lymph drainage, modern medicine uses a complex of five drugs introduced into the fatty body of Hoff.

Lymphotropic lymphostimulant injections increased the microcirculation by 20-30% in the region of the knee joint.

In the complex therapy of gonarthrosis, the methods of physiotherapy are of no small importance.

Methods of physiotherapy gonarthrosis

With the progression of gonarthrosis treatment should be supplemented by methods of physiotherapy. These include:

• electrophoresis;
• laser therapy;
• cryotherapy;
• magnetotherapy;
• UFO, UHF;
• hyperbaric oxygenation;
• diadynamic currents;
• hydrotherapy.

There are many treatment regimens for gonarthrosis using methods of physiotherapy. For example, treatment by the method of the doctor of medical sciences. M.

Bubnovsky, who advises the use of a complex consisting of kinesiotherapy (physical exercises) and physiotherapy. Or Evdokimenko, who suggests combining medicamental effects, physiotherapy and diet therapy.

In cases of complete destruction of cartilage and ankylosis, the only effective method of treatment is surgical intervention.

Surgical treatment of gonarthrosis

If the disease has not been cured conservatively (or time was lost to start treatment), then surgery is prescribed. Most often, in the treatment of stage 3 or stage 4 arthrosis of the knee joint, the following treatment methods are used:

• arthroscopy;
• corrective osteotomy;
• endoprosthetics.

Arthroscopy in addition to its application for rehabilitation and revision of the joint condition includes a number of techniques, such as:

• laser and plasma ablation;
• chondroplasty.

According to statistics, the effectiveness of arthroscopy at the initial stages of the disease is 75-80%.

In severe cases of arthrosis of the knee joint, corrective osteotomy is used, which is indicated for axial disorders of the limb. These operations have positively proven themselves for 20 years already.

Restoration of the limb axis allows to reduce the instability of the joint and reduce the load on the surface of the cartilage. Corrective osteotomy allows to postpone total prosthetic joint. This operation, conducted at the FBU. Academician G. A.

Ilizarov, showed a positive delayed result in 95% of patients.

Endoprosthetics are used in severe pain syndrome and functional joint failure. The use of modern materials in joint prosthetics can significantly reduce pain and restore mobility of the knee in 90% of cases.

What is it - the endoprosthesis can see the photo. With the proper installation of an endoprosthesis, the normal functioning of the limb persists for more than 15-20 years.

The advantages of endoprosthetics are the predictability of the long-term outcome, the rapid restoration of the joint function, the improvement of the quality of life and complete labor rehabilitation.

Since the operation is traumatic, post-operative complications often arise.

For the operation requires a highly qualified team of surgeons, expensive tools and quality prosthesis, which affects the cost of surgery.

With early diagnosis and timely treatment of gonarthrosis of the knee joint, the prognosis is positive. With the advanced stage and the use of radical treatments, the prognosis is average and only in the absence of treatment is negative.

A source: https://OrtoCure.ru/kosti-i-sustavy/artroz/gonartroz-sposoby-lecheniya.html

Osteoarthritis of the knee joint: symptoms, degrees, causes

Deforming arthrosis of the knee joint, in medicine is called gonarthrosis - this degenerative-dystrophic disease in the hyaline cartilage of the knee that covers the condyles of the femoral and tibia.

With arthrosis of the knee joint, the symptoms develop gradually over the years, the main manifestation of the disease are pain, stiffness during movement.

It is gonarthrosis considered the most common disease among arthrosis of other joints, such as hip arthrosis, arthrosis of the elbows or shoulder joints, phalanges of the fingers.

Most often, the disease affects people over 40 years of age, women are most prone to arthrosis. Sometimes it develops in young people on the background of injury or sportsmen from excessive loads.

