Treatment of osteoarthritis of the knee joint (gonarthrosis)

With age, the vast majority of people face the acute question of how to treat arthrosis of the knee joint, with typical symptoms,inherent to this disease in its different phases.These include the appearance of swelling in the knee area, redness around these swellings, creaking and rustling, clearly audible in silence when the knee moves, especially during squats, and a distinct pain syndrome of varying degrees of intensity.Pain may appear immediately after normal daily physical activity or after physical exercise inappropriate for age in duration and intensity.When addressing the underlying causes of this pain, we must bear in mind that its appearance can also be the result of:

• Inflammatory process in the knee joint.In other words, it is a consequence of arthritis.It occurs as an independent pathology or as a complication of other diseases.
• Osteoarthritis is a degenerative process during which joint tissues are destroyed, mobility is lost and, if the course of arthrosis is prolonged, it also causes deformation of the joint.
• Injuries.Most often, it occurs due to a fall, a blow to the knee, or a hit to the knee on a hard surface.The gasket may become deformed.
• Ligament damage.Ligaments keep the joint in the correct position, preventing it from moving.But when they are damaged (stretched, displaced, torn), the joint also suffers - with severe pain and the appearance of a tumor.In order not to aggravate the injury, in these cases, urgent medical attention and rest of the injured leg are necessary.
• Damage to the meniscus of the kneecap.This protruding, round, mobile knee cartilage can be injured even when you squat or turn sharply.It is not always detected visually due to the swelling of the knee joint that often occurs in these cases.Accurate diagnosis is made using ultrasound, X-rays and palpation by an experienced specialist.
• Popliteal cyst (Becker cyst).As a result of inflammation, fluid forms in the joint, which accumulates in the inner part of the popliteal fossa, in the region 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 the knee is used (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.Examples are 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 these cases would be to ignore the pain and hope that if you just rest, “everything will go away on its own.”Only a specialist can give treatment recommendations and make a correct diagnosis, therefore the treatment of arthrosis of the knee joint is unacceptable at home only on the basis of the advice of “knowledgeable people”, and even with the use of purely traditional medicine.Effective treatment is only possible 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.

Making a diagnosis

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

• Relating to laboratory tests, such as biochemical examination of blood and bacterial microflora, smear, puncture of joint fluid and/or bone marrow, serological analysis, that is, study for the presence of antibodies and antigens contained in the blood serum.
• Instrumental studies, which may include ultrasound, magnetic resonance imaging, densitometry and others.
• Examination of the internal joint capsule using an arthroscope - a device for a minimally invasive procedure for penetrating the cavity through an incision.Most often, this method is used after damage to the meniscus or with cracks and severe wear of cartilaginous tissue, as well as to restore the anterior cruciate ligaments.Although the anthroscope has recently been rarely used as a diagnostic tool, it has been successfully replaced by a completely non-invasive diagnostic method using MRI.
• Only “by ear” - with a joint injury of the 3rd degree, extraneous sounds in the form of creaks, rustles and clicks are clearly audible in the joint.

The information obtained is gathered into a general history, and only from there it is possible to begin a complete and effective treatment.

How to treat gonarthrosis?

Restoring joint mobility is not a matter of a month.The treatment is complex, expensive due to the high cost of medicines, and the result depends only on the patient's willingness 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 work involves so much stress, negotiate with management (if necessary, with a doctor's note in hand) to change your type of activity.For a while or forever - life will tell.Although often at first, 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, this will only make the situation worse.Activating life with intense movement may be necessary later, after 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, a cane, crutches, 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, with outpatient medications prescribed by a doctor - chondroprotectors, analgesics and anti-inflammatories.Depending on the degree of damage to the joint and the type of inflammation, your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs).But, despite all their effectiveness in relieving symptoms, they do not eliminate the causes of the disease.

Don't heat painful joints with osteoarthritis!On the contrary, apply an ice pack to the inflamed area - this will help relieve swelling, redness and inflammation.

The use of chondroprotectors, on the contrary, does not relieve pain.But the restoration of cartilaginous tissue will occur slowly but surely.The only question is the effectiveness of the medicine, but you should try to use proven and certified medicines for treatment.Preferably with international recognition.

