Gonarthrosis of the knee joint: degrees, treatment, disability

Learn everything about disabilities with knee arthrosis

Gonarthrosis, or arthrosis of the knee joint, is one of the diseases that lead to the limitation of mobility, disability. Long, regular, comprehensive treatment helps to delay this moment.

If conservative treatment is no longer effective, resort to surgery, but it does not always help to avoid disability. The further the development of arthrosis has gone, the higher the risk.

People with a diagnosis of arthrosis of the knee joint of the 2nd degree are given a disability rarely, with a disease of 3-4 degrees, getting the group is more likely.

Many patients are interested in what criteria the commission is oriented on, which gives a disability, what group can be obtained, and what kind of examination it takes to get through.

Degrees of gonarthrosis

There are several approaches to the classification of degrees of arthrosis, some sources distinguish 3 degrees of this disease, others - 4:

• 1 degree - this is the initial stage of the disease, in which degenerative-dystrophic changes of the cartilaginous tissues are just beginning, and the possible deformity of the knee is associated with swelling, swelling of the soft fabrics;
• at an arthrosis of 2 degrees of a knee joint destruction, thinning of a cartilage progresses, the synovial cover inflames more often, that is shown by the expressed puffiness;
• gonarthrosis of the 3rd degree is characterized by deformation of the bones of the articular joint, on the edges of the articular areas appear outgrowths in the form of spines - osteophytes. Deformation of bones leads to the curvature of the limb axis;
• sometimes allocate 4 degree. This is the stage at which the cartilage is completely destroyed, and the bones of the knee joint coalesce, ankylosis is formed, that is, complete immobility of the joint.

The treating doctors-rheumatologists in the diagnosis are based on the roentgenological classification of arthrosis, the latest version of which was developed in 1982. Leuquesne.

Within the framework of this classification, 4 stages of the disease are distinguished, not including zero, in which there are no x-ray changes. For medico-social expertise (ITU), another classification is used, according to Kosinskaya.

It is also based on X-ray examination data, clinical symptoms are also taken into account, but only 3 stages are allocated.

Classification of deforming osteoarthritis according to Kosinskaya

If the picture shows a moderate narrowing of the gap between the bones of the joint, and the uneven, and osteophytes, which just began to form, a deforming arthrosis of the 1st degree is diagnosed. The restriction of mobility is weakly expressed.

With arthrosis of the knee joint of the 2nd degree, the changes are more pronounced:

• The joint gap narrows in comparison with normal parameters in 2-3 times;
• osteophytes are large, localized along the periphery of the joint site;
• in the epiphysis of the subchondral bone (the bone section directly in contact with the cartilage), the compaction of the bone tissue (osteosclerosis) is seen, in places cavities-cysts are formed.

Deforming osteoarthritis (DOA) of the third degree of the knee joint is manifested by a pronounced restriction of mobility, the patient is able to perform only swinging movements, the leg in the joint deviates from the initial position maximum at 5-7 °. X-ray signs:

• The bone surfaces are compacted, the scale deformation of the joint is visible;
• large osteophytes are formed throughout the articular site;
• the joint gap is completely closed;
• in the joint appear cavities - subchondral cysts;
• in the synovial cavity, the presence of fragments of the destroyed cartilage is possible.

A state where even swinging movements are impossible, and bones are fused, according to Kosinskaya is classified as ankylosis.

The results of an X-ray examination are the main criterion of the ITU.

But when it is carried out, the results of functional diagnostics are also taken into account, which assesses the degree of restriction of movements (contractures), the severity of violations of the statodynamic function (SDF). SDP is the ability to maintain support and move, provided by compensatory processes.

Functional diagnostics, SDF assessment

When the patient performs a number of functional tests, the amplitude of movements in the joint is measured, and the deviation from the norm (a functionally advantageous position) is estimated. Allocate 4 degrees of contracture of knee joints.

1. Amplitude is not less than 50% of the norm.
2. The amplitude was reduced to 25-40%.
3. The amplitude does not exceed 15% or motion is impossible (ankylosis).
4. The joint is immobilized, fixed in a functionally uncomfortable position, the limb as a result is shortened.

