Treatment of arthrosis of the knee joint (gonarthrosis)

Over the years, the vast majority of people face the acute question of how to treat arthrosis of the knee joint, with typical symptoms,characteristic of this disease in different stages.These include the appearance of swelling in the knee area, redness around these swellings, squeaking and rustling, which are clearly heard in silence when the knee moves, especially during squats, and a distinct pain syndrome of varying intensity.The pain may appear immediately after normal, daily physical activity or after physical exercise that is not appropriate for the age in terms of duration and intensity.When we talk about the basic causes of this pain, we must remember that its appearance can also be the result of:

• Inflammatory process in the knee joint.That is, to be the result of arthritis.It occurs as an independent pathology or as a complication of other diseases.
• Arthrosis is a degenerative process in which joint tissue is destroyed, it loses mobility, and if the course of arthrosis is prolonged, joint deformation occurs.
• Injuries.It most often occurs from a fall, a blow to the knee or a knee strike on a hard surface.The joint can be deformed.
• Ligament damage.Ligaments hold the joint in the correct position, preventing it from moving.But when they are damaged (stretched, displaced, ruptured), the joint also suffers - with severe pain and the appearance of tumors.In order for the injury not to worsen, in such cases, emergency medical assistance and rest of the injured leg are required.
• Damage to the meniscus of the kneecap.This protruding, round, mobile cartilage in the knee can be injured even when you squat or turn suddenly.It is not always detected visually due to the swelling of the knee joint that often occurs in such cases.An accurate diagnosis is made by ultrasound, X-ray and palpation by an experienced specialist.
• Popliteal cyst (Becker's cyst).As a result of inflammation, fluid is created 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 to the area along the muscles along the ligaments and nerves, above the knee, to the femoral ligaments and muscles, and below - to the lower leg.
• Ischemic pain, caused by impaired blood circulation in the knee joints.They can appear due to a sudden change in weather, severe hypothermia for a long time.Examples are sailors who work long hours at high (Arctic) latitudes.In most cases, the localization of the pain is symmetrical, equally intense and in the first phase does not affect the mobility of the joint.

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, therefore it is unacceptable to treat arthrosis of the knee joint at home only on the advice of "convinced people", and even exclusively with traditional medicine.Effective treatment is possible only with a combination of drugs in the form of tablets, rubs, ointments and the use of physiotherapy.Sometimes, in severe or advanced cases, surgery cannot be avoided.

Establishing a diagnosis

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

• Related to laboratory tests, such as biochemical tests of blood and bacterial microflora, smear, puncture of joint fluid and/or bone marrow, serological analysis, i.e. study of the presence of antibodies and antigens contained in blood serum.
• Instrumental studies, which may include ultrasound, magnetic resonance, densitometry and others.
• Examination of the internal joint capsule with an arthroscope - a device for a minimally invasive procedure for penetrating the cavity through an incision.Most often, this method is used after damage to the meniscus or in the case of 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, extraneous sounds in the form of screeching, rustling and clicking are clearly heard in the joint.

The obtained data are combined into a general anamnesis and only on the basis of them can complete and effective treatment be started.

How to treat gonarthrosis?

Restoring joint mobility is not a matter of one month.Treatment is complex, expensive due to the high price of drugs, and the result depends only on the patient's desire to cooperate with the doctor and strict adherence to 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 job involves such stress, negotiate with management (if necessary, with medical notes in hand) to change the type of activity.For a while or forever - life will tell.Although often initially, bed rest may be necessary for the initial restoration of joint function.Remember: the joint is not a muscle, you cannot "work" it with intense exercise, it will only make it worse.Activation of life with intense movements may be needed later, after the most acute inflammation has subsided.But even when increasing the load, you must use means of support in the form of elastic elastic bandages, a stick, a 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 the doctor - hodroprotectors, painkillers and anti-inflammatory drugs.Depending on the degree of joint damage and the type of inflammation, the doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs).But despite their effectiveness in relieving symptoms, they do not eliminate the causes of the disease.

Do not heat painful joints in arthrosis!On the contrary, put an ice pack on the inflamed 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 take place slowly but surely.The question is only the effectiveness of the drug, but for treatment you should try to use tested and certified drugs.Preferably internationally recognized.

