Gonarthrosis or deforming arthrosis of the knee joint is a degenerative-dystrophic disease involving the hyaline cartilage of the knee, the condyles of the tibia and femur.
The symptoms of arthrosis of the knee joint develop over years, gradually, and the main manifestation of the disease is the stiffness of movement and pain.Among arthrosis of other joints (phalanges of fingers, shoulder and elbow joints, hip joints), the most common disease is gonarthrosis.
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 (due to increased stress) and young people (due to previous injuries).
Causes of gonarthrosis
Osteoarthritis of the knee joint does not develop for a single reason;in most cases, the development of the disease depends on a combination of several negative factors, which worsen with age and can eventually lead to such a disorder.Medicine determines the following mechanisms for the formation of arthrosis:
Primary - occurs due to the aging of body tissues in old age, as well as against the background of some factors that provoke this disease (constantly increasing stress, heredity, obesity).
Secondary - accounts for 30% of all gonarthrosis cases, mainly after meniscus damage, 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, symptoms may take 2-3 months to appear.
About 7-8% of cases of knee arthrosis occur after forty years when a person begins to actively engage in physical exercises, that is, squatting and running.However, due to age, the weakening of the tissue tone of the knee joint and characteristic age-related changes under sudden loads can lead to the appearance of rapid degenerative and dystrophic changes in the joints.
Another reason for the development of gonarthrosis in a person can be concomitant diseases - varicose veins, excess weight, ankylosing spondylitis, gout, psoriatic, rheumatoid or reactive arthritis.
Constant critical loads on the knees, regularly climbing stairs for a long time in old age or lifting heavy loads, as well as professional sports can cause arthrosis of the knee joint.The risk of arthrosis of the knee joint increases significantly with genetic weakness of the ligamentous apparatus, diabetes mellitus and other metabolic disorders, neurological diseases and spinal injuries.
Spasm of the muscles of the front thigh is the cause of 50-60% of cases of arthrosis of the knee joint.Such muscle spasm may not manifest itself for a long time before pain appears in the knees, at which time a person may feel heaviness in the legs, fatigue, and 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.
Degrees of gonarthrosis
In most cases, the development of arthrosis of the knee joint occurs in one of the knees.Depending on the intensity of pathological processes, medicine distinguishes 3 degrees of gonarthrosis:
First, there is no deformation of the bones of the joint;periodic dull pain in the knee is characteristic after physical stress on the joint.After a while, a small swelling of the joint may develop, which disappears on its own.
The second degree is characterized by an increase in arthrosis symptoms.The pain is long-lasting and intense and occurs with minimal exertion (heavy lifting, walking), and a cracking sound may also be seen in the joint.In the second degree of gonarthrosis, deformation of the knee joint can develop, as well as moderate limitation of movement.
Third degree - there are obvious signs of arthrosis of the knee joint.Marked deformation of the joint and constant pain cause the patient to walk impaired, and the joint has limited mobility.In the third degree of gonarthrosis, the pain can increase depending on weather conditions and reach such an intensity that the patient's sleep is disturbed, the limitation of mobility is reduced to a minimum, which makes it impossible to find a comfortable position for the leg.
Diseases and pathologies in which gonarthrosis is mixed
Blockage of the knee joint in case of meniscus damage.
The disease develops after an unsuccessful movement, it is accompanied by a crisis in the knee, after 15 minutes there is a severe pain that subsides, and the next day swelling occurs in the knee.
Ankylosing spondylitis, gout, articular rheumatism, arthritis - psoriatic, reactive, rheumatoid.
To distinguish gonarthrosis from arthritis, it is necessary to conduct a general blood test.With arthritis, the test results will show the presence of an inflammatory process in the body, while with arthrosis, there are no changes in the blood test.
Inflammation of the knee tendons.
In most cases, it develops 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 knees.
The pain is characterized by symmetry and occurs in both knees at the same time.It is characteristic of young people during the period of accelerated bone growth, it can occur during physical activity, cold or weather change.Patients use the term "twisted knees" to describe their condition.
Stages of arthrosis of the knee joint
The disease is insidious as it develops gradually.At the beginning, the patient feels only a slight discomfort, feels pain when moving, going up or down stairs.In some cases, the patient's sensations are reduced to mild stiffness and tightness of the joint in the popliteal region.A characteristic feature of arthrosis of the knee joint is that after a sharp transition from a sitting position to movement, a person begins to feel pain in the first steps, which gradually disappears, and is considered the initial symptom of pain that reappears only after a heavy load.
With the first degree of arthrosis, the appearance of the knee joint does not differ from a healthy knee, only in some cases patients note a slight swelling.Also, in some cases, fluid begins to accumulate in the knee joint, it becomes swollen and spherical, and synovitis begins to develop, which causes a feeling of heaviness and limited movement of the joint.