To evaluate SDP take into account the results of functional and radiological diagnostics. Also evaluated are:

• intensity and duration of pain;
• the pace of walking and the length of the distance that a person is able to overcome at one time, the ability to move without auxiliary devices;
• The change in the size of a sick leg in comparison with a healthy one.

Allocate such degrees of severity of violations SDP:

• minor - normal compensation, reduction in amplitude does not exceed 10%, aching pains occur after a load and pass after rest;
• moderate in the initial stage - relative compensation, moderate contracture. The load in addition to pain causes lameness, but the pain passes after a long rest. The supporting limb is shortened by a maximum of 4 cm, the muscle strength is reduced by 40%, the hip circumference on the aching leg (2 cm) decreases;
• moderate in the late stage - subcompensation (lack of compensation), pronounced contracture. The pains are constant, the decrease in muscle strength reaches 40-70%, the progression of hypotrophy and shortening of the patient finiteness in comparison with healthy (shortening by 4-6 cm, reduction of the hip circumference by 3-5 cm, leg circumference by 1-2 cm);
• expressed - the stage of decompensation, pronounced contracture, lameness. Hipotrophy of the hip exceeds 6 cm, shin - 3 cm, shortening - 7 cm, muscle strength decreased by more than 70%;
• significantly expressed - a person can move only over short distances with the help of other people or using crutches, walkers.

Reasons for assigning a disability group

Considering the question of recognizing a person suffering from gonarthrosis as an invalid, the medical commission accepts in view of the severity of the pain syndrome, and the degree of limitation of leg mobility in the joint, the violation SDF.

The phenomena of bone deformation and destruction of cartilage should be confirmed by X-rays and the results of arthroscopy.

Also, the length of the hospital, which was drawn up in connection with temporary disability, is taken into account.

A patient who has applied to doctors for recognition as an invalid is subject to medical and social expertise. It combines clinical and functional diagnostics with social. Whether disability is given in gonarthrosis, and which group, depends on a number of factors:

• how many joints are affected;
• whether there are complications of the disease;
• how quickly progresses arthrosis;
• whether the functional disorders are persistent and how much they are expressed;
• whether the patient is able to perform his official duties (the nature of work is taken into account);
• whether he retains the capacity for self-service;
• whether it is possible to move without assistance / accessories.

The last 3 points refer to social diagnostics.

How to pass the examination

To make a disability with arthrosis, you need to collect a solid package of documents: extracts from the medical history, epicrisis from institutions where the patient underwent treatment, sickness sheets confirming incapacity for work, results surveys.

The attending physician-rheumatologist, after studying the medical history, can accurately predict whether the commission will give the group.

And as a mediator between the patient and the specialist heading the commission, the district therapist is acting, he in the established order addresses with the corresponding statement.

With arthrosis 1 degree, the group will not be given unequivocally. With gonarthrosis of the knee joint of 2nd degree, disability is appropriated in exceptional cases:

• Both knee joints or other joints, besides the knee, are affected;
• gonarthrosis of 2nd degree is complicated by other diseases;
• at least persistent moderate violations of SDP and 1 degree of impaired movement are noted.

Submitting documents to the MCEC makes sense if:

• the patient suffers from arthrosis for at least 3 years, and during this period suffered a minimum of 3 exacerbations, accompanied by a reactive synovitis;
• on the background of arthrosis, concomitant diseases developed;
• the disease progresses rapidly, decompensation develops;
• the attempt at surgical treatment led to a worsening of the condition;
• disease prevents habitual life.

In most cases, the commission assigns a disability for arthrosis of the knee joint of the third degree.The group needs to be confirmed annually, undergoing a second examination.

If the condition worsens or improves, the disability group can be revised.

If the treatment prescribed for arthrosis of the 2nd degree of the knee joint was effective enough, or the patient with grade 3 arthrosis performed a successful endoprosthesis operation, the group can be removed.

Disability groups for arthrosis

Basically gonarthrosis is the basis for assigning 2-3 groups of disability. But if the deforming arthrosis deprives the disabled person of the ability to move independently, self-service, appoint 1 group.

The third group of disability is assigned:

• with bilateral gonarthrosis or arthrosis of different types of joints of the legs of the 2nd degree;
• with deforming osteoarthritis of the third degree with moderate functional impairment.

