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Treatment of arthrosis of the knee joint (gonarthrosis)

With age, the majority of people are faced with the acute question of how to treat arthrosis of the knee joint with typical symptoms,arthrosis of the knee jointinherent in this disease in its various stages.This includes the appearance of swelling in the knee area, redness around these swellings, creaking and rustling, clearly audible in silence when the knee moves, especially during squatting, and a distinct pain syndrome of varying degrees of intensity.The pain may occur immediately after normal, everyday physical activity or after physical exertion that is age-inappropriate in duration and intensity.When we touch on the main causes of this pain, we must keep in mind that its appearance can also be the result of:

  • Inflammatory process in the knee joint.That is, to be a consequence of arthritis.It occurs as an independent pathology or as a complication of other diseases.
  • Arthrosis is a degenerative process in which the tissues of the joint are destroyed, it loses mobility, and if the course of arthrosis is prolonged, it also causes deformation of the joint.
  • Injuries.It is most commonly caused by a fall, a blow to the knee, or a bump with the knee on a hard surface.The joint can be deformed.
  • Damage to links.The ligaments hold the joint in the correct position, preventing its movement. But when they are damaged (stretching, displacement, rupture), the joint also suffers - with severe pain and the appearance of a tumor.In order not to worsen the injury, in such cases, urgent medical assistance and rest of the injured leg is necessary.
  • Damage to the meniscus of the knee cap.This bulging, round, movable cartilage in the knee can be injured even by squatting or twisting.It is not always visually detected due to swelling of the knee joint, which often occurs in such cases.The exact diagnosis is made with the help of ultrasound, X-rays and palpation by an experienced specialist.
  • Popliteal cyst (Becker's cyst).As a result of the inflammation, fluid is formed in the joint, which accumulates on the inside of the popliteal fossa, in the area of the tendons.
  • Inflammation of ligaments and tendons (tendinitis).They cause unpleasant, painful sensations localized along the ligaments and are accompanied by swelling.The pain intensifies when using the knee (flexion and extension), radiates in the area of the muscles along the ligaments and nerves, above the knee, in the femoral ligaments and muscles, and below - in the lower leg.
  • Ischemic pain, from impaired blood circulation in the knee joints.They can appear from a sudden change in weather, severe hypothermia for a long time.Examples are sailors who work for long periods in high (Arctic) latitudes.In most cases, the localization of the pain is symmetrical, equally intense, and at the first stage does not affect the mobility of the joints.

The most serious mistake in such cases would be to ignore the pain and hope that if you just rest, "everything will go away by itself."Only a specialist can give recommendations for treatment and make a correct diagnosis, which is why it is unacceptable to treat arthrosis of the knee joint at home only on the basis of advice from "people in the know" and even with the help of traditional medicine.Effective treatment is possible only with a combination of drugs in the form of tablets, rubbing, ointments and the use of physiotherapy.Sometimes, in severe or advanced cases, surgery cannot be avoided.

Making a diagnosis

An orthopedic surgeon can make a diagnosis of knee osteoarthritis after range of motion tests and a medical history.In addition to diagnostics, the following procedures are usually prescribed:

  • Related to laboratory tests, such as biochemical blood test and bacterial microflora, Pap smear, puncture of joint fluid and/or bone marrow, serological analysis, i.e.examination for the presence of antibodies and antigens contained in the blood serum.
  • Instrumental studies, which may include ultrasound, nuclear magnetic resonance, densitometry and others.
  • Examination of the internal joint capsule with an arthroscope - a device for a minimally invasive procedure to penetrate the cavity through an incision.Most often, this method is used after damage to the meniscus or with cracks and severe wear of the cartilage tissue, as well as for the restoration of the anterior cruciate ligaments.Although recently the antroscope is rarely used as a diagnostic tool, it has been successfully replaced by a completely non-invasive diagnostic method using MRI.
  • Only "by ear" - with a joint lesion of the 3rd degree, external sounds are clearly heard in the joint in the form of creaking, rustling and clicking.

The information received is combined into a general history and only on its basis can complete and effective treatment begin.

How to treat gonarthrosis?

Restoring joint mobility is not a matter of a month.Treatment is complicated, expensive due to the high cost of drugs, and the result depends only on the patient's willingness to cooperate with the doctor and strict compliance with all medical recommendations and prescriptions.

But first.What needs to be done is to immediately reduce the load on the affected joint(s).If the work is associated with such stress, negotiate with management (if necessary, with doctor's notes) to change your type of activity.For a while or forever - life will show.Although bed rest may often be required at first for the initial recovery of joint function.Remember: a joint is not a muscle, you cannot "work it out" with intense exercises, it will only make the situation worse.Activation of life with intense movements may be necessary later, after the most acute inflammation has subsided.But even when increasing the load, you should use means of support in the form of elastic elastic bandages, cane, crutch, etc.Sometimes you can't do without special orthopedic insoles or even custom-made orthopedic shoes.

