Gonarthrosis, or deforming osteoarthritis of the knee joint, is a degenerative-dystrophic disease of the hyaline cartilage of the knee, which covers the condyles of the tibia and femur.
The symptoms of osteoarthritis of the knee joint develop over the years, gradually, and the main manifestation of the disease is stiffness of movement and pain.Among osteoarthritis of other joints (phalanges of the fingers, shoulder and elbow joints, hip joints), gonarthrosis is the most common disease.
The category of the population most susceptible to osteoarthritis of the knee joint is women, as well as people over 40 years of age.In some cases, gonarthrosis can develop in athletes (due to increased stress) and in young people (against the background of previous injuries).
Causes of gonarthrosis
Osteoarthritis of the knee joint does not develop from a single cause;In most cases, the development of the disease depends on a combination of several negative factors, which worsen with age and can ultimately lead to such a disorder.Medicine identifies the following mechanisms for the appearance of osteoarthritis:
Primary - occurs in old age due to aging of the body's tissues, as well as against the background of some factors that provoke this disease (constant increase in stress, heredity, obesity).
Secondary: represents 30% of all cases of gonarthrosis and occurs mainly after damage to the meniscus, rupture of ligaments, fracture of the tibia and other injuries.In most cases, symptoms of knee osteoarthritis begin to appear after 3 to 4 years.However, if the injury is severe enough, it may take 2 to 3 months for symptoms to appear.
About 7-8% of cases of osteoarthritis of the knee joint occur when, after forty years, a person begins to actively engage in physical exercise, that is, squats and running.But due to age, weakening of the tissue tone of the knee joint and characteristic age-related changes under sudden loads can provoke the appearance of rapid degenerative and dystrophic changes in the joints.
Another reason for the development of gonarthrosis in a person may be concomitant diseases: varicose veins, excess weight, ankylosing spondylitis, gout, psoriatic, rheumatoid or reactive arthritis.
Constant critical loads on the knees, regular and prolonged climbing of stairs in old age or lifting heavy objects, as well as professional sports, can lead to osteoarthritis of the knee joint.The risk of osteoarthritis of the knee joint increases significantly with weakness of the ligamentous apparatus of genetic origin, diabetes mellitus and other metabolic disorders, neurological diseases and spinal injuries.
Spasm of the muscles of the anterior thigh is the cause of 50-60% of cases of osteoarthritis of the knee joint.Such muscle spasms may not manifest themselves for a long time before pain in the knees appears, while the person may feel heaviness in the legs, fatigue and lower back pain.When the iliopsoas and rectus femoris muscles are in a state of constant spasm, with age this leads to a "tightening" of the knees, which limits their free movement.
Degrees of gonarthrosis
In most cases, the development of osteoarthritis of the knee joint occurs in one of the knees.Medicine distinguishes 3 degrees of gonarthrosis depending on the intensity of the pathological processes:
The first is that there is no deformation of the bones of the joint;Periodic dull pain in the knee is characteristic after physical stress on the joint.A slight swelling of the joint may appear, which disappears on its own after a while.
The second degree is characterized by an increase in osteoarthritis symptoms.The pain is long-lasting and intense, and occurs with minimal effort (lifting heavy objects, walking), and a cracking sound may also appear in the joint.In the second degree of gonarthrosis, deformation of the knee joint may develop, as well as moderate limitation of movement.
Third degree - has pronounced symptoms of osteoarthritis of the knee joint.Noticeable deformation of the joint and constant pain cause alterations in the patient's gait and limited mobility of the joint.In the third degree of gonarthrosis, the pain can intensify depending on the weather and reach such intensity that the patient's sleep is disturbed, the limitation of mobility is reduced to a minimum, making it impossible to find a comfortable position for the leg.
Diseases and pathologies with which gonarthrosis is confused.
Locking the knee joint in case of meniscus damage.
The disease develops after an unsuccessful movement, accompanied by a crunch in the knee, severe pain appears, which disappears after 15 minutes, and the next day swelling of the knee occurs.
Ankylosing spondylitis, gout, joint rheumatism, arthritis: psoriatic, reactive, rheumatoid.
To distinguish gonarthrosis from arthritis, it is necessary to perform a general blood test.With arthritis, the test results will indicate the presence of an inflammatory process in the body, while with osteoarthritis there are no changes in the blood test.
Inflammation of the tendons of the knee.
It develops in most cases in women over 40 years of age, when carrying heavy objects or going down stairs.The pain is localized on the inner surface, but the movement of the knee is not limited.
Vascular pain in the knees.
The pain is characterized by symmetry and occurs in both knees at the same time.Characteristic of young people during a period of accelerated bone growth, they can occur during physical activity, a cold or a change in weather.To describe their own condition, patients use the term "sprained knees."
Stages of osteoarthritis of the knee joint.
The disease is insidious due to its gradual development.Initially, the patient feels only a slight discomfort, pain when moving, going up or down stairs.In some cases, the patient's sensations are reduced to slight stiffness of the joint and tightness in the popliteal region.A characteristic feature of osteoarthritis of the knee joint is considered to be an initial pain symptom, which consists in the fact that after a sharp transition from a sitting position to a moving position, a person begins to feel pain during the first steps, which gradually disappears, only to arise again after a heavy load.
The appearance of the knee joint with the first degree of osteoarthritis is no different from that of a healthy knee, only in some cases patients notice slight swelling.Also, in some cases, fluid begins to accumulate in the knee joint, it swells and becomes spherical, synovitis begins to develop, which causes a feeling of heaviness and limited movement of the joint.
