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Treatment of knee joint arthrosis (gonarthrosis).

With advancing age, the vast majority of people are faced with the acute question of how to treat arthrosis of the knee joint, with characteristic symptoms,arthrosis of the knee jointinherent in the various stages of this disease.This includes the appearance of swelling in the area of the knee, redness of the skin around the swelling, squeaking and rustling that can be heard quietly when the knee moves, especially when squatting, and a pain syndrome of varying intensity.Pain may appear immediately after normal, everyday physical activity or exercise of a duration and intensity that is inappropriate for the age.When we touch on the root causes of pain, we must keep in mind that its appearance can also be caused by the following:

  • Inflammatory process in the knee joint.In other words, it should be a consequence of arthritis.It occurs as an independent pathology or as a complication of other diseases.
  • Arthrosis is a degenerative process during which the tissues of the joint die, lose mobility, and if the course of arthrosis is prolonged, it also causes deformation of the joint.
  • Injuries.It is most often caused by a fall, hitting the knee, or hitting the knee on a hard surface.The joint may be deformed.
  • Damage to the taste buds.The ligaments hold the joint in the correct position, preventing it from moving.But if they are damaged (stretched, displaced, torn), the joint also suffers - with severe pain and the appearance of a tumor.In order to avoid aggravation of the injury, urgent medical care and rest of the injured leg are required in such cases.
  • Damage to the meniscus of the patella.This protruding, round, movable cartilage in the knee can also be damaged when squatting or turning sharply.It is not always visible visually due to the swelling of the knee joint that often occurs in such cases.The accurate diagnosis is carried out by an experienced specialist using ultrasound, X-ray and palpation.
  • Popliteal cyst (Becker cyst).As a result of the inflammation, fluid is formed in the joint, which accumulates on the inner side of the popliteal fossa, in the area of the tendons.
  • Inflammation of ligaments and tendons (tendinitis).They cause unpleasant, painful sensations along the ligaments and are accompanied by swelling.The pain intensifies when the knee is used (flexion and extension), radiates along the muscles along the ligaments and nerves, above the knee, into the ligaments and muscles of the hamstrings, and below it into the leg.
  • Ischemic pain due to impaired blood circulation in the knee joints.They can occur for a long time due to a sudden change in weather or severe hypothermia.For example, sailors who work for long periods at high (Arctic) latitudes.In most cases, the localization of pain is symmetrical, equally intense, and does not affect joint mobility in the first stage.

The worst mistake in such cases would be to ignore the pain and hope that if we just rest, it will "go away by itself."Only a specialist can give recommendations for treatment and establish the correct diagnosis, therefore home treatment of arthrosis of the knee joint is unacceptable, only on the advice of "conscious people", and even purely with the help of traditional medicine.Effective treatment is only possible with a combination of drugs in the form of tablets, rubbing, ointments and physiotherapy.Sometimes, in severe or advanced cases, surgery cannot be avoided.

Making a diagnosis

The orthopedic surgeon can determine arthrosis of the knee joint based on movement tests and medical history.As a rule, the following procedures are prescribed as a supplement to diagnostics:

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

The information obtained is compiled into a general anamnesis, and it is only on this basis that complete and effective treatment can begin.

How to treat gonarthrosis?

Restoring joint mobility is not a matter of a month.The treatment is complex, expensive due to the high cost of drugs, and the result depends only on how much the patient wants to cooperate with the doctor and strictly follows all medical recommendations and prescriptions.

But first.What needs to be done is to reduce the load on the affected joint(s) immediately.If the job involves such stress, discuss with management (with medical records in hand if necessary) about changing the type of activity.For a while or forever - life will tell.Although initially, bed rest may often be necessary for the initial restoration of joint function.Remember: the joint is not a muscle, you cannot "work it out" with intensive training, it will only make the situation worse.Later, after the most acute inflammation subsides, it may be necessary to revive life with intensive movements.But even when increasing the load, support devices should be used: elastic, flexible bandages, sticks, crutches, etc.in the form ofSometimes you cannot do without special orthopedic insoles or even unique orthopedic shoes.

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

Do not warm up painful joints in arthrosis!On the contrary, apply an ice pack to the inflamed area - this will help reduce 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 question is only the effectiveness of the drug, but you should try to use proven and certified drugs for treatment.Preferably internationally recognized.

In the case of certain types and degrees of joint damage, the application and permanent (or temporary) wearing of a tightening bandage that secures the joint can help.But this measure should be used only if the method has been approved by the attending physician, since in the case of certain types of arthrosis, wearing such a bandage can aggravate the course of the disease.

You cannot completely immobilize yourself when you have knee pain.Moreover, in the case of certain types of inflammation, moderate physical activity is only good for the joint.An orthopedic doctor will tell you when and how much you should exercise.In addition, the complete passivity of physical activity causes weight gain, and this further aggravates the situation, burdening the joint.

Drug treatment is usually combined with the most favorable physiotherapy courses for the treatment of arthrosis: magnet and laser therapy (coherent laser radiation is used at a safe frequency), mechanical vibration and ultrasound therapy, deep tissue microwave equipment - if this is therapeutically justified.

During the diagnosis, three degrees of arthrosis of the knee joint are distinguished.

Arthrosis I degree

The mildest stage of the disease.It is characterized by the fact that the treatment does not require a high degree of medicinal influence, the list of medicines is small, and measures involving physical therapy, massage, and movement therapy 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 makes the use of glucocorticosteroids unnecessary during the treatment, which cause many side effects.

