Treatment of arthrosis of the knee joint (gonarthrosis)

With age, the vast majority of people face the acute question of how to treat arthrosis of the knee joint, with typical symptoms,inherent in this disease in its various stages.This includes the appearance of swelling in the knee area, redness around these swellings, crackling and rustling, clearly audible in silence when the knee moves, especially during squats, and a distinct pain syndrome of varying degrees of intensity.The pain may appear immediately after normal, daily physical activity or after physical exercises that are age-inappropriate in duration and intensity.When we touch on the underlying 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 appears as an independent pathology or as a complication of other diseases.
• Arthrosis is a degenerative process during which joint tissues are destroyed, mobility is lost, and if the progress of arthrosis is prolonged, it also causes joint deformity.
• Injuries.It is most often caused by a fall, a blow to the knee, or a blow to the knee on a hard surface.The connection may be deformed.
• Ligament damage.Ligaments hold the joint in place, preventing it from moving.But when they are damaged (stretched, displaced, ruptured), 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 care and rest for the injured leg is needed.
• Damage to the meniscus of the knee cap.This prominent, round, mobile cartilage in the knee can also be injured when you sit down or turn hard.It is not always detected visually due to the swelling of the knee joint that often occurs in such cases.The correct diagnosis is made using ultrasound, x-ray and palpation by an experienced specialist.
• Popliteal cyst (Becker's cyst).As a result of inflammation, fluid forms 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 localized along the ligaments and are accompanied by swelling.The pain intensifies when the knee is used (bending and stretching), radiates to the area along the muscles along the ligaments and nerves, above the knee, in the ligaments and muscles of the femur, and below - in the lower part of the leg.
• Ischemic pain, from damaged 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 a long time in high latitudes (Arctic).In most cases, the localization of the pain is symmetrical, equally intense and in the first stage does not affect the mobility of the joints.

The worst 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 an accurate diagnosis, therefore it is unacceptable to treat arthrosis of the knee joint at home only on the advice of "knowledgeable people", even just using traditional medicine.Effective treatment is possible only with a combination of medications 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 osteoarthritis of the knee joint after range of motion tests and a medical history.The following procedures are usually prescribed as additional diagnostics:

• In relation to laboratory tests, such as biochemical analysis of blood and bacterial microflora, staining, puncture of joint fluids and/or bone marrow, serological analysis, i.e. a study of the presence of antibodies and antigens contained in the blood serum.
• Instrumental studies, which may include ultrasound, magnetic resonance imaging, densitometry, and others.
• Examination of the internal joint capsule using 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 with severe tears and wear of the cartilage tissue, as well as to restore the anterior cruciate ligaments.Although the antroscope has recently been rarely used as a diagnostic tool, it has been successfully replaced by a completely non-invasive diagnostic method using MRI.
• Simply "by ear" - with an articular lesion of the 3rd degree, external sounds in the form of crackles, rustling and clicking are clearly audible in the joints.

The information obtained 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.The treatment is complex, it is expensive due to the high cost of drugs, and the result depends only on the patient's desire 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 joints.If the work involves such stress, negotiate with management (if necessary, with doctor's notes in hand) to change the type of your activity.For a while or forever - life will tell.Although often initially, bed rest may be required for 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.Active life with vigorous movement may be required later, after the more acute inflammation has subsided.But even during increased load, you should use support tools in the form of elastic elastic bandages, cane, crutch, etc.Sometimes you cannot 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 medications prescribed by a doctor - chondroprotectors, pain relievers 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 the injured joints with arthrosis!Instead, apply an ice pack to the inflamed area - it 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.Internationally known preferred.

For some types and degrees of joint damage, the application and permanent (or temporary) placement of a compression bandage that adjusts the joint may help.But this measure should be used only if the method is approved by the attending physician, since 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.An orthopedic doctor will tell you when and how much you should exercise.Moreover, complete inactivity in terms of physical activity will cause weight gain and this will further aggravate the situation, loading the joint.

Drug treatment is usually combined with physiotherapy courses, the 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 deep tissue effects - when this is therapeutically justified.

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

Grade I arthrosis

The mildest degree of the disease.It is characterized by the fact that the treatment does not require a large degree of medicinal influence, the list of medications is small, and measures that include physiotherapy, massage and exercise therapy help well.One of the most effective methods is considered to be 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 treatment, which cause many side effects.

Grade II arthrosis

It is characterized by more intense and acute processes of inflammation and degeneration of cartilage tissue.In the acute period, special medications 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 any movement related to squatting.Special orthoses for the knee joint can be prescribed - devices that fix the joint and severely limit its mobility.

In the medical arsenal for the treatment of arthrosis of the second degree, along with chondroprotectors with glucosamine and chondroitin, steroidal and non-steroidal anti-inflammatory drugs 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 in relation to each other.

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

Grade III arthrosis

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 use of medications increases with a slight shift towards glucocorticosteroid hormones.If there are no results, there is a need for surgery 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 passes the age of 50 - 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 age-related acquired pathologies of the musculoskeletal system.To one degree or another, it is natural for all patients after 50 - another thing is that by leading a healthy lifestyle and avoiding extreme physical activity, the integrity of the cartilage layer in the joint can be preserved both after 70 and after 80 years.

Possible onset of the disease

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

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

There are primary and secondary arthrosis of the knee joints.The etymology of the former is not fully understood and may have various reasons.When - from a sedentary lifestyle, and when, conversely, from a lot of physical activity.Poor ecology, excess weight and addiction to tobacco or alcohol can also have an impact.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 onset of the disease.Therefore, it is better for people prone to such diseases not to choose professions related to the cold (refrigerators, sailors working in northern latitudes), etc.

In women over 45, the frequent development of gonarthrosis is associated with the 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, fibroadenoma, endometriosis, endometrial hyperplasia.Often in women, gonarthrosis is also provoked by strict diets for weight loss, 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 the development and formation of tissues;
• The impact of neurodystrophic processes on the cervical and lumbar spine;
• Arthritis of the knee joint;
• His injuries and microtraumas;
• Meniscectomy, that is, surgical removal of the meniscus;
• Hormonal imbalance and chronic endocrine diseases;
• Heavy and continuous 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 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 the knee joint in the 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 if 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 while sleeping.

These signs should be given more 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 grade II

Which is typical:

• Pain at night, as well as pain in the first few minutes of the morning when getting out of bed.
• Pain when climbing stairs.
• The possibility of using public transport with restrictions.
• Slightly pronounced lameness.
• The appearance of pain when moving at a distance of up to 800-1000 meters.
• Limited capacity for self-care.

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 grade III

It is characterized by:

• pain that begins immediately after rest or occurs after 500 meters of smooth movement;
• severe lameness, when the help of improvised means (sticks, 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;
• pain at night even without moving the joint.

The affected joint develops ankylosis, a condition in which the articular ends of opposite adjacent 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 influence.

During diagnosis, a distinction is often made between unilateral and bilateral arthrosis, and between unilateral, right- and left-sided 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 milk 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 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 more abundant - it puts the body in the mood for work and preserves strength until lunch.

If, especially at 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 the jelly meats.Carrying collagen in 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.

Eliminate from your diet:

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

Treatment of gonarthrosis in a sanatorium

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

One of the advanced treatment methods is the intra-articular injection of hyaluronic acid.They compensate for the lack of production of their hyaluronic acid, which serves as a lubricating element for the surface of the joint and protects it from erosion.The effect of this procedure is felt from the first day.The effect of an injection lasts on average for one month.Patients in advanced stages of arthrosis feel a significant decrease in the pain that has tormented them for many years since 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.