Causes of development and treatment of deforming osteoarthritis of the knee joint (gonarthrosis)

Deforming knee osteoarthritis (gonarthrosis) is a degenerative-dystrophic disease character, which has a chronic course and is manifested by the gradual destruction of the cartilaginous and, later, bone tissue. The disease leads to impaired motor activity.

In the late stages of gonarthrosis proceeds with painful pain and almost complete restriction of the functions of the knee joint, so it is very important to detect and begin to treat it as early as possible. Deforming osteoarthritis is an irreversible disease, but timely treatment can stop the development of the disease and preserve the functionality of the knee bones for many years.

Causes of the disease

Depending on the causes and features of the flow,

1. Primary (idiopathic) gonarthrosis- defeat, developing independently on the background of complete well-being.
2. Secondary osteoarthritis of the knee joint- a disease that occurs against the background of other relapses, which also provoke its growth.

Causes of primary gonarthrosis

Idiopathic gonarthrosis develops in elderly people who have not previously suffered from diseases of the musculoskeletal system.The exact cause of this disease is not clear, but there are several theories of its occurrence, each of them is based on a certain factor to which can be attributed:

1. Metabolic disorders- very often the disease develops in people who are overweight or obese, the cause of which can be the wrong metabolism. The cause of metabolic disorders can be endocrine disorders, as a result of which trophic and metabolic disturbances are disturbed cartilage tissue or metabolic syndrome, in which the development of gonarthrosis is associated with the eating habits of modern rights.
2. Violation of the hormonal background, the cause of which can be the use of hormonal drugs for a long time or a period of menopause in women.
3. Genetically determined tendency to develop deforming osteoarthritis of knee joints.In this case, the cause of the disease may be congenital abnormalities of the tissue structures (dysplasia, synovial fluid synthesis) or the genetic predisposition of the organism to gonarthrosis.

Causes of secondary gonarthrosis

Secondary osteoarthritis of the knee always has a visible cause of development.The main factors that cause the emergence of secondary gonarthrosis are:

• sharp single or chronic increased load on the knees (at the risk group includes athletes, people whose professional activity is associated with high loads on their knees);
• traumatic injury (dislocation, rupture of meniscuses, severe bruise, ligamentous apparatus damage, fracture of bones inside the joint);
• surgery after a trauma;
• inflammation;
• neoplasm in the knee region (both benign and malignant);
• untimely begun therapy of diseases and traumas.

Secondary gonarthrosis in all cases occurs on the one hand.

Symptoms of gonarthrosis depending on the stage

The clinical manifestations of the deforming arthrosis of the knee depends on the progress stage of the process.

First degree of gonarthrosis

As a rule, at this stage, gonarthrosis is detected when the patient is examined for another pathology.In the initial or first stage, the disease manifests itself:

• a feeling of discomfort in the knee, which appears after a long load (walking, running, long time spent on legs);
• the pain that appears when the injured knee is bent and unbent;
• a feeling of fatigue, arising even after the usual loads.

Radiographically you can see the narrowing of the joint cavity and single osteophytes (bony outgrowths).

Second degree of gonarthrosis

The clinical picture of the second stage of osteoarthritis is quite vivid, so most patients seek medical attention at this time.Symptoms of the second degree are:

• constant pain, intensifying in the morning and falling during a rest period, but not completely passing;
• crunching in the knee while driving;
• changing gait and slowing the speed of movement;
• knee joint deformation;
• pronounced edema, which develops as a result of the inflammatory process;
• palpation of the knee is very painful.

On the roentgenogram, it can be seen that the tissues have been seriously altered. During this period, the complication of the disease associated with the ingress of part of the bone or cartilaginous tissue into the synovial cavity of the knee joint may develop.

The third stage of gonarthrosis

Disease in the third stage often leads to the appearance of a complete limitation of the person's mobility and disability.The clinical manifestations of the disease during this period include:

• persistent severe pain;
• amyotrophy;
• curvature of the legs (in the form of the letter O or X);
• pronounced deformation of the joint;
• maximum limitation of motor activity (until complete immobility).

Gonarthrosis complicated by synovitis

Synovitis is an inflammatory process, localized in the inner articular membrane.Most often synovitis complicates the second degree of the disease, manifested by a significant increase in the joint due to an increase in synovial fluid synthesis due to inflammation. There are also increased pain syndrome hyperemia (redness) and hyperthermia (local temperature increase).

The third stage of gonarthrosis is almost always complicated by synovitis, which aggravates the change in the shape of bones and increases the severity of the pain syndrome.

Different treatments

Treatment of deforming osteoarthritis should be complex, and therapeutic methods are selected individually depending on the clinical manifestations, the stage of evolution of the process and the state of human health generally.

Medication Therapy

When gonarthrosis, drugs that have anti-inflammatory and analgesic effects (non-steroidal and hormonal depending on the stage of development and severity of pain syndrome) are used.Medications are prescribed in tableted, injectable form in the form of ointments, gels or creams.

The second group of drugs used in the first and second stages of the disease are chondroprotectors.

Adaptations for orthopedic treatment

Orthopedic treatment is called, aimed at reducing the burden on the knees with the help of various devices:

• orthoses - hard knee pads, worn during movement to limit it;
• orthopedic insoles in shoes;
• cane or crutches.

Any orthopedic device is selected individually according to strict medical indications.

Operative methods of treatment

Surgical treatment is used in the late stages, when conservative techniques do not give positive results and consists in replacing the knee joint with an artificial analog (endoprosthetics).This operation is possible only if gonarthrosis is not accompanied by increased brittleness of bone tissue (osteoporosis).

Physiotherapy and other complementary therapies

The complex of therapeutic measures for gonarthrosis also includes:

• the appointment of massage or manual therapy;
• acupuncture (acupuncture);
• hirudotherapy;
• physiotherapeutic procedures, such as laser therapy, warming procedures using paraffin, therapeutic mud or ozocerite, cryotherapy, UHF, electrophoresis, diadynamic therapy, magnetotherapy;
• complex of therapeutic gymnastics.

To prevent the development of the disease, it is necessary to systematically play sports, exclude increased loads on the knee joint, normalize weight, and timely treat diseases and injuries.