Arthrosis II degree

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

Recommendations: reducing the load on the affected joint, limiting walking, avoiding movements related to squatting.A special orthosis may be prescribed for the knee joint - devices that fix the joint and severely limit mobility.

In the medical arsenal for the treatment of secondary arthrosis, together with glucosamine and chondroitin chondroprotectors, there may be steroid drugs and anti-inflammatory non-steroids.It is possible to inject hyaluronic acid and other drugs into the joint capsule to facilitate the sliding of the cartilage surfaces relative to each other.

A special diet with excess collagen is prescribed: jellied meat, jelly, aspic and confectionery products - gelatin soufflé.It is useful to include fish oil in the diet.

Arthrosis III degree

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

Gonarthrosis of the knee joint

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

A completely different picture emerges when a person reaches the age of 50 - when the elasticity of the ligaments is lost, the drying processes of the tissues begin, and the metabolism slows down.

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

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

Possible onset of the disease

The knee joint, located between the tibia and femur, bears perhaps one of the heaviest loads in the human body.An example of this is regular running on a hard (mostly asphalt) surface: each step of such running causes a shock-like load on the knee joint.

This joint also includes the largest movable sesamoid bone - the patella, which is located at the crown of the tendons of the quadriceps femoris muscle.The articular surfaces are covered by a thick cartilaginous membrane of up to 2.5 mm, which consists of cartilage cells.Medicines with the generic name chondroprotectors help restore these cartilage tissue cells, which are primarily affected by gonarthrosis.

There are primary and secondary arthrosis of the knee joints.The etymology of the first is not fully known and there may be various reasons for this.When - from a sedentary lifestyle, and when, conversely, from too much physical activity.Poor ecology, excess weight, and smoking or alcohol addiction can also have an effect.Doctors consider the identification of the first stage of arthrosis a great success, since the cause of the pathology is difficult to analyze.

Regular hypothermia of the legs can also provoke the development of the disease.Therefore, it is better if people prone to such diseases do not choose professions related to cold (refrigerators, navy working in northern latitudes), etc.

The frequent development of gonarthrosis in women over 45 is associated with the long-term use of contraceptives due to a decrease in the natural synthesis of estrogen.It often occurs during menopause or under the influence of gynecological diseases, such as fibroids, fibroadenomas, endometriosis, endometrial hyperplasia.In women, gonarthrosis is often provoked by strict dieting, during 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:

  • Defects in tissue development and formation;
  • The effect of neurodystrophic processes in the cervical and lumbar spine;
  • Arthritis of the knee joint;
  • His injuries and microtraumas;
  • Meniscectomy, i.e. surgical removal of the meniscus;
  • Hormonal imbalance and endocrine chronic diseases;
  • Heavy and constant physical activity, including sports.In order to prevent joint injuries after the age of 40, it is better to significantly limit and later abandon exercises related to extreme loading of the knee joint (in the form of running on hard surfaces or heavy squatting);
  • 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 grade)

  • Stiffness of the knee joint in the morning;
  • The appearance of pain in the knee when walking one and a half kilometers;
  • Pain in the joint after standing for a long time (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 during the first half of the night while sleeping.

The most serious attention should be paid to these signs, because if you do not consult a doctor during this period, the disease progresses rapidly, which leads to the second stage of the disease.

Goranthrosis grade II

What is typical:

  • Pain at night, as well as pain in the first minutes of the morning when getting out of bed.
  • Pain when climbing stairs.
  • Public transport option with restrictions.
  • Mild lameness.
  • Occurrence of pain when moving at a distance of 800-1000 meters.
  • Limited self-care ability.

Often, measures that simply increase the production of synovial fluid in the joint are an effective way to cure the second degree of gonarthrosis.

Goranthrosis III.degree

Characteristic:

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

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

The choice of drugs and treatment methods depends not only on the degree of damage to the cartilage tissue, but also on the age of the patient, the tolerability of certain drugs and the methods of influencing physiotherapy.

During diagnosis, a distinction is often made between unilateral and bilateral arthrosis, and unilateral arthrosis between right and left arthrosis.The latter is often diagnosed in left-handed people.

Nutrition in case of gonarthrosis

First, doctors advise that red meat and offal, such as liver, be excluded from the diet.Preference should be given to fruits and vegetables, cereals with a high gluten and fiber content, salt and sugar free.As well as fermented milk products, fish and nuts.

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

Breakfast should be the most abundant - it brings the body to work and preserves strength until lunch.

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

Don't give up jellied meats.Delivery of collagen to the body and joints - the raw material for the construction of cartilage tissue.

Drink at least 2 liters of fluids a day: water and/or natural fruit juices.

Remove from your diet:

  • Red meat;
  • Pork fat, any smoked meat;
  • Everything is spicy;
  • Semi-finished products of unknown origin;
  • carbonated drinks with sugar;
  • Vegetables: white cabbage, tomato, red bell pepper.
  • Potatoes because they are high in calories (carbohydrates!) and help with excess 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 kinds of massages in the treatment of knee arthrosis.

One advanced treatment method is the intra-articular injection of hyaluronic acid.They compensate for the lack of production of own hyaluronic acid, which serves as a lubricant for the surface of the joint and protects it from wear.The effect of this procedure can be felt on the first day.The effect of an injection lasts an average of one month.Patients in the advanced stages of arthrosis significantly reduce the pain that has been tormenting them for many years in the first days, and those with moderate, 1-2 degree disease forget the pain completely for about six months after 5 injections in most cases.