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Treatment of osteoarthritis of the knee joint (gonarthrosis)

With age, the vast majority of people face the acute question of how to treat osteoarthritis of the knee joint, with typical symptoms,osteoarthritis of the knee jointinherent to this disease in its different stages.This includes the appearance of swelling in the knee area, redness around this swelling, crackling and crunching sounds, clearly audible in silence when the knee moves, especially during squats, and a distinctive pain syndrome of varying degrees of intensity.The pain may appear immediately after normal, everyday physical activity or after physical exercise inappropriate for age in duration and intensity.When addressing the underlying causes of this pain, we must take into account that its appearance can also be a consequence of:

  • Inflammatory process in the knee joint.That is, being a consequence of arthritis.It occurs as an independent pathology or as a complication of other diseases.
  • Osteoarthritis is a degenerative process during which the tissues of the joint are destroyed, mobility is lost and, if the course of osteoarthritis has been prolonged, it also causes deformation of the joint.
  • Injuries.Most often it occurs from a fall, a blow to the knee, or hitting the knee on a hard surface.The joint may become deformed.
  • Ligament damage.Ligaments keep the joint in the correct position, preventing it from moving.But when they are damaged (stretched, displaced, broken), the joint also suffers, with intense pain and the appearance of a tumor.In order not to aggravate the injury, urgent medical attention and rest of the injured leg are needed in such cases.
  • Damage to the meniscus of the patella.This mobile, round, protuberant cartilage of the knee can be injured even when squatting or turning sharply.It is not always detected visually due to the inflammation of the knee joint that usually appears in these cases.An experienced specialist makes an accurate diagnosis using ultrasound, X-ray and palpation.
  • Popliteal cyst (Becker's cyst).As a result of inflammation, fluid forms in the joint, which accumulates in the inner part of the popliteal fossa, in the area of the tendons.
  • Inflammation of ligaments and tendons (tendinitis).They cause painful and unpleasant 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, due to impaired blood circulation in the knee joints.They can appear due to a sudden change in weather, severe hypothermia for a long time.For example, sailors who work for a long time in high (arctic) latitudes.In most cases, the location of the pain is symmetrical, equally intense and in the first stage it does not affect joint mobility.

The most serious mistake in such cases would be to ignore the pain and hope that just by resting “everything will go away by itself.”Only a specialist can give treatment recommendations and make a correct diagnosis, therefore treatment of osteoarthritis of the knee joint is unacceptable at home based solely on the advice of "knowledgeable people", and even using exclusively traditional medicine.Effective treatment is possible only with a combination of medications in the form of tablets, rubs, ointments and the use of physiotherapy.Sometimes, in severe or advanced cases, surgery cannot be avoided.

make a diagnosis

An orthopedic surgeon can make a diagnosis of osteoarthritis of the knee joint after motion testing and medical history.As a complement to the diagnosis, the following procedures are generally prescribed:

  • In relation to laboratory tests, such as biochemical analyzes of blood and bacterial microflora, smears, puncture of joint fluid and/or bone marrow, serological analysis, that is, a study of the presence of antibodies and antigens contained in the blood serum.
  • Instrumental studies, which may include ultrasound, MRI, densitometry and others.
  • Examination of the internal joint capsule using an arthroscope, a device for a minimally invasive procedure to penetrate the cavity through an incision.Most often, this method is used after damage to the meniscus or in case of cracks and severe wear of the cartilage tissue, as well as to restore the anterior cruciate ligaments.Although the anthroscope is rarely used as a diagnostic tool lately, it has been successfully replaced by a completely non-invasive diagnostic method using MRI.
  • Simply "by ear": with a third-degree joint injury, extraneous sounds in the form of crackling, crackling and clicking are clearly audible in the joint.

The information obtained is gathered into a general history and only from this can a complete and effective treatment be initiated.

How to treat gonarthrosis?