At the same time, labor productivity is reduced, the patient can not perform certain types of work, the choice of specialties for him is limited. A disabled student can attend a general education institution, but must follow a special schedule and regime.

The ability to self-service is not lost, the patient is able to move for short distances without ancillary devices or to restrict the use of the cane.

But the implementation of the usual actions takes more effort and requires a longer rest.

The grounds for assigning the second group are:

• gonarthrosis of the knee joint of the third degree with pronounced functional impairment;
• ankylosis of the knee joint in a functionally unprofitable position;
• a decrease in the length of the diseased limb by 7 or more cm;
• periodic prolonged exacerbation of synovitis;
• rapid progression of the disease, which is not stopped by medication, physiotherapy, exercise therapy.

The patient can move only with the help of ancillary equipment or other people, experiencing severe pain during movement. It is possible to work in specially equipped places, study in specialized institutions or at home.

Is arthroplasty the basis for disability?

To surgery for the replacement of the affected joint with a prosthesis (endoprosthetics) resorted to avoid disability, increase the amount of motion in the joint.

After surgery and rehabilitation, the patient in most cases returns to a full life, can move independently, work.

Of course, you need to observe a number of precautions, protect the endoprosthesis from excessive loads, some activities will have to be abandoned.But a person with a joint prosthesis is not an invalid if the operation was successful.

The reason may be an unsuccessful selection of the geometric dimensions of the prosthesis, its low quality, as a result of which rejection develops.

In a number of cases, the patient himself is guilty, who did not undergo full rehabilitation, did not follow the instructions of the specialist.

Often operated do not develop the joint as follows due to fear of pain or banal laziness. Sometimes, complications lead to excessive stress on the joint, a violation of diet.

2 months after endoprosthetics, ITU is conducted. If before the operation the patient was on the group, and joint replacement and rehabilitation helped to eliminate the limitations of life activity, the group is withdrawn.

Conversely, the appearance of pronounced musculoskeletal disorders is the basis for recognizing him as disabled. As a rule, disability is assigned after an unsuccessful total bilateral endoprosthetics.

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At the expressed disturbances SDP it is assigned 2 group, at considerably expressed, with decompensation - 3.

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Starting with the 2nd stage of gonarthrosis, the patient can be recognized as an invalid. The commission that decides to assign a group takes into account not only the clinical picture and the severity of functional disorders, but also social factors.

So, if a patient with gonarthrosis is engaged in mental labor, he may not be assigned a disability despite the limitation of movements and violations of the static-dynamic function.

As a result of successful treatment, the group can be reduced or withdrawn, usually this effect is given only by surgical intervention.

A source: https://artroz-help.ru/gonartroz/invalidnost-pri-artroze-kolennyh-sustavov

Gonarthrosis of the knee joint 1, 2, 3 degrees: what is it, the symptoms, treatment, disability

Gonarthrosis is the destruction of the articular cartilage of the knee joint, which has three stages of development. Consider gonarthrosis of the knee joint of 2 degrees, treatment of the disease, its causes and symptoms.

This is a disease in which joints appear at the joints around the edges and cystic growths. Gonarthrosis of the 2nd degree is most common.

Often, treatment in this phase of the disease is just beginning, and the first stage, called gonarthrosis of the knee joint of the 1st degree, the person does not notice and does not pay the beginning illness of due attention.

This disease can develop not only in the elderly. In the risk group, people engaged in professional sports, and those who experience great physical exertion, have lower limb varicose and excess body weight.

Causes of development of gonarthrosis

The disease appears due to a violation of blood flow in the surrounding tissues cartilage tissues. As a result, strong friction arises between the surfaces of the joints lacking hyaline coating.

This causes problems in the movement and deformation of the joint.

In some cases, the causes of the development of the disease are unclear: the patient did not change the style of nutrition, did not use any special medications, did not injure the joint, there was no inflammation.

This is called - primary gonarthrosis, which often appears in women of adulthood as a result of deterioration of blood supply of articular tissues and their aging. As a rule, the disease develops immediately in both cartilages of the knee joints.

The development of secondary gonarthrosis can cause surgery on the knee joint, trauma or inflammation. The factor that causes the disease is nutrition with the predominance of carbohydrates and fatty foods from animal meat grown on low-grade feeds.

