Gonarthrosis, or deformed arthrosis of the knee joint, is a degenerative-dystrophic disease in the hyaline cartilage of the knee, covering the condyles of the tibia and femur.
Symptoms of arthrosis of the knee joint develop over many years, gradually, and the main manifestation of this disease is stiffness of movement and pain.Among arthrosis of other joints (phalanxes of fingers, shoulder and elbow joints, hip joints), gonarthrosis is the most common disease.
The population category most susceptible to arthrosis of the knee joint is women, as well as people over 40 years of age.In some cases, gonarthrosis can develop in athletes (from increased stress) and young people (against the background of previous injuries).
Causes of gonarthrosis
Osteoarthritis of the knee joint does not develop from one cause;in most cases, the development of the disease depends on a combination of several negative factors, which worsen with age and can eventually cause such disorders.Medicine identifies the following mechanisms for the occurrence of arthrosis:
Primary – occurs in old age from the aging of body tissues, as well as against the background of several factors that trigger this disease (continuously increased pressure, heredity, obesity).
Secondary – accounts for 30% of all cases of gonarthrosis, occurs mainly after damage to the meniscus, ligament rupture, tibial fracture and other injuries.In most cases, symptoms of knee arthrosis begin to appear after 3-4 years.However, if the injury is severe enough, it may take 2-3 months for symptoms to appear.
About 7-8% of cases of arthrosis of the knee joint occur when, after forty years, a person begins to actively engage in physical exercises, namely squats and running.But due to age, the weakening of the tissue tone of the knee joint and the characteristics of age-related changes under sudden loads can trigger the appearance of rapid degenerative and dystrophic changes in the joint.
Another reason for the development of gonarthrosis in a person may be concomitant diseases - varicose veins, overweight, ankylosing spondylitis, gout, psoriatic, rheumatoid or reactive arthritis.
Constant critical load on the knee, frequent long-term climbing in old age or heavy lifting, as well as professional sports can cause arthrosis of the knee joint.The risk of arthrosis of the knee joint increases significantly with the weakness of the ligaments caused by genetics, diabetes mellitus and other metabolic disorders, neurological diseases, and spinal injuries.
Anterior thigh muscle spasm is the cause of 50-60% of cases of knee arthrosis.Such muscle spasms may not manifest for a long time before the appearance of pain in the knee, while the person may feel heaviness in the legs, fatigue, and experience lower back pain.When the iliopsoas and rectus femoris muscles are in a constant state of spasm, with age this leads to "tightening" of the knees, which limits their free movement.
Stage of gonarthrosis
In most cases, the development of arthrosis of the knee joint occurs in one of the knees.Medicine distinguishes 3 degrees of gonarthrosis depending on the intensity of the pathological process:
The first is that there is no deformation of the joint bones;Periodic dull pain in the knee is characteristic after physical stress on the joint.A small swelling of the joint may develop, which disappears on its own after some time.
The second stage is characterized by increased symptoms of arthrosis.The pain is prolonged and intense, and occurs with minimal effort (lifting heavy, walking), and a throbbing sound may also appear in the joints.In the second stage of gonarthrosis, deformation can develop in the knee joint, as well as a moderate limitation of movement.
Third degree - has expressed symptoms of arthrosis of the knee joint.Significant deformation of the joint and constant pain lead to disturbances in the patient's gait, and there is limited mobility of the joint.In the third stage of gonarthrosis, the pain can increase depending on the weather and reach such an intensity that the patient's sleep is disturbed, mobility limitations are reduced to a minimum, which makes it impossible to find a comfortable position for the legs.
Diseases and pathologies with which gonarthrosis is confused
Restriction of the knee joint in case of meniscus damage.
The disease develops after unsuccessful movements, accompanied by cramps in the knees, severe pain appears, which subsides after 15 minutes, and the next day knee swelling occurs.
Ankylosing spondylitis, gout, articular rheumatism, arthritis - psoriatic, reactive, rheumatoid.
To distinguish gonarthrosis from arthritis, it is necessary to take a general blood test.With arthritis, the test results will show the presence of an inflammatory process in the body, while with arthrosis, no changes in blood tests occur.
Knee tendonitis.
It develops in most cases in women over 40 years old, 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 knee.
The pain is characterized by symmetry and occurs in both knees at once.Characteristic of young people during a period of accelerated bone growth, it can occur during physical activity, colds, or weather changes.To describe their own condition, patients use the term "twisted knee."
Arthrosis stage of the knee joint
This disease is dangerous because of its gradual development.At first, the patient only feels a little discomfort, pain when moving, going up or down stairs.In some cases, the patient's sensation is reduced to a slight stiffness of the joints and tension in the popliteal area.The characteristic feature of arthrosis of the knee joint is considered to be the initial symptom of pain, which consists in the fact that after a sharp transition from a sitting position to movement, a person begins to feel pain during the first step, which gradually disappears, only to reappear after a heavy load.
The appearance of the knee joint with the first stage of arthrosis does not differ from a healthy knee, only in some cases the patient notes a slight swelling.Also, in some cases, fluid begins to accumulate in the knee joint, it swells and becomes spherical, and synovitis begins to develop, which leads to a feeling of heaviness and limited movement of the joint.
Such changes in the joint in the first stage of arthrosis occur due to the disruption of blood circulation in the small intraosseous vessels that nourish the hyaline cartilage.This leads to changes in the cartilage surface, dryness, loss of smoothness, and the appearance of cracks.Because of this, unhindered and gentle movement between the cartilages is difficult and accompanied by constant microtrauma when the cartilages cling to each other.Cartilage tissue, being in a constant state of microtrauma, begins to lose its shock-absorbing properties and becomes thinner.