Recovering joint mobility is not a matter of a month.The treatment is complex, expensive due to the high cost of medications, and the result depends solely 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 joint(s).If the job involves a lot of stress, negotiate with management (if necessary, with the doctor's notes in hand) about changing the type of activity.For a time or forever, life will tell.Although often initially, bed rest may be necessary for initial restoration of joint function.Remember: a joint is not a muscle, you cannot “solve” it with intense exercise, it will only get worse.Activation of life with intense movements may be necessary later, once the most acute inflammation has subsided.But even when increasing the load, it is necessary to use support means in the form of elastic bandages, cane, crutch, etc.Sometimes you can't do without special orthopedic insoles or even custom-made orthopedic shoes.

Treatment of osteoarthritis of the knee joint is also possible at home, using outpatient medications prescribed by a doctor: codroprotectors, analgesics and anti-inflammatories.Depending on the degree of damage to the joint and the type of inflammation, the doctor may prescribe nonsteroidal 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 with osteoarthritis!Instead, apply an ice pack to the swollen area;This will help relieve swelling, redness, and inflammation.

The use of chondroprotectors, on the other hand, does not relieve pain.But the restoration of cartilage tissue will progress slowly but surely.The only question is the effectiveness of the drug, but for treatment you should try to use proven and certified drugs.Preferably internationally recognized.

For some types and degrees of joint damage, it may be helpful to permanently (or temporarily) apply and wear a tension bandage that repairs the joint.But this measure should be used only if the method is approved by the treating doctor, since in some types of osteoarthritis, the use of such a bandage can aggravate the course of the disease.

You cannot be completely immobilized if you have knee pain.Additionally, in some types of inflammation, moderate physical activity only benefits the joint.An orthopedic doctor will tell you when and how much exercise you should do.In addition, complete passivity in terms of physical activity will cause weight gain, which will further aggravate the situation, loading the joint.

Drug treatment is usually combined with physiotherapy courses, the most favorable for the treatment of osteoarthritis: magnetic and laser therapy (coherent laser radiation at safe frequencies is used), mechanical vibration and ultraphonotherapy, microwave installations with deep tissue effects, when this is therapeutically justified.

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

Osteoarthritis I degree

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 including physiotherapy, massage and physiotherapy are of great help.One of the most effective methods is considered to be laser therapy, which significantly reduces pain, stimulates 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.

Osteoarthritis degree II

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 physiotherapy designed for such cases is recommended.During these periods, physiotherapy and massages are excluded.

Recommendations: reduce the load on the affected joint, limit walking, avoid any movement associated with the squat.Special orthoses for the knee joint may be prescribed - devices that fix the joint and severely limit its mobility.

In the medical arsenal for the treatment of second degree osteoarthritis, along with chondroprotectors with glucosamine and chondroitin, steroid drugs, as well as non-steroidal anti-inflammatory drugs, may be present.Hyaluronic acid and other drugs can be injected into the joint capsule to facilitate the sliding of the cartilage surfaces against each other.

A special diet with excess collagen is prescribed: jellied meat, gelatin, gelatin, and confectionery products: gelatin soufflé.Including fish oil in your diet is beneficial.

Osteoarthritis III degree

When the knee joint is affected by third degree osteoarthritis, the treatment is not much different from the previous condition, except that the frequency of drug use increases with a slight shift towards glucocorticosteroid hormones.If there are no results, surgery followed by joint replacement is necessary.

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 has no relationship with the aging of the body.

A completely different picture arises when a person exceeds 50 years of age: when the flexibility of the ligaments is lost, tissue dehydration processes begin and the metabolism slows down.

Under these conditions, the development of gonarthrosis, deforming osteoarthritis of varying severity, begins.In the classification accepted in medicine, gonarthrosis of the knee joint is divided into I, II and III degrees.

This disease, once it starts, progresses very quickly.It refers to acquired age-related pathologies of the musculoskeletal system.To one degree or another, it is inherent in all patients after 50 years of age;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 both after 70 and 80 years.

Possible appearance of the disease.

Located between the tibia and the femur, the knee joint in the human body carries perhaps one of the heaviest loads.An example would be running regularly on a hard surface (usually asphalt): each step in that run causes a shock load on the knee joint.