The main cause of gonarthrosis is still microtraumas of articular cartilage, causing its degeneration.

The researchers found that during the disease in the cartilaginous tissue the content of chondroitin sulfate, an important cartilage component, decreases.

Degrees of severity of the disease

This disease has several stages of development.

• Gonarthrosis 1 degree - the initial phase of the disease, usually ignored by a sick person. It manifests itself only with minor knee pains that occur after large physical exertion. In this case, the knee joint can swell and slightly deform.
• Gonarthrosis of the 2nd degree makes itself felt by stronger and more prolonged pains that appear not only during movement, but also in a calm state. There is a crunch in the knee and difficulties with its extension in the morning. The joint swells and deforms already palpably.
• Gonarthrosis of the third degree is the most severe phase of the disease, characterized by severe pain that occurs during movement, at rest and even from changes in weather conditions. There is a strong deformation of the joint in the inner or outer side. The third phase of the disease affects the gait of a sick person, which varies greatly.

Identify the severity of the disease and get a detailed picture of its course can be using radiographic and ultrasound.

Consider how to treat gonarthrosis by medicamental methods. When the second stage of the disease begins, the following means are used:

• Diclofenac, Movalis and Nimesulide are used as analgesics and anti-inflammatory drugs drugs that have an effect on prostaglandins (important substances for all body systems person);
• chondroprotectors are used for the restoration of articular cartilage, it is a synthetic analogue of the substances "chondrotin" and "glucosamine available in the cartilage tissue;
• use of preparations Duralan, Fermatron, Synvisc, produced with the help of hyaluronic acid and being synthetic analogue of the lubricating articular fluid, helps to reduce the friction of the knee joints when flexing and extension;
• In addition to medicines for the treatment of the disease, physiotherapy (magnets, UHF, phonophoresis) is used, and during the periods of remission the sessions of massage and manual therapy are of great help.

In what cases is surgery necessary?

Surgery is required if there is an obvious ineffectiveness of drug treatment, if drugs and physiotherapy do not help, and the patient's condition worsens.

The operation involves replacing the affected joint with an artificial prosthesis made of a hypoallergenic, durable material similar to human bone.

The procedure is very complicated and time-consuming, it is performed under general or epidural anesthesia.

After surgery in the early period, the patient is instructed to perform a series of exercises that help restore respiratory and circulatory system functions and reduce the risk of complications. Later, more exercises are used, including on the stationary bike, a course of massage and sanatorium treatment is prescribed.

Can I get a disability?

Does the sick person have a disability group with arthrosis of the lower limbs? Yes. Disability can be prescribed to patients with severe impairment of motor function and a significant restriction of natural life activity.

However, only patients with grade 3 disease can receive disability. And only, as an exception, it is issued at 2 degrees of the disease. When a disability group is assigned, the following is taken into account:

• is there a disruption in the mobility of the knee joints;
• severe pain syndrome is not a reason for the appointment of a disability;
• moving the patient on crutches can be a factor in the appointment of II or III group, the first group is very problematic;
• It is necessary to confirm compliance with the assigned group every year;
• in case of improvement of the patient's condition, the group can be changed;
• the commission considers only the data, evidenced by radiographic examination and arthroscopy.

Confirm disability is necessary by providing an extract and a medical history from a rehabilitation medical institution. Disability can be obtained by patients with a duration of incapacity for work of at least three months during one half-year.

Traditional medicine with articular pathology

People with knee arthrosis often use folk recipes. Here are a few of them, which most effectively relieve painful symptoms and have good reviews.

1. A large cabbage leaf with honey flower applied on the inner surface is tied to a sick joint for the night. From above you can bind a place with polyethylene and pure woolen cloth. The duration of the procedure is at least one month.
2. Rasirka from the root of elecampane, infused in vodka in the proportion of 50 g / 125 ml (soak for 2 weeks in a dish of dark glass). Ready tincture to rub daily into the affected knee until the pain disappears.
3. Oat flakes, cooked on water for 7-8 minutes, in the form of a viscous gruel are applied to a wool bandage and tied with the affected knee, polyethylene is applied from above. The dressing should be worn all night, the procedure repeated every day until relief comes. It is important to brew fresh flakes every time.
4. The egg shell powder, mixed with a small amount of kefir, is applied to a linen cloth and applied to the diseased joint, the knee is tied with polyethylene on top. Soak for 2-3 hours, perform daily.
5. A similar compress is made from a mixture of ordinary school chalk with curdled milk. It is applied to the diseased knee and covered with polyethylene. Keep the mixture for several hours or leave overnight.
6. Rhizome finely grated and steamed on a small fire horseradish is applied to natural tissue (linen, wool) and in the form of a compress attached to a sore spot.
7. Decoction of the bulb with the husks take 1 glass three times a day before meals. The course of treatment is 1-2 weeks.

