If a crunch is heard in the knee joint during movement, this is the first sign of gonarthrosis. Conservative methods of traditional and alternative medicine will help prevent cartilage destruction and maintain normal motor function. Treatment must begin immediately; only in this case, rheumatologists give a favorable prognosis.
What is gonarthrosis?
A non-inflammatory, degenerative-dystrophic disease that affects the largest joint, the knee, is called gonarthrosis. A rather unusual medical definition, it has a simpler "folk" concept - "salt deposition". Although the clinical picture of gonarthrosis of the joints has little to do with an excess of calcified salts in the knee joint. They have no effect on pathology and are a side effect of impaired metabolism.
The development of gonarthrosis of the knee joint is facilitated by negative processes in the hyaline cartilage, primarily poor blood circulation in the small bone vessels. The lack of nutrients and oxygen carried by the lymphatic flow leads to the destruction of the outer layer of the knee cartilage.
In the early stages, the disease is extremely difficult to recognize. Joint deformity occurs slowly, until the vitreous hyaline cartilage is introduced into the process. The anatomical structure of the ligament is modified. Cloudiness occurs, the tissue thickens, thins, cracks in all directions. The result of the pathology can be the complete disappearance of the cartilage, which leads to neoplasms in the bone tissue and irreversible curvature of the knee.
Disease classification
The International Classification of Diseases divides gonarthrosis into seven clarifying subheadings:
- Bilateral primary gonarthrosis. The diagnosis is most often made in women aged 70 to 74 years and men aged 60 to 64 years. This puts the disease in the "elderly" category.
- Other primary gonarthrosis. Pathology of a knee joint, due to natural wear or in the context of other diseases.
- Bilateral post-traumatic gonarthrosis. It affects people of different age categories with severe leg injuries.
- Other post-traumatic gonarthroses. Unilateral, in the context of injuries and contusions of the extremity.
- Other secondary gonarthroses are bilateral. They are the result of chronic bruises, fractures or dislocations, not completely healed. It is most often diagnosed in athletes who have heavy loads on both legs - football players, athletes, figure skaters.
- Other secondary gonarthroses. Unilateral development of pathology associated with the profession. For example, miners, metallurgists, fishermen.
- Gonarthrosis, unspecified. It is diagnosed with an unexplained etiology of the disease, after excluding age, occupation, and genetic predisposition.
According to medical statistics, more than 10 million people of different age groups suffer from gonarthrosis of one kind or another. Every year about 3 thousand people die with an established diagnosis.
Causes
Osteoarthritis of the knee joint develops due to impaired metabolism in the knee joint, which leads to a loss of smoothness and elasticity of the cartilage.
Destructive processes are caused by various reasons:
- Diseases of the thyroid gland, which violate the hormonal background;
- Decreased permeability of blood vessels in the knee joint;
- genetic conditioning;
- natural aging;
- Past or present knee injuries, of various origins;
- Obesity (more than 20% of the norm), which puts a lot of pressure on the knee joint;
- Inflammatory diseases of the joints (polyarthritis, purulent arthrosis);
- autoimmune diseases (rheumatoid arthritis);
- Specific infectious pathologies (syphilis, tuberculosis, encephalitis);
- Living in ecologically unfavorable areas, poor quality of food and water.
Also, rheumatologists identify several additional reasons that lead to the development of gonarthrosis. Dysplasia in newborns. With this diagnosis, the joint wears out faster. Changes in the structure of collagen lead to violations of the protein located in the connective tissue.
Symptoms according to the degree of gonarthrosis
It is difficult to diagnose the initial stage of knee osteoarthritis. Only a description of the symptoms by the patients themselves and external examinations by rheumatologists make it possible to draw up a clinical picture that differs for each degree of gonarthrosis progression:
- I grade gonarthrosis.Drawing pain in the knee, a feeling of some stiffness, partial loss of sensation, difficulty bending the leg, especially after prolonged immobility, the inability to walk or run for a long time, the appearance of slight swelling. As a rule, the symptoms disappear after rest or simple anesthesia.
- II degree gonarthrosis.At this stage, it is already possible to determine the pathology on an X-ray examination. The pain becomes stronger and occurs after each physical activity. The discomfort can still be relieved with rest. In the morning it becomes more difficult to straighten the legs, it takes some time to restore motor function. The discomfort is complemented by frequent calf cramps, especially at night. During movement, a cracking sound is heard. The swelling of the knee joint is pronounced. There are visible signs of limb deformity.
- III degree of gonarthrosis.There are irreversible changes in the knee joint. Cartilage abnormalities can be unequivocally determined on an X-ray. The pain in the knee becomes constant, sharp. The leg stops bending at the knee. The patient cannot walk without a cane or crutches. The swelling is important. The anatomical shape of the knee is smoothed and takes on a solid appearance. There is a primary curvature of the spine.
Diagnosis
To make a correct diagnosis, a combination of clinical manifestations of arthrosis of the knee joint and patient complaints is used. To clarify or exclude the causes of the disease, studies are carried out in various ways.
The standard diagnosis is as follows:
- Carrying out an anamnesis of the disease. History of concomitant diseases, genetic predisposition, past traumas and surgical interventions, professional activities, etc.
- External evaluation of the deformation of the musculoskeletal system. Gait, posture, state of the knee joint, curvature of the legs.
- General inspection. Palpation of the lower leg, thigh, damaged joint, determination of the localization of the disease.