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

There are primary and secondary osteoarthritis of the knee joints.The etymology of the former is not fully understood and may have different reasons.When, due to a sedentary lifestyle and when, vice versa, due to too much physical activity.Bad ecology, excess weight and addiction to tobacco or alcohol can also play a role.Doctors consider identifying the first stage of osteoarthritis a great success, since the cause of the pathology is difficult to analyze.

Regular hypothermia of the feet can also provoke the onset of the disease.Therefore, it is better for people prone to this type of disease not to choose professions related to the cold (refrigerators, sailors working in northern latitudes), etc.

In women over 45 years of age, the frequent development of gonarthrosis is associated with long-term use of contraceptives due to a decrease in the natural synthesis of estrogens.It also usually occurs during menopause or under the influence of gynecological diseases such as fibroids, fibroadenomas, endometriosis, endometrial hyperplasia.Often in women, gonarthrosis is also provoked by strict weight loss diets, during which many useful minerals and vitamins are removed from the diet.

It is much easier to decide how to influence secondary osteoarthritis, which can be a consequence of:

  • Defects in the development and formation of tissues;
  • The influence of neurodystrophic processes on the cervical and lumbar spine;
  • Arthritis of the knee joint;
  • Their injuries and microtraumas;
  • Meniscectomy, that is, surgical removal of the meniscus;
  • Hormonal imbalances and chronic endocrine diseases;
  • Constant, intense physical activity, including sports.To prevent joint injuries after 40 years, it is better to significantly limit and then abandon all exercises associated with extreme loads on the knee joint (in the form of running on hard surfaces or loaded squats);
  • Abnormal joint mobility.This condition occurs when the ligaments that keep the joint in the correct position are underdeveloped or naturally weak;
  • Stress and constant nervous tension.

Signs and symptoms of the onset of the disease (stage or grade)

  • 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;
  • 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 in the first half of the night while sleeping.

These signs should be given the greatest 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.

Gorantrosis II degree

What is typical:

  • Night pain, as well as pain in the first minutes of the morning when getting out of bed.
  • Pain when climbing flights of stairs.
  • 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 by the joint become an effective way to cure even the second degree of gonarthrosis.

Gorantrosis grade III

Characterized by:

  • pain that begins immediately after rest or occurs after 500 meters of calm movement;
  • severe lameness, when the help of improvised means (canes, crutches) is required;
  • stiffness after waking up 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 joint ends of adjacent opposing bones fuse.The leg completely loses its mobility and the only way to recover 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 cartilage tissue, but also on the patient's age, his ability to tolerate certain medications and physiotherapeutic methods of influence.

When diagnosing, a distinction is often made between unilateral and bilateral osteoarthritis, and between unilateral, right-sided and left-sided osteoarthritis.The latter is usually diagnosed in left-handed people.

Nutrition for gonarthrosis

First of all, doctors advise excluding red meat and offal such as liver from the diet.Priority should be given to fruits and vegetables, cereals with high gluten and fiber content, without salt or sugar.As well as fermented dairy products, fish and nuts.

The last time you eat must be no later than 7:00 p.m.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 or 6 times a day, in the morning.

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

If, especially at first, 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 jellied meats.Transport collagen to the body and joints: the raw material for the construction of cartilage tissue.

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

Eliminate from your diet:

  • Red meat;
  • Lard, smoked meats 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 (carbohydrates!) and help you gain 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 types of massage as treatment methods for osteoarthritis of the knee joint.

One of the advanced treatment methods is intra-articular injections of hyaluronic acid.They compensate for the lack of production of their own hyaluronic acid, which serves as a lubricating element for the joint surface and protects it from abrasion.The effect of this procedure is felt from the first day.The effect of an injection lasts an average of one month.Patients in advanced stages of osteoarthritis feel in the first days a significant reduction in the pain that torments them for many years, and people with a moderate course of the disease, grade 1-2, after a course of 5 injections, in most cases completely forget about pain for about six months.