Healing baths

A coniferous bath helps well in the treatment of disease. Use such a bath is useful, essential substances of the needles act soothingly and relaxing.

To make such a bath, pine branches are used and several Jerusalem artichokes are cut into small pieces, they are immersed in a bath with hot water.

For greater efficiency, 1 teaspoon turpentine from gum, 1 kg of food or sea salt and 2 tablespoons of honey is added to the container.

It is possible to stay in such a bath for 15-20 minutes, no more, at the end of the procedure it is necessary to dry it dry, apply iodine net and honey to the affected knee. Bath should be taken every day for 1-2 weeks.

The hay bath is prepared by their 3-4 handfuls of triturated leaves, seeds, stems, senna flowers, infused in boiling water and poured into a bath. Stay in the treatment bath should be within 30 minutes. It is good to wrap the patient's limbs with a bandage soaked in Senna decoction.

Massage of affected joints in water with dissolved sea or food salt is very effective. It runs for 20 minutes. At the end of the procedure, wear woolen stockings and go to bed. The course of treatment is 1-2 months.

Principles of Nutrition and Gymnastics

People with this disease should follow certain principles of nutrition:

• Do not eat too fatty fish, meat and carbohydrates containing food;
• to refuse cakes, cakes, chips, alcoholic and carbonated drinks;
• use cereals from whole-grain cereals, lots of vegetables, fruits, greens;
• limit the consumption of meat (not more than 100 gr) and eggs (no more than 2-3 per day);
• necessarily include in the diet of dairy products;
• pasta and bread do not affect the course of the disease.

To facilitate movement with affected joints, it is necessary to use a cane, which reduces the load on the diseased leg well. Choose it follows the length, the optimal size is from the floor to the bend of the wrist, if you stand with your hands down along the trunk.

To carry a cane is necessary in the hand, which is on the opposite side in relation to the diseased leg. You can also use special insoles and orthoses, selected by a specialist.

Gymnastics is needed to activate life processes in the patient's joint.

With its help, its mobility increases, the circulation of the articular tissue improves, and painful sensations decrease.

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Perform the exercises need to calmly, at a slow pace, without sharp jerks. Both legs exercise one by one. Here is the set of exercises for gonarthrosis of the second stage.

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1. From the supine position on the back, the straight leg slowly (not allowing pain) to raise to a height of 15 cm from the floor. If pain is absent, you should start with a five-fold increase, daily increasing this number by one. At the first signs of pain, stop the exercise.
2. Hold the straightened sick limb for a few seconds low above the floor, avoid the appearance of pain. If there is a feeling of fatigue in the leg muscles, then the exercise is performed correctly.
3. From the position lying on the side with the bent lower leg for a few seconds, keep the straightened upper leg at an angle of 45 °. Then repeat the exercise with the other leg.
4. Sit on a chair with a straight back, hold for a few seconds a straight leg at the maximum height for yourself, repeat the exercise with the other leg.
5. Standing with the support on the back of the chair, slowly rise on your toes, linger for 2-3 seconds, to fall on the feet.

Effectively helps in the treatment of gonarthrosis gymnastics in the pool. Holding on to the handrail, the patient simulates the toad swimming, performs the exercise "bicycle" and others.

Establish an accurate diagnosis and appoint treatment can only specialist orthopedic.

A source: http://legsgo.ru/arthrosis/gonartroz-kolennogo-sustava-2-stepeni-lechenie.html

Gonarthrosis of the knee joint of the third degree

The cartilaginous tissue covering the bones of the knee joint is destroyed gradually, the symptoms appear and grow consistently.

If they are ignored for a long time, gonarthrosis of the third degree develops (he also has arthrosis or osteoarthritis).