Treatment of arthrosis of the knee joint is also possible at home, using outpatient drugs prescribed by a doctor - hodoprotectors, pain relievers and anti-inflammatory drugs.Depending on the degree of damage to the joint and the type of inflammation, the doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs).But for all their effectiveness in relieving symptoms, they do not eliminate the causes of the disease.

Do not heat the diseased joints in case of arthrosis!On the contrary, apply an ice pack to the sore area - this will help relieve swelling, redness and inflammation.

The use of chondroprotectors, on the contrary, does not relieve pain.But the restoration of cartilage tissue will proceed slowly but surely.The only question is the effectiveness of the drug, but you should try to use proven and certified drugs for treatment.Preferably internationally recognized.

For some types and degrees of joint damage, the placement and permanent (or temporary) wearing of a compression bandage that fixes the joint can help.But this measure should be used only if the method is approved by the attending physician, because in some types of arthrosis, wearing such a bandage can worsen the course of the disease.

You cannot completely immobilize if you have knee pain.In addition, with some types of inflammation, moderate physical activity is beneficial only for the joint.An orthopedist will tell you when and how much to exercise.In addition, complete passivity in terms of physical activity will lead to weight gain, and this will further worsen the situation, putting strain on the joint.

Drug treatment is usually combined with courses of physiotherapy, most favorable for the treatment of arthrosis: magnetic and laser therapy (coherent laser radiation is used at safe frequencies), mechanical vibration and ultrasound therapy, microwave installations with a deep impact on the tissue - when this is therapeutically justified.

In diagnostics, three degrees of arthrosis of the knee joint are distinguished.

Arthrosis I degree

The mildest degree of the disease.It is characterized by the fact that the treatment does not require a large degree of drug impact, the list of drugs is small, and measures including physiotherapy, massage and therapeutic exercises help well.One of the most effective methods is laser therapy, which significantly reduces pain, stimulates the regeneration of irradiated areas and reduces inflammation.In addition, the use of coherent radiation with a strictly defined wavelength eliminates the need to use glucocorticosteroids in the treatment, which causes many side effects.

Arthrosis II degree

It is characterized by more intense and acute processes of inflammation and degeneration of cartilage tissue.In the acute period, special drugs are prescribed, a special diet and physiotherapy designed for such cases are recommended.Physiotherapy and massage are excluded during these periods.

Recommendations: reduce the load on the affected joint, limit walking, avoid any movements related to squatting.Special orthoses can be prescribed for the knee joint - devices that fix the joint and severely limit its mobility.

In the medical arsenal for the treatment of arthrosis of the second degree, together with chondroprotectors with glucosamine and chondroitin, steroid drugs, as well as anti-inflammatory non-steroids, may be present.It is possible to inject hyaluronic acid and other drugs into the joint capsule to facilitate the gliding of the cartilage surfaces against each other.

A special diet with an excess of collagen is prescribed: jellied meat, jelly, aspic, and from confectionery products - gelatin souffle.Including fish oil in your diet is beneficial.

Arthrosis III degree

When the knee joint is affected by arthrosis of the third degree, the treatment does not differ much from the previous condition - except that the frequency of drug use increases with a slight shift to glucocorticosteroid hormones.If there are no results, surgery is required, followed by joint replacement.

Gonarthrosis of the knee joint

All of the above applies mainly to people of working age, when organic damage to the knee joint is caused by extreme circumstances and is in no way related to the aging of the body.

A completely different picture appears when a person is over 50 years old - when the flexibility of the ligaments is lost, processes of tissue dehydration begin and the metabolism slows down.

Under these conditions, the development of gonarthrosis begins - deforming arthrosis of varying severity.In the classification accepted in medicine, gonarthrosis of the knee joint is divided into I, II and III degrees.

This disease, once it starts, progresses very quickly.It refers to acquired age-related pathologies of the musculoskeletal system.To one degree or another, it is inherent in all patients after 50 - another thing is that by leading a healthy lifestyle and avoiding extreme physical exertion, the integrity of the cartilage layer in the joints can be preserved both after 70 and after 80 years.

Possible occurrence of the disease

Located between the tibia and femur, the knee joint in the human body bears perhaps one of the greatest loads.An example of this is regular running on a hard (most often asphalt) surface: each step during such running causes a shock load on the knee joint.

This joint also includes the largest sesamoid movable bone - the patella, located in the crown of the tendons of the quadriceps femoris muscle.The articular surfaces are covered with a thick, up to 2.5 mm, cartilage membrane consisting of chondrocytes.Medicines under the general name of chondroprotectors help to restore those cells of the cartilage tissue, which are mainly affected by gonarthrosis.

There is primary and secondary arthrosis of the knee joints.The etymology of the first is not fully understood and may have various causes.When - from a sedentary lifestyle, and when, on the contrary, from too much physical activity.Bad ecology, overweight and addiction to smoking or alcohol can also have an impact.Doctors believe that the identification of the first stage of arthrosis is a great success, since the cause of the pathology is difficult to analyze.

Regular hypothermia of the legs can also provoke the appearance of the disease.Therefore, it is better for people with a tendency to such diseases not to choose professions related to the cold (refrigerators, fleet working in northern latitudes), etc.