In the first degree of arthrosis, such changes in the joint occur due to disruption of blood circulation in the small intraosseous vessels that feed the hyaline cartilage.This leads to changes in the cartilage surface, drying, loss of smoothness, and the formation of cracks.Because of this, smooth and smooth movement between the cartilages becomes difficult and is accompanied by permanent microtrauma when the cartilages stick together.Cartilage tissue in a state of constant microtrauma begins to lose its shock absorption properties and becomes thinner.
The development of pathological processes causes changes in bone structures.The articular area is flattened, growths in the form of spines (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 nutrition process of the cartilage and accelerates its degeneration.
When the disease progresses to the second stage, the symptoms begin to intensify, the pain occurs even with light loads and is localized along the inner front 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 distinct rough crunch is heard when moving.Synovitis is more common;the joint expands and changes its configuration due to a large accumulation of fluid.
The third degree of arthrosis of the knee joint is accompanied by a significant deformation of the bones, which seem to be pressed together.There is practically no cartilage tissue and the limitation of joint movement increases.The alignment of the joints becomes quite problematic, and pain begins to bother the patient day and night, both during walking and at rest.Due to the severe deformation of the joints, the legs become O- or X-shaped, the gait becomes unstable, swaying, and often the patient cannot do without a cane or crutches.
Diagnosis and treatment of gonarthrosis
During a routine examination, it is not possible to determine whether the patient has first-degree arthrosis of the knee joint.If it is 2 or 3 degrees, swelling, edema (with synovitis), a crackling sound is heard during the examination, 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 for the diagnosis of arthrosis, thanks to which it is possible to study the disorders of bone structures in more detail and to examine pathological changes in soft tissues.
Treatment of the disease includes a complex of orthopedic procedures and drug therapy.The orthopedist prescribes mud treatment, therapeutic exercises, massage and physiotherapy.
Drug treatment involves the use of chondroprotectors, which are drugs that replace synovial fluid.In some cases, intra-articular injection of steroid hormones is performed.Sanatorium-spa treatment is also recommended for patients.
If the treatment of a young patient with severe limitation of movement and pain is ineffective, the method of joint replacement, which involves a rehabilitation period of 3-6 months, can be used.
What happens to the knee joint with arthrosis?
Articular cartilage plays an important role in human movement and is a smooth, flexible and durable lining that allows joint bones to move smoothly relative to each other, as well as absorb and distribute load during walking.
However, due to excessive regular loads, genetic predisposition, metabolic disorders in the body, long-lasting muscle spasms and injuries, the cartilage loses its smoothness and begins to thin.Soft sliding of the articular bones is replaced by strong friction, and the first degree of gonarthrosis develops, when the cartilage loses its shock-absorbing properties.
The degradation process continues to progress, and poor shock absorption leads to the flattening of bone surfaces with the formation of osteophytes in the form of bone growths.In this case, the disease is already secondary and is accompanied by degeneration of the synovial membrane and 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 process of cartilage nutrition is disturbed, which causes the patient's condition to worsen.
Thinning cartilage causes the distance between the joint bones to decrease by up to 80%.When walking, destructive processes in the joint increase rapidly due to abnormal friction and the lack of a shock absorber, which quickly leads to the development of third-degree arthrosis with obvious symptoms:
Pain when moving, especially when going up or down stairs.
Pain, morning stiffness, both during exercise and at rest.
The patient begins to limp, trying to protect his painful joint.
Severe cases of the disease require the use of crutches or a cane.
The third degree of arthrosis of the knee joint is characterized by the almost complete absence of cartilage tissue, which leads to a decrease in joint mobility.Therefore, no magic methods, super drugs or ointments can restore the worn cartilage tissue, and given the degree of bone deformation, normal functioning of the joint is impossible.In this case, only surgical intervention can help.
Gymnastics for arthrosis of the knee joint
Any treatment option for arthrosis of the knee joint should be carried out only as prescribed by the doctor.Therapeutic gymnastics involves slow, measured exercises that exclude squatting, twisting and jumping.It is best to do morning gymnastics sitting or lying down for 20 minutes, repeating each exercise 10 times.
The main goals of therapeutic exercises are to relieve muscle spasms that cause pain, increase blood supply to the joint, slow down the progression of the disease, and prevent further destruction of the cartilage.During the exacerbation of the disease, physical activity is prohibited.
Lying on your back, you can do the bicycle exercise, but you need to straighten your legs parallel to the floor, make circular movements with your legs, turn your legs to the sides, slide them alternately along the floor, and strain your legs up to 10.
Sit on the 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.
Focusing on the wall, standing on the floor, alternately swing your legs back and forth.
By placing your straightened leg on the chair, while resting your hands on your thigh, as if trying to straighten your leg more, make inclined movements of a spring nature.
Lying on your stomach, alternately raise your straightened leg and hold for 3 counts.
Sitting on the floor, spread your legs to the sides, move along the floor, pull your knees to your stomach when you inhale and return them to the starting position when you exhale.