If the destructive process touched both limbs, then the diagnosis sounds like "bilateral gonarthrosis."

Gonarthrosis of the knee joint

Characteristics of disease

This is due to a violation of the cycle of resumption of cartilage tissue for various reasons. The synovium of the joint suffers: an effusion appears. Independently these processes do not stop, conservative treatment does not help much.

As a result, the subchondral surfaces of the bones are exposed (and they are soft enough) and begin to contact each other directly. There is a protective reaction in the form of overgrowth of bone tissues, peculiar spines - osteophytes are formed.

This stage of gonarthrosis is called "deforming arthrosis". In this case, changes in the shape of the knee joint are pronounced: it thickens, and pineal glands are visible. Two-sided deforming arthrosis bends the legs with the letter "O" or "X".

To make a diagnosis in this case, the doctor simply has to feel the knee area.

At X-ray examination, the following changes are seen:

• The joint gap between the heads of the bones is extremely narrowed;
• a large number of osteophytes;
• sclerosing cartilage;
• destruction of ligaments.

At roentgenologic research it is visible, that an articulate cleft between heads of bones is extremely narrowed

Nuclear magnetic tomography at this stage is much more informative, all the damage to the bone and soft tissues of the joint is visible. If necessary, arthroscopy can be prescribed.

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Symptoms

Gonarthrosis of the 3rd degree can also be recognized without the involvement of a physician - the consequences of joint destruction are so noticeable.

The main signs that there are practically no condyles are:

• pain in the joint, which does not pass even in a static position;
• the gait is broken. The person is forced to change the normal biomechanics in such a way as to remove the load from the aching joint as much as possible. Develops lameness;
• the leg is difficult to bend and unbend, the mobility of the joint is severely limited, a crunch (bone friction against bone) is heard during movement;
• knee joints are enlarged and deformed;
• the articular fluid accumulates, forming a large edema.

Ultimately, mobility is completely lost, a person becomes disabled.

Disability

Full or partial immobility in gonarthrosis of the third degree means loss of a person's working capacity and ability to fully self-service. In this state, the right to receive disability arises.

For this it is necessary to collect all the documents confirming the diagnosis, describing the prescribed treatment, to undergo a special medical commission.

Based on the results of the patient's examination and consideration of the submitted documents, a corresponding category is awarded.

Disability for arthrosis is determined by the following gradation:

Full or partial immobility in gonarthrosis of the third degree gives the right to receive a disability, which is confirmed by the medical commission

• 1 group: a person is unable to move to provide himself with food, perform basic functions of self-service. This category includes 3 and 4 stages of arthrosis of the knee joint;
• 2 group: the movement is partly possible, but mostly with outside help. Awarded to patients with arthrosis of the knee joint of the third degree, with ankylosis, with a limb shortening more than 7 cm;
• 3 group: a person is able to move, but not fully. It is given for 2 stages of gonarthrosis.

Disability with arthrosis must be confirmed, since effective treatment is expected.

Treatment

Treatment of any arthrosis can only stop the destruction, but do not turn it back.

The further the process has gone, the more difficult it is to regain the mobility of the joint.

But with the competent complex approach of the doctor to therapy and the patient's persistence, gonarthrosis of the third degree can also be partially brought to the stage of remission.

Medicines

Treatment begins with pain relief with anti-inflammatory non-steroid drugs, such as Celebrex

• Treatment of arthrosis of the knee joint begins with the removal of pain and inflammation, that is, anti-inflammatory non-steroid preparations are prescribed: Celebrex, Meloxicam, Indomethacin.
• In the case of osteoarthritis, grade 3 pills may not be enough, then injections directly into the joint are made (Prednisolone, Metipred). Strong-acting Tramadol is allowed only in extreme cases of severe pain syndrome. Regenerating effect of these drugs do not have, but significantly improve the quality of life of the patient and make it possible to move on to the next stage.
• After removal of an acute condition, treatment of gonarthrosis of the knee joint is accompanied by a symptomatic reception of such agents as Celecoxib, Rofecoxib, using ointments based on Diclofenac. These drugs do not have such a negative effect on the digestive tract, like NSAIDs, and relieve pain.
• For partial restoration of mobility of the joint by stimulating the reproduction of cartilaginous tissue (if any) and normalization of articular fluid production is used by treatment with chondroprotectors (chondroitin sulfate and glucosamine). With grade 3 gonarthrosis, the effect becomes visible only after one and a half years of use.