- Lab tests. A general blood test gives data on the absence of an inflammatory process. If the process is present against the background of other diseases, an increased rate of erythrocyte sedimentation in the blood will be found. The level of protein, globulin and fibrinogen will differ from the normative indicators. The biochemical composition will remain within standard limits. If the progress of the pathology is in the final stages, a biopsy of the synovial fluid of the knee joint is performed.
- Instrumental research. Radiography is the main and most common method for diagnosing suspected gonarthrosis. As a rule, a rheumatologist can easily determine changes in the structure of bone tissue from an image that is already at the beginning of stage 2 of the disease. The presence of secondary diseases and the causes of their occurrence are diagnosed with the help of the most modern and accurate equipment: MRI, computed tomography, ultrasound, osteostincigraphy, thermography.
Treatment of gonarthrosis
Like all joint diseases, gonarthrosis requires systemic treatment, which should be started when the first symptoms appear. In this case, the prognosis of therapy becomes favorable and guarantees the return to a normal lifestyle in a fairly short time.
Comprehensive treatment is aimed at eliminating the main signs of the disease:
- Discomfort, pain syndrome and muscle tone;
- Improve the motor function of the knee joint;
- Stop the process of cartilage destruction;
- Strengthening of the connective muscles;
- Restoration of normal blood circulation in the knee joint.
medicines
anti-inflammatory drugs
They help to cope with pain, relieve swelling caused by inflammation of muscle tissue.
Chondroprotectors
Regeneration and restoration of cartilage tissue is impossible without chondroprotectors. They are the main component of conservative treatment.
Vasodilators
They are used to improve the permeability of intra-articular blood vessels.
hormonal drugs
Reduce the production of the hormone cortisone, to prevent the development of inflammatory processes.
hyaluronic acid injections
It is used to restore intra-articular synovial fluid. Due to this, the friction between the articular parts is reduced, motor function is normalized, and the elasticity of the cartilage tissue is restored.
antienzymatic agents
They inhibit the activity of trypsin, thus preventing further destruction of the joint. Appointed in the complex.
Physiotherapy
Physiological treatments have been used successfully for decades to treat osteoarthritis of the knee. It can be as a separate type of therapy, for prevention or during the rehabilitation period. So is an integrated approach to disease.
In most cases, a rheumatologist prescribes the following types of procedures:
- Electrophoresis with analgesics;
- ultrasound treatment;
- magnet therapy;
- laser exposure;
- paraffin applications;
- mud treatment;
- Therapeutic exercise (exercise therapy);
- Manual therapy, massage with medicinal ointments.
Surgery and prosthetics
If gonarthrosis is at an advanced stage, the knee joint and cartilage tissues are destroyed, it is impossible to do without a surgical operation. Otherwise, the person will be disabled for life.
Modern medicine offers several ways to solve the problem:
- Arthrodesis. Complete removal of the affected tissues and the knee joint. The body is freed from the focus of the disease, but the motor function of the limb is completely lost. It is used extremely rarely, if the patient has additional joint diseases.
- arthroscopy. Destroyed hyaline cartilage is removed. The operation is not very traumatic, it has a short rehabilitation period. It is indicated for patients whose evolution has not affected the knee joint itself.
- Periarticular osteomy. A complex operation, the essence of which is to file deformed bones and outgrowths, with subsequent connection to the necessary anatomical structure.
- endoprosthesisThe completely destroyed knee joint is removed and a titanium prosthesis is placed in its place. An effective method that allows you to forget about gonarthrosis forever. It requires careful preparation and long rehabilitation.
Traditional medicine
The use of folk recipes in combination with conservative treatment can relieve external symptoms (pain, swelling). Recipes based on laurel, burdock root, St. John's wort, malt and hay have proven their effectiveness. Ointments, creams, tinctures and decoctions are made from them.
These plants have anti-inflammatory and analgesic properties. It requires regular and long-term use to achieve visible results.
Ointments and compresses made on the basis of honey, with the addition of alcohol or apple cider vinegar, well relieve swelling and have a calming effect on the affected tissues.
A nutritious mixture is made from lemon and garlic, which is taken orally, one teaspoon of each, after breakfast and dinner. Such a recipe has a general strengthening effect on the body, increases the permeability of blood vessels and nourishes the joints with useful trace elements.
It must be remembered that home treatments do not eliminate the main problem - the pathological destruction of the knee joint.
Diet
Compliance with the diet is an integral part of complex treatment. Adjusting your diet will not only help control your weight, it will also provide your bones and joints with essential vitamins.
For a patient diagnosed with gonarthrosis, it is contraindicated:
- Fried, spicy, salty, pickled foods;
- fatty broths;
- sweet cakes;
- Fruits, with a high content of acid enzymes;
- Alcoholic drinks.
The menu should be replenished with raw vegetables, fruits and herbs, low-fat sour-milk products, bone broths, and dishes containing gelatin (gelatin, jelly).
Additional methods
For the treatment of gonarthrosis, it is necessary to undergo regular spa treatment, at least once a year, if possible more often. Hydrotherapy, mud therapy and manual therapy procedures manage to preserve the disease for a long time and prevent the destruction of the joint.
It will take the rest of your life to keep a sore knee in a stable condition. But it can turn out to be quite useful for the body as a whole. Reviewing nutrition, eliminating bad habits, playing sports, visiting resorts - the quality of life can be significantly improved.
It should be remembered that self-medication, ignoring the main symptoms and unbearable stress on the sore knee joint can quickly turn a healthy person into a helpless disabled person.