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

You cannot completely immobilize yourself if you have knee pain.Moreover, with some types of inflammation, moderate physical activity only benefits the joint.The orthopedic doctor will tell you when and how much to exercise.Moreover, complete passivity in terms of physical activity will cause weight gain, and this will further worsen the situation, stressing the joint.

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

Three stages of arthrosis of the knee joint are distinguished in the diagnosis.

Arthrosis of the first degree

The mildest degree of the disease.It is characterized by the fact that the treatment does not require a large degree of medicinal effect, the list of medicines is small, and the measures of physiotherapy, massage and exercise help a lot.Laser therapy is considered one of the most effective methods, 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 treatment, which cause many side effects.

Arthrosis II degree

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

Recommendations: reduce the load on the affected joint, limit walking, avoid any movements associated with 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, in addition to chondroprotectors with glucosamine and chondroitin, steroid drugs and anti-inflammatory non-steroids may also 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 excess collagen is prescribed: jelly, jelly, aspic, and from confectionery - 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 medication is increased 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 organic damage to the knee joint is caused by extreme circumstances and is in no way related to the aging of the organism.

A completely different picture emerges when a person turns 50 years old - when the flexibility of the ligaments is lost, the 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 degrees I, II and III.

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

Possible occurrence of disease

Located between the tibia and femur bones, the knee joint bears perhaps one of the heaviest loads in the human body.An example would be regular running on a hard (most often asphalt) surface: every step in such running causes impact load on the knee joint.

This joint also includes the largest sesamoid movable bone - the patella, which is located on 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 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 understood and may have various reasons.When - from a sedentary lifestyle, and when, conversely, from too much physical activity.Poor ecology, excess weight and addiction to smoking or alcohol can also have an impact.Doctors consider the identification of the first stage of arthrosis a great success, because the cause of the pathology is difficult to analyze.

Regular hypothermia of the feet can also cause the appearance of the disease.Therefore, it is better for people prone to such diseases not to choose occupations related to cold (refrigerators, navy working in northern latitudes), etc.

In women over the age of 45, the frequent development of gonarthrosis is associated with the long-term use of contraceptives due to the reduction of natural estrogen synthesis.It often occurs during menopause or under the influence of gynecological diseases such as fibroids, fibroadenomas, endometriosis, endometrial hyperplasia.Often, gonarthrosis in women is caused by strict weight loss diets, 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 a consequence of:

• Defects in tissue development and formation;
• The influence 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.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 squats with loads);
• 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 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 in the first half of the night during sleep.

The most serious attention should be paid to these signs, 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:

• Night pain, as well as pain in the first minutes of the morning when getting out of bed.
• Pain when walking up stairs.
• The possibility of using public transport with restrictions.
• Mild lameness.
• Occurrence of pain when moving at a distance of up to 800-1000 meters.
• Limited ability to care for oneself.

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

Goranthrosis III degree

Characterized by:

• 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 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 moving the joint.

The affected joint develops ankylosis, a condition in which the articular ends of adjacent opposite bones fuse together.The leg completely loses mobility, and the only way to get it back is by replacing 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 influence.

When establishing a diagnosis, a distinction is often made between unilateral and bilateral arthrosis, and 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 red meat and offal such as liver from the diet.Priority should be given to fruits and vegetables, cereals with a high gluten and fiber content, without salt and sugar.As well as fermented dairy products, fish and nuts.

The last time you eat food should not be later than 7 pm.The frequency of food intake may remain known, as it has developed over many years.But it is better to eat in fractions - in small portions 5-6 times a day in the morning.

Breakfast should be as abundant as possible - it sets the body for work and maintains strength until lunch.

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

Don't give up on jelly.Transferring collagen to the body and joints - the raw material for building cartilage tissue.

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

Exclude from your diet:

• Red meat;
• Pork fat, smoked meat of any kind;
• Everything is spicy;
• Semi-finished products of unknown origin;
• Carbonated drinks with sugar;
• Vegetables: white cabbage, tomato, red pepper.
• Potatoes because they are high in calories (carbohydrates!) and help you gain extra pounds.Therefore, the Dukan diet will be relevant.

Treatment of gonarthrosis in a sanatorium

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

One of the advanced methods of treatment are intra-articular injections 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 the 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.