Preparations based on hyaluronic acid also have a regenerating effect. One intra-articular injection can relieve pain and improve mobility for up to 3 months.

Physiotherapy

The process of restoration of the joint tissues in gonarthrosis will go much faster if you regularly use physiotherapy:

The process of restoration of joint tissues in gonarthrosis will go much faster if you regularly use physiotherapy

• electrophoresis;
• magnetoperapy;
• UHF;
• paraffin therapy;
• mud wraps;
• therapeutic saline and radon baths;
• cryotherapy.

All these manipulations are aimed at improving the blood supply and nutrition of the knee joint.

Gonarthrosis of the knee joint of the third degree is difficult to win without the use of medical gymnastics.

Treatment with the help of exercise therapy consists in the regular performance of a complex of static exercises (holding the tension in a certain position without additional weight), which do not burden the knee joint, but well strengthen the surrounding and supporting muscles and ligamentous apparatus.

Also very useful for osteoarthritis is massage and manual therapy. But these procedures should be performed only by a good specialist.

Endoprosthetics

But often it happens that the destructive process with gonarthrosis of the 3rd degree has gone so far that conservative treatment does not help.

That is, the cartilage is lost almost completely, the bones are deformed and there is nothing to restore. Then there remains such a version of high-tech medical care, as endoprosthetics.

The operation is a complete or partial replacement of the damaged joint with artificial elements.

You can replace one condyle or both, there are different types of implants for prosthetics of the knee joint, even with a complete loss of the ligament apparatus, as well as with age-related brittleness of the bones.

All these designs correspond to the human anatomy and serve about 25-30 years, while observing the rules of wearing.

Treatment continues with a rehabilitation period: physiotherapy, which develops exercises. After recovery, the motor activity of patients, especially young ones, is almost completely restored. They can conduct their usual lifestyle, once a year undergoing an examination to monitor the endoprosthesis.

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Despite the fact that gonarthrosis will be defeated even in 3 stages with the current level of development of medicine, it is not necessary to bring joints to this state. Because the treatment will be long, painstaking, painful.

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If joint replacement occurs, complications can occur in the form of loosening of the endoprosthesis, infection, inflammation, followed by revision operations.

Timely observed signs of knee gonarthrosis and adequate measures to suppress the process are a pledge to preserve joint mobility.

• All means have been tried, and nothing has helped?
• Are you in constant pain?
• And now you are ready to take advantage of any opportunity that will give you the long-awaited well-being!

A source: http://lechuspinu.ru/artroz/gonartroz-kolennogo-sustava-3-stepeni.html

Whether disability is given at a gonarthrosis of 3 degrees of a knee joint

Gonarthrosis of the knee joint of the third degree is the last stage of the disease leading to the destruction of the cartilaginous tissue, at which the disability group is provided.

A person with such a disease needs constant support of both physical and material plan. The cost of drugs that slow down the processes of destruction is high enough, and the patient can not work physically.

Therefore, assigning the status of a disabled person helps to partially solve some problems.

Characteristics of disease

Gonarthrosis or knee arthrosis deforming is a disease that affects hyaline cartilage, causing degenerative processes. The disease affects mostly elderly people, mostly women.

The articular cartilage functions as a shock absorber, allowing the joint to flex and expand the leg.

When the "shock absorber" wears out, thinens and collapses, there is friction of the bones, which is accompanied by pain and a number of accompanying symptoms.

The exact etiology of the disease is not known. However, doctors identify the following factors that contribute to its development:

• knee injury;
• overweight;
• permanent heavy physical activity;
• poor nutrition;
• diseases of the musculoskeletal system;
• transferred operations on the joint;
• genetic predisposition;
• a state of constant psychological overstrain.

Depending on the latitude of the lesion, there are 3 degrees of gonarthrosis.

The first is characterized by periodic pain in the knee region, manifested mainly in the evening. A person pays attention to a certain stiffness. With hardware diagnostics, changes are not noticeable, only a slight narrowing of the joint gap is visible.