The causes of arthrosis of the knee joint

There is no one single cause of the development of such a disease as knee arthrosis, as a rule, This is a combination of several provoking factors that can lead to a similar violation. Mechanisms of arthrosis in medicine are usually divided into:

• Primary - which occurs in the elderly from the natural aging of body tissues and against the background of some factors that cause this disease, such as obesity (10% of cases), heredity, increased the course of life.
• Secondary - he owns 30% of all cases of arthrosis of the knee, it usually manifests itself after injury, fracture of the tibia, rupture of ligaments, damage to the meniscus. Moreover, with such arthrosis of the knee joint, the symptoms of the disease in most cases appear 3-4 years later, but after a serious injury it is possible and in 2-3 months.

It is also common cases (7-8% of cases) of arthrosis, when a person after 40 years suddenly sharply begins physical activity, especially running and intense squats.

It is at this age that there are age-related changes in the joints and sharp loads can provoke rapid dystrophic and degenerative changes in the joints.

Also, one more reason for arthrosis of the knee joint may be not only injuries, serious damage, but also concomitant diseases - rheumatoid, reactive or psoriatic arthritis (see FIG. the more dangerous and contagious is psoriasis), gout, Bechterew's disease, excess weight and varicose veins (see p. treatment of varicose veins at home).

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Occupation of professional sports or just constant heavy physical activity, lifting heavy objects or frequent long climbing stairs in the elderly - may be the cause of the development of osteoarthritis of the knee the joint. Also increases the risk of gonarthrosis in spinal injuries, with neurological diseases, with sugar diabetes and other metabolic disorders, as well as with genetic weakness of the ligamentous apparatus (3-5% of cases).

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In 50-60% of cases, the cause of arthrosis of the knee joint is spasm of the muscles of the anterior surface of the thigh.

Until the patient's knees ache, such muscle spasm for a long time does not manifest itself in any way, and a person only experiences back pain, fatigue, heaviness in the legs.

If the straight and ilio-lumbar muscles of the thigh are in a constant spasmodic state, then gradually "knee tightening" gradually occurs, which does not allow them to move freely.

An interesting discovery about the bone joint shocked scientists

Belgian orthopedic surgeons in the city of Leuven recently discovered an unexplored and unknown earlier a bunch of ALL, which is in the human knee, is now given the name anterolateral or anterolateral.

The fact is that in some patients, even after successful operations after injuries and ruptures of knee ligaments, instability of the knee joint and pain during physical exertion were felt.

The carried out researches within 4 years on 40 knee joints, have allowed to find out this very sheaf about which medicine in general was not known.

Read more about this discovery in our article The previously unknown binding is open in the knee joint of a person.

Degrees of arthrosis of the knee joint

Most often, arthrosis develops in one of the knee joints and, taking into account the intensity of pathological processes in medicine, 3 degrees of gonarthrosis are distinguished:

• The first - at this degree of deformation of the bones of the joint is not present, however for initial manifestations stupid periodic pains after loading on the joint are characteristic. There may be swelling of the joint, insignificant and self-vanishing.
• Osteoarthritis of the 2nd degree of the knee joint - with the symptoms of arthrosis beginning to increase significantly, pain already occurs with minor physical exertion, with walking, lifting weight, they are more intense and lasting, there is a crunch in the joint, to the second degree, the development of joint deformation and a moderate limitation movement.
• 3 degree of arthrosis of the knee joint is characterized by maximum symptoms of arthrosis of the knee joint. The gait of the patient from constant pain and appreciable deformation of the joint is violated, and also the mobility of the joint is limited. The pains intensify depending on weather conditions, often they are so strong that a person can not find a comfortable position, sleep is disturbed, and the limitation of joint mobility can be reduced to minimum.

Even before the blood test for arthritis, there are all signs of inflammation: swelling, redness, hot skin over the affected joint, a violation of its movements. Osteoarthritis is pain in combination with radiological changes.

• Damage menisci and blockade of the knee joint

This disease develops very quickly, with unsuccessful movement after a crunch in the knee, there is a sharp pain, which after 15 minutes subsides, swelling of the knee arises the next day.

• Arthritis - rheumatoid, reactive, psoriatic, articular rheumatism, gout, Bekhterev's disease

To distinguish arthrosis from arthritis it is possible by the analysis of a blood, at an arthrosis the general analysis of a blood does not show any changes, and here a blood test for arthritis almost always indicates an inflammatory process (except, for example, cases of lesions of the small joint brushes).

