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 the destruction of cartilage and maintain normal motor function. Treatment should 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, 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 do not have any effect on the 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 small bone vessels. Lack of nutrients and oxygen carried by the lymphatic flow leads to destruction of the outer cartilage layer of the knee.
In the early stages, the disease is extremely difficult to recognize. Joint deformity occurs slowly, until vitreous hyaline cartilage is drawn into the process. The anatomical structure of the ligament is modified. Turbidity occurs, the tissue thickens, becomes thin, cracks in all directions. The result of the pathology can be the complete disappearance of cartilage, which leads to neoplasms on the bone tissue and irreversible curvature of the knee.
Classification of the disease
The International Classification of Diseases divides gonarthrosis into seven clarifying subheadings:
- Primary gonarthrosis bilateral. Diagnosis is most often made in women aged 70 to 74 and men aged 60 to 64. This puts the disease in the category of "elderly".
- Another primary gonarthrosis. Pathology of one knee joint, due to natural wear and tear or against the background of other diseases.
- Post-traumatic gonarthrosis bilateral. People of different age categories with serious leg injuries are affected.
- Other post-traumatic gonarthroses. Unilateral, against the background of injuries and bruises of the limb.
- Other secondary gonarthroses are bilateral. They are the result of chronic, not fully cured bruises, fractures or dislocations. 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, occupational 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 with an established diagnosis die.
Causes
Osteoarthritis of the knee joint develops due to impaired metabolism in the knee joint, which leads to a loss of softness and elasticity of the cartilage.
Destructive processes are caused by various reasons:
- Diseases of the thyroid gland, which violate the hormonal background;
- Decreased patency 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 joint diseases (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 leading 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 depending on the degree of gonarthrosis
It is difficult to diagnose the initial stage of knee arthrosis. 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 progression of gonarthrosis:
- I degree gonarthrosis.Pulling pain in the knee, sensations of some stiffness, partial loss of sensation, difficulty in bending the leg, especially after prolonged immobility, the impossibility of prolonged walking or running, the appearance of slight swelling. As a rule, symptoms disappear after rest or simple anesthetics.
- 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. Discomfort can still be relieved by rest. In the morning it becomes more difficult to straighten your legs, it takes some time to restore motor function. Discomfort is complemented by frequent cramps in the calf, especially at night. During the movement, a crunch is heard. 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 anomalies can be unmistakably determined on an x-ray. The pain in the knee becomes constant, acute. The leg stops bending at the knee. The patient cannot walk without a cane or crutches. The swelling is significant. The anatomical shape of the knee is smoothed out and takes on a solid look. There is a primary curvature of the spinal column.
Diagnosis
To make a correct diagnosis, a combination of clinical manifestations of arthrosis of the knee joint and patient complaints are used. To clarify or exclude the causes of the disease, studies are carried out in various ways.
Standard diagnostics goes as follows:
- Making an anamnesis of the disease. History of concomitant diseases, genetic predisposition, past traumas and surgical interventions, professional activities, etc.
- External assessment of 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.
- Laboratory 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, then an increased erythrocyte sedimentation rate will be found in the blood. 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, then a biopsy of the synovial fluid of the knee joint is performed.
- Instrumental research. X-ray is the main and most common method of diagnosing suspected gonarthrosis. As a rule, a rheumatologist can easily determine changes in the structure of bone tissue from a picture already at the beginning of stage 2 of the disease. The presence of side diseases and the causes of their occurrence is diagnosed with the help of more modern and accurate equipment - MRI, CT, ultrasound, osteostincigraphy, thermography.
Treatment of gonarthrosis
Like all joint diseases, gonarthrosis requires systemic treatment, which is desirable to start when the first symptoms appear. In this case, the prognosis of therapy becomes favorable and guarantees a return to a normal lifestyle in a fairly short time.
Comprehensive treatment is aimed at removing the main signs of the disease:
- Discomfort, pain syndrome and muscle tone;
- Improving the motor function of the knee joint;
- Stopping the process of cartilage destruction;
- Strengthening the connective muscles;
- Restoration of normal blood circulation in the knee joint.
Medications
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 patency of intra-articular blood vessels.
Hormonal drugs
Reduce the production of the hormone cortisone, to prevent the development of inflammatory processes.
Hyaluronic acid injections
Used to restore intra-articular synovial fluid. Due to this, friction between the articular parts is reduced, motor function is normalized, and the elasticity of cartilage tissue is restored.
Anti-enzymatic agents
They inhibit the activity of trypsin, thereby 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 the disease.
Most often, the following types of procedures are prescribed by a rheumatologist:
- Electrophoresis with painkillers;
- Ultrasound treatment;
- Magnetotherapy;
- Laser exposure;
- Paraffin applications;
- Mud treatment;
- Therapeutic exercise (exercise therapy);
- Manual therapy, massage with medicinal ointments.
Surgery and prosthetics
If gonarthrosis is in an advanced stage, the knee joint and cartilage tissues are destroyed, it is impossible to do without a surgical operation. Otherwise, the person will remain 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 articular diseases.
- Arthroscopy. The destroyed hyaline cartilage is removed. The operation is low-traumatic, has a short rehabilitation period. It is indicated for patients whose progress 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 into the necessary anatomical structure.
- Endoprosthetics. The 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. Requires careful preparation and long rehabilitation.
Traditional medicine
The use of folk recipes in combination with conservative treatment can alleviate external symptoms (pain, swelling). Recipes based on bay leaf, burdock root, St. John's wort, malt and hay have proven themselves well. Ointments, creams, tinctures and decoctions are made from them.
These plants have anti-inflammatory and analgesic properties. 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, relieve swelling well and have a calming effect on the affected tissues.
A nutritional mixture is made from lemon and garlic, which is taken orally, one teaspoon each, after breakfast and dinner. Such a recipe has a general strengthening effect on the body, increases the patency of blood vessels and nourishes the joints with useful trace elements.
It should be remembered that home treatments do not remove the main problem - 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 you control your weight, but it will also provide your bones and joints with essential vitamins.
For a patient with a diagnosis of gonarthrosis, it is contraindicated:
- Fried, spicy, salty, pickled food;
- Fatty broths;
- Sweet pastries;
- Fruits, with a high content of acidic enzymes;
- Alcoholic drinks.
The menu should be replenished with raw vegetables, fruits and herbs, low-fat sour-milk products, bone broths and dishes that contain gelatin (jelly, 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. Procedures of hydrotherapy, mud therapy and manual therapy are able to conserve the disease for a long time and prevent the destruction of the joint.
Maintaining a sore knee in a stable condition will take the rest of your life. But it can become quite useful for the body as a whole. Reviewing nutrition, eliminating bad habits, playing sports, visiting resorts - the quality of life can improve significantly.
It should be remembered that self-medication, ignoring the primary symptoms and unbearable stress on the sore knee joint can very quickly turn a healthy person into a helpless disabled person.