These changes in the joint in the first degree of osteoarthritis occur due to an alteration of blood circulation in the small intraosseous vessels that nourish the hyaline cartilage.This causes changes in the surface of the cartilage, dryness, loss of smoothness and the appearance of cracks.Because of this, smooth, unhindered movement between the cartilages is difficult and is accompanied by constant microtrauma when the cartilages adhere to each other.Cartilage tissue, being in a constant state of microtrauma, begins to lose its shock absorption properties and becomes thinner.
The development of pathological processes leads to changes in bone structures.The joint area flattens and spine-like growths (osteophytes) appear along the edges.The joint capsule degenerates, the joint fluid thickens, and the synovial membrane contracts.This leads to a significant deterioration in the nutritional process of cartilage and accelerates its degeneration.
As the disease progresses to the second stage, the symptoms begin to intensify, the pain appears even with light loads and is localized along the inner front part of the joint.Rest brings relief, but resuming movement causes severe pain.
The mobility of the joint is significantly reduced, attempts to bend the leg as much as possible cause sharp pain, and a distinctive harsh crunch is heard when moving.Synovitis is more common;The joint enlarges and changes its configuration due to a large buildup of fluid.
The third degree of osteoarthritis of the knee joint is accompanied by a significant deformation of the bones, in which they seem to be pressed against each other.There is practically no cartilaginous tissue and the limitation of joint movement increases.Straightening the joints becomes quite problematic and the pain begins to bother the patient 24 hours a day, both when walking and at rest.Due to severe deformation of the joints, the legs become O- or
Diagnosis and treatment of gonarthrosis.
During a routine examination, it is impossible to determine whether a patient has first-degree osteoarthritis of the knee joint.If there are 2 or 3 degrees, during the examination, swelling, edema (with synovitis) is observed, a crunch is heard, stiffness of movements is noted, a change in the axis of the limbs is noted, and deformation of the joints is noted.
Today, in addition to radiography, CT and MRI methods are widely used to diagnose osteoarthritis, thanks to which it is possible to study disorders of bone structures in more detail and examine pathological changes in soft tissues.
Treatment of the disease involves a complex of orthopedic procedures and drug therapy.An orthopedist prescribes mud therapy, therapeutic exercises, massages and physiotherapy.
Drug treatment involves the use of chondoprotectors, these are drugs that replace synovial fluid.In some cases, an intra-articular injection of steroid hormones is performed.Patients are also recommended to undergo treatment in a sanatorium.
If the treatment of a young patient with severe limitation of movement and pain is not effective, a joint replacement method can be used, which provides for a rehabilitation period of 3 to 6 months.
What happens to the knee joint with osteoarthritis?
Articular cartilage plays an important role in human movement and is a soft, elastic and durable covering, thanks to which the articulated bones move smoothly relative to each other and also absorbs and distributes the load when walking.
But with excessive regular loads, genetic predisposition, metabolic disorders in the body, prolonged muscle spasms and injuries, cartilage loses its softness and begins to thin.The smooth sliding of the articulated bones gives way to strong friction and the first degree of gonarthrosis develops, in which the cartilage loses its shock absorption properties.
The degradation process continues to progress and poor shock absorption leads to flattening of bone surfaces with the formation of osteophytes in the form of bone growths.In this case, the disease already has a second degree and is accompanied by degeneration of the synovial membrane and the joint capsule.The lack of pumping and movement atrophies the structure of the knee joint, the consistency of the knee fluid becomes more viscous, the cartilage nutrition process is disturbed, which leads to even further deterioration of the patient's condition.
The thinning of the cartilage causes a reduction in the distance between the articulated bones by up to 80%.When walking, due to abnormal friction and the absence of a shock absorber, destructive processes in the joint increase rapidly, this quickly leads to the development of the third degree of osteoarthritis with pronounced symptoms:
Pain when moving, especially when going up or down stairs.
Pain both during exercise and at rest, morning stiffness.
The patient begins to limp, trying to save the painful joint.
Severe cases of the disease require the use of crutches or a cane.
The third degree of osteoarthritis of the knee joint is characterized by an almost complete absence of cartilaginous tissue, which leads to a decrease in joint mobility to a minimum.Therefore, no magic method, super medicine or ointment can restore the worn-out cartilage tissue, and given the degree of bone deformation, normal functioning of the joint is impossible.In this case, only surgery can help.
Gymnastics for osteoarthritis of the knee joint.
Any treatment options for osteoarthritis of the knee joint should only be performed as prescribed by a doctor.Therapeutic gymnastics involves slow, measured exercises that exclude squats, joint twisting and jumping.It is best to do gymnastics in the morning, sitting or lying down, for 20 minutes, repeating each exercise 10 times.
The main goals of therapeutic exercises are to relax muscle spasms that cause pain, increase blood supply to the joint, slow the progression of the disease, and prevent further cartilage destruction.During the period of exacerbation of the disease, physical exercise is prohibited.
Lying on your back, you can perform the bicycle exercise, but you need to stretch your legs parallel to the floor, make circular movements with your feet, move your legs to the sides, sliding them alternately along the floor, tense your feet while counting to 10.
Sitting on a chair with your legs down, straighten your legs, simultaneously bend your feet and hold this position, counting to 10, alternately bring each knee to the stomach with your hands and slowly return to the starting position.
Focusing on the wall, standing on the floor, move your legs alternately forward and backward.
Placing your stretched leg on a chair, perform inclined movements of an elastic nature, while resting your hands on your thigh, as if trying to straighten your leg further.
Lying face down, alternately raise your straight leg and hold it for a count of 3.
Sitting on the floor, spread your legs to the sides, moving them along the floor, bring your knees towards your stomach as you inhale and return them to their starting position as you exhale.