The development of the pathological process leads to changes in the bone structure.The articular area is flattened, and growths in the form of thorns (osteophytes) appear along the edges.The joint capsule degenerates, the joint fluid thickens, and the synovial membrane shrinks.This leads to a significant deterioration in the process of cartilage nutrition and accelerates its deterioration.
When the disease progresses to the second stage, the symptoms begin to increase, the pain occurs even with a light load and is localized along the front of the inner part of the joint.Rest brings relief, but continued movement causes severe pain.
Joint mobility is significantly reduced, attempts to bend the leg as much as possible cause sharp pain, and a clear grunt is heard when moving.Synovitis is more common;the joint becomes enlarged and changes its configuration due to a large accumulation of fluid.
The third stage of arthrosis of the knee joint is accompanied by a significant deformation of the bones, where they seem to be pressed against each other.There is almost no cartilage tissue, and the limitation of joint movement is increased.Straightening the joint becomes quite problematic, and pain begins to bother the patient all the time, both when walking and at rest.Due to the severe deformation of the joints, the legs acquire an O- or X-shape, the gait becomes unstable, wobbly, and often the patient cannot do without crutches or crutches.
Diagnosis and treatment of gonarthrosis
During a routine examination, it is impossible to determine whether the patient has arthrosis of the first stage of the knee joint.If there is 2 or 3 degrees, after examination there is swelling, edema (with synovitis), crackling sounds are heard, stiffness of movements is observed, changes in the axis of the limbs, and deformation of the joints are noticeable.
Today, in addition to radiography, CT and MRI methods are widely used to diagnose arthrosis, thanks to which it is possible to study bone structural disorders in more detail and examine pathological changes in soft tissues.
Treatment of the disease involves a complex of orthopedic procedures and drug therapy.Orthopedists prescribe mud therapy, therapeutic exercise, massage, and physiotherapy.
Drug treatment involves the use of chondoprotectors, these are drugs that replace synovial fluid.In some cases, intra-articular injections of steroid hormones are performed.Patients are also recommended to undergo sanatorium-resort treatment.
If the treatment of young patients with limited mobility and severe pain is not effective, the method of joint replacement can be used, which provides a recovery period of 3-6 months.
What happens to the knee joint with arthrosis?
Articular cartilage plays an important role in human movement and is a smooth, elastic and durable layer, thanks to which the articulated bones move smoothly relative to each other, and also absorb and distribute the load when walking.
But with normal overload, genetic predisposition, metabolic disorders in the body, muscle spasms and prolonged injuries, the cartilage loses its smoothness and begins to thin.The gentle sliding of the articular bones is replaced by strong friction, and the first stage of gonarthrosis develops, where the cartilage loses its shock-absorbing properties.
The degradation process continues to develop, and poor shock absorption causes the bone surface to flatten with the formation of osteophytes in the form of bone growth.In this case, the disease already has a second stage and is accompanied by degeneration of the synovial membrane and joint capsule.The lack of pumping and movement destroys the structure of the knee joint, the consistency of the knee fluid becomes more viscous, the cartilage nutrition process is disrupted, which leads to a greater deterioration of the patient's condition.
Thinned cartilage leads to a reduction of the distance between the articular bones by up to 80%.During walking, due to abnormal friction and the absence of shock absorbers, destructive processes in the joints increase rapidly, this quickly leads to the development of third-degree arthrosis with obvious symptoms:
Pain when moving, especially when going up or down stairs.
Pain during exercise and at rest, morning stiffness.
The patient began to suffocate, trying to save the aching joint.
Severe cases of the disease require the use of crutches or crutches.
The third stage of arthrosis of the knee joint is characterized by an almost complete absence of cartilage tissue, which leads to a decrease in joint movement to a minimum.Therefore, no magic method, super medicine or ointment can restore worn cartilage tissue, and given the degree of bone deformation, normal joint function is impossible.In this case, only surgery can help.
Gymnastics for arthrosis of the knee joint
Any treatment option for arthrosis of the knee joint should only be carried out as prescribed by the doctor.Therapeutic gymnastics involves slow and measured exercises that exclude squats, twisting joints and jumping.It is better to do gymnastics in the morning, sitting or lying down, for 20 minutes, repeat each exercise 10 times.
The main objective of therapeutic exercises is to relieve muscle spasms that cause pain, increase blood supply to the joints, slow the progression of the disease, and prevent further destruction of cartilage.During the period of exacerbation of the disease, physical exercise is prohibited.
Lying on your back, you can do bicycle exercises, but you need to straighten your legs parallel to the floor, make circular movements with your legs, move your legs to the sides, slide alternately along the floor, strain your legs for a count of 10.
Sit on a chair with your legs down, straighten your legs, at the same time bend your legs, and hold this position, count to 10, alternately pull each knee to your stomach with your hands and slowly return to the starting position.
Focus on the wall, stand on the floor, swing your legs forward and back alternately.
Put the straightened leg on the chair, make elastic inclined movements, while resting your hands on your thighs, as if trying to straighten your legs more.
Lying on your back, lift the straightened legs alternately and hold for 3 counts.
Sit on the floor, spread your legs out to the sides, move them along the floor, pull your knees to your stomach as you inhale and return them to the starting position as you exhale.