At the second degree, the existing symptoms are added crunch and lumbago in the knees. The amplitude of the movements strongly narrows. The pain manifests itself periodically, often with acute attacks. When diagnosed, the narrowing of the joint gap, the thinning of the disc and the proliferation of bone tissue are revealed.

The third degree is characterized by complete or partial immobilization of the joints. Hyaline cartilage is destroyed, and on the X-ray there is a proliferation of bone tissue with the formation of osteophytes (spurs). Violated blood circulation, lost sensitivity of the affected area.

The factors in which disability develops

Despite the seriousness of gonarthrosis, disability or restriction of physical abilities, it occurs only with the aggravation of the disease. The development of disability is facilitated by a number of factors.

1. Lack of treatment. If a person for a long time refuses to receive specialized care, trying to heal on his own - the disease is progressing. Every year the scale of the growth of bone tissue increases, and the person's physical capabilities are limited.
2. Incorrect treatment. There is a negative dynamics on the background of ongoing therapy. A person receives treatment, but instead of the opposite happens.
3. Non-compliance with recommendations. If a person ignores the rules of nutrition, exercise and the right way of life in general - it stimulates the progression of the disease. For example, a patient ignores the importance of diet, gaining excess weight. The load on the muscles increases - the deformation of the joint is accelerated.
4. Getting injured. People suffering from diseases of the musculoskeletal system are more prone to damage. Often against the background of arthrosis, a mechanical damage occurs, which as a result leads to the spread of the disease and the appearance of new lesions.
5. Postoperative complications. This phenomenon is rare, but nevertheless, the risk of unforeseen circumstances is present.

Signs of development

The concept of "disability" - implies a limitation of life. It is appropriated if a person in connection with an existing disease is deprived of the ability to self-service. With aggravation of gonarthrosis to grade 3, the likelihood of disability is high enough.

The following signs indicate the need to assign a disability group:

• bilateral knee joint damage;
• deformation;
• In addition to gonarthrosis, there are other forms of arthrosis;
• diagnose ankylosing of the joint;
• the diseased limb is 5 to 7 centimeters shorter than the healthy one;
• conservative treatment does not give tangible results;
• for the movement of a person, outside help is needed.

Assignment of the group is not based on a specific diagnosis, but on the consequences of the disease leading to a particular condition.

A person is given a disability with gonarthrosis of the third degree of both knee joints, since this deprives the person of the ability to move fully.

If the patient has not yet diagnosed the disease of the knee joint, and the destructive processes bring significant inconvenience, the decision to assign the group is taken individually.

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Many patients turn to the treating doctor with the question of whether a disability (in particular which group) is given in gonarthrosis of the third degree of the knee joint.

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Usually, the doctor finds it difficult to give a full answer, since the decision to assign the status of the disabled person is accepted Special Commission of Experts after a long study of the patient's medical history and evaluation of its current state. After this, the patient is given a group or rejects the request.

How to avoid disability

If a person suffering from gonarthrosis does not recognize his physical limitations, and confronts the development of the disease - he must adhere to certain recommendations.

Complex treatment implies not only medical therapy. Obligatory conditions are adherence to a special diet, daily exercise therapy, swimming, massage.

If the hyaline cartilage is already destroyed, the bone tissue rubs and also collapses, as is observed at grade 3 disease, endoprosthetics are required.

The operation is less invasive, and the rehabilitation period is much shorter.

The second is the complete replacement of the joint with a special metal or ceramic construction, in which the polymer component plays the role of the disk. The structure is movable and fixed. What to apply, the doctor solves in view of a status and age of the patient.

The second main rule of preventing disability is the psychological mood of a person. If the patient does not "fall in the spirit" and is ready to resist the disease - this greatly increases the chances of a positive outcome. According to statistics, a negative attitude reduces the effectiveness of treatment.

Gonarthrosis is a disease that has been developing for years. To not fall into the number of disabled people, a sick person needs a full treatment. The sooner you turn to the doctor - the more effective the therapy will be.

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Do not wait for the right moment, ignoring or not paying attention to the disease. This will not help to solve the problem, but will only exacerbate the condition, and reduce the chances of a full life in the future.

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A source: http://PozvonochnikPro.ru/bolezni-sustavov/invalidnost-gonartroz-3-stepeni.html