In women over 45 years of age, the frequent development of gonarthrosis is associated with long-term use of contraceptives due to a decrease in the natural synthesis of estrogen.It also often appears during menopause or under the influence of gynecological diseases such as fibroids, fibroadenomas, endometriosis, endometrial hyperplasia.Often in women, gonarthrosis is also provoked by strict weight loss diets, in which many useful minerals and vitamins are removed from the diet.

It is much easier to decide on ways to influence secondary arthrosis, which can be a consequence of:

  • Defects in the development and formation of tissues;
  • Influence of neurodystrophic processes in the cervical and lumbar vertebrae;
  • Arthritis of the knee joint;
  • His injuries and microtraumas;
  • Menisectomy, that is, surgical removal of the meniscus;
  • Hormonal imbalance and endocrine chronic diseases;
  • Heavy and constant physical activity, including sports.To prevent joint injuries after 40 years, it is better to significantly limit and later abandon all exercises associated with extreme loads on the knee joint (in the form of running on hard surfaces or squatting with a load);
  • Abnormal joint mobility.This condition occurs when the ligaments that hold the joint in the correct position are underdeveloped or naturally weak;
  • Stress and constant nervous tension.

Signs and symptoms of disease onset (stage or degree)

  • Stiffness of knee joint in morning;
  • The appearance of pain in the knee if you walk a distance of one and a half kilometers;
  • Joint pain after prolonged standing (even without movement);
  • Pain in the knee even after complete rest, up to 2 hours, in a sitting position;
  • Pain before going to bed or in the first half of the night during sleep.

These signs should be given the most serious attention, because if you do not consult a doctor during this period, the disease begins to progress rapidly, which leads to the second stage of the disease.

Goranthrosis II degree

Which is typical:

  • Nocturnal pain, as well as pain in the first minutes of the morning when getting out of bed.
  • Pain when climbing stairs.
  • Possibility of using public transport with restrictions.
  • Mild lameness.
  • The appearance of pain when moving at a distance of up to 800-1000 meters.
  • Limited self-service ability.

Often, measures to simply increase the production of synovial fluid from the joint become an effective way to cure even the second degree of gonarthrosis.

Goranthrosis III degree

It is characterized by:

  • pain that begins immediately after rest or appears after 500 meters of quiet movement;
  • severe lameness, when the help of improvised means (canes, crutches) is required;
  • stiffness after waking up to half an hour or even more;
  • inability to climb stairs or enter high-level vehicles independently or without assistance;
  • night pain even without movement of the joint.

The affected joint develops ankylosis, a condition in which the articular ends of adjacent opposing bones fuse together.The leg completely loses its mobility, and the only way to get it back is to replace the joint with an artificial one.

The choice of drugs and treatment methods depends not only on the degree of cartilage tissue damage, but also on the patient's age, his ability to tolerate certain drugs and physiotherapeutic methods of impact.

When diagnosing, a distinction is often made between unilateral and bilateral arthrosis, as well as between unilateral, right and left arthrosis.The latter is often diagnosed in left-handed people.

Nutrition for gonarthrosis

First of all, doctors advise to exclude from the diet red meat and offal such as liver.Priority should be given to fruits and vegetables, cereals with a high content of gluten and fiber, without salt and sugar.As well as fermented dairy products, fish and nuts.

The last time you eat food should be no later than 19:00.The frequency of food intake may remain familiar as it has evolved over many years.But it is better to eat in portions - in small portions 5-6 times a day in the morning.

Breakfast should be the most plentiful - it sets the body up for work and maintains strength until lunch.

If, especially at the beginning, the feeling of hunger becomes unbearable, soothe your stomach - eat an apple or chew a carrot.Just don't eat high-calorie bananas and grapes!

Don't give up the jellied meat.Transporting collagen to the body and joints - the raw material for building cartilage tissue.

Drink at least 2 liters of fluid per day: water and/or natural juices.

Exclude from your diet:

  • Red meat;
  • Lard, smoked meats of all kinds;
  • Everything is spicy;
  • Semi-finished products of unknown origin;
  • Aerated drinks with sugar;
  • Vegetables: white cabbage, tomatoes, red peppers.
  • Potatoes because they are high in calories (carbs!) and help you gain weight.Therefore, the Dukan diet will be relevant.

Treatment of gonarthrosis in a sanatorium

The institution uses a wide range of physiotherapy, mud therapy, acupuncture and all types of massages as methods of treating knee arthrosis.

One of the modern methods of treatment is the intra-articular injection of hyaluronic acid.They compensate for the lack of production of own hyaluronic acid, which serves as a lubricating element for the surface of the joint and protects it from abrasion.The effect of this procedure is felt already on the first day.The effect of one injection lasts an average of one month.Patients in an advanced stage of arthrosis feel a significant reduction in the pain that has tormented them for many years already in the first days, and people with a moderate course of the disease, grade 1-2, after a course of 5 injections, in most cases forget about the pain completely for about six months.