• Inflammation of knee ligaments (tendinitis)

Such pain occurs more often in women after 40 years of age when they are lowered with stairs or heavy weights, it is localized on the inner or outer side of the knee, at the base of the patella attachment. It is difficult to unbend the leg in the joint, there may be swelling.

• Vascular pain in the knees

These are symmetrical pains that occur in both laps simultaneously and mostly in young people during accelerated growth bones, arise when weather changes, with colds, physical exertion, describe such a state of patients as "twists knees".

Symptoms of arthrosis of the knee joint by stages

This insidious disease develops gradually. First, the patient begins to worry only a slight discomfort, pain during movement, descent and climbing the stairs. Sometimes a person describes his sensations as a constriction in the popliteal region and a small stiffness of the joint.

A distinctive sign of arthrosis of the knee joint is a symptom of starting pain, that is, when a person from a sedentary the position abruptly rises and begins to move, pain occurs at the first steps, but as it moves, it softens or disappears at all. However, after a considerable load, again arises.

At the first degree, the knee does not externally differ from the healthy one, only sometimes the patients notice a small swelling in the affected area.

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Also, there are cases when fluid accumulates in the knee joint, it swells, becomes spherical, then the synovitis develops, the movement of the joint is limited, the heaviness is felt.

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Why are there such pains and changes in the joint?

At the first degree of arthrosis there is a disturbance of blood circulation in the intraosseous small vessels, which supply hyaline cartilage with nutrients.

For this reason, the surface of the cartilage over time becomes not smooth, dry, cracks appear on the surface of the cartilage.

Sliding cartilage during the movement should be soft, and unhindered, and in this case they cling to each other friend, this constant state of microtraumens thins the cartilaginous tissue, so it loses its amortization properties.

The capsule of the joint is reborn, the synovial membrane wrinkles, the joint fluid thickens. All this leads to an even more significant decrease in the supply of food to the cartilage and degeneration begins to accelerate.

Therefore, at 2 degrees of arthrosis of the knee joint, the symptoms increase, the pains are localized more often in the anterior The side of the joint and there are already even under weak loads, rest gives relief, but the movement again causes a strong pain.

Also, the mobility of the joint is reduced, when you try to bend your leg, a sharp pain occurs, a rough crunch is heard during movement.

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Synovitis is already observed much more often than at the beginning of the disease, the fluid accumulates in a larger amount, the joint changes its configuration, it becomes as if enlarged.

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At an arthrosis of a knee joint of 3 degrees there is a considerable deformation of a bone, they as though pushed into each other, the cartilaginous tissue is already practically absent, restriction of joint motion is growing.

The pains worry the patient, and during the day, and at night, and at rest, and when walking, bend or unbend the joint becomes problematic.

The joint is deformed, the legs become X or O shaped, the gait is overwhelming, unstable, often in severe cases the patient needs crutches or canes.

Diagnosis and treatment of arthrosis

With the first degree of arthrosis, such a diagnosis during normal examination is not possible to establish. At 2-3 degrees already on examination, deformities of the bones and joint are noticeable, changes in the axis of the limbs, stiffness of the movement, a crunch is audible, swelling and swelling are noticeable with synovitis.

To date, in addition to standard radiography for the diagnosis of arthrosis of the knee, modern methods of MRI and CT, which allow more thorough examination of pathological changes in soft tissues and to study bone disorders structures.

Treatment of this disease is a whole complex of procedures and drug therapy. More details on the treatment of arthrosis of the knee joint can be found in our next article. Orthopedists prescribe physiotherapy, massage, therapeutic gymnastics, mud therapy.

If the treatment is ineffective, if a young patient and arthrosis with severe pain syndrome and restriction of movement, it is possible to perform joint replacement with the subsequent rehabilitation period in the course of 3-6 months.

A source: http://zdravotvet.ru/artroz-kolennogo-sustava-simptomy-stepeni-prichiny/