For some types and degrees of joint damage, applying and permanently (or temporarily) wearing a tightening bandage that secures the joint may help.But this measure should only be used if the method is approved by the attending physician, as in some types of osteoarthritis the use of this dressing can worsen the course of the disease.

You cannot completely immobilize yourself if you experience 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 to exercise.Furthermore, total passivity in terms of physical activity will cause weight gain, which will further aggravate the situation, putting strain on the joint.

Drug treatment is usually combined with physiotherapy courses, the most favorable for the treatment of arthrosis: 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.

When diagnosing, three degrees of arthrosis 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 involving physiotherapy, massage and physiotherapy help a lot.One of the most effective methods is 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.

Grade II osteoarthritis

It is characterized by more intense and acute processes of inflammation and degeneration of cartilaginous tissue.In the acute period, special medications are prescribed, a special diet is recommended and specific physiotherapy is recommended for these cases.Physiotherapy and massage are excluded during these periods.

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

In the medical arsenal for the treatment of second-degree arthrosis, along with chondroprotectors with glucosamine and chondroitin, steroid medications may be present, as well as non-steroidal anti-inflammatory drugs.It is possible to inject hyaluronic acid and other drugs into the joint capsule to facilitate the sliding of the cartilage surfaces relative to each other.

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

Grade III osteoarthritis

When the knee joint is affected by third-degree arthrosis, the treatment is not much different from the previous picture - except that the frequency of taking medications increases with a slight switch to 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 is in no way related to the aging of the body.

A completely different picture emerges when a person turns 50 - when the flexibility of the ligaments is lost, tissue dehydration processes begin and the metabolism slows down.

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

This disease, once started, progresses very quickly.Refers to age-related acquired pathologies of the musculoskeletal system.One way 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 after 80 years.

Possible onset of the disease

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

This joint also includes the largest movable sesamoid bone - the patella, located on 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, composed of chondrocytes.Medicines with the general name chondroprotectors help restore these cartilaginous tissue cells, which are mainly affected by gonarthrosis.

There are primary and secondary arthrosis of the knee joints.The etymology of the first is not fully understood and may have different reasons.When - because of a sedentary lifestyle, and when, vice versa, because of too much physical activity.Poor ecology, being overweight and addiction to smoking or alcohol can also have an impact.Doctors consider the identification of the first stage of osteoarthritis a great success, as 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 these diseases not to choose professions related to the cold (refrigerators, navy working in northern latitudes), etc.

In women over 45 years of age, the frequent development of gonarthrosis is associated with prolonged use of contraceptives due to a decrease in natural estrogen synthesis.It also often 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 on ways to influence secondary arthrosis, 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;
• Your injuries and microtraumas;
• Meniscectomy, that is, surgical removal of the meniscus;
• Hormonal imbalances and chronic endocrine diseases;
• Intense and constant physical activity, including sports.To prevent joint injuries after the age of 40, it is better to significantly limit and subsequently abandon all exercises associated with extreme loads on the knee joint (in the form of running on hard surfaces or squats with a load);
• Abnormal joint mobility.This condition occurs when the ligaments that hold 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 degree)

• Stiffness of the knee joint in the morning;
• The appearance of knee pain if you walk a kilometer and a half;
• Joint pain after standing for a long time (even without movement);
• Knee pain even after complete rest, up to 2 hours, in a sitting position;
• Pain before bed or in the first half of the night while sleeping.

These signs need to be paid close 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.

Grade II goranthrosis

What is typical:

• Nighttime pain, as well as pain in the first few 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 occurrence of pain when moving at a distance of 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 second-degree gonarthrosis.

Grade III goranthrosis

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 for up to half an hour or more;
• inability to climb stairs or enter high-level vehicles independently or without assistance;
• nighttime pain even without moving the joint.

The affected joint develops ankylosis, a condition in which the articular ends of adjacent opposing bones fuse together.The leg completely loses 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 cartilaginous tissue, but also on the patient's age, his ability to tolerate certain medications and methods of physiotherapeutic influence.

When diagnosing, a distinction is often made between unilateral and bilateral arthrosis, and between unilateral, right and left arthrosis.The latter is often diagnosed in left-handers.

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 a high gluten and fiber content, without salt and sugar.As well as fermented dairy products, fish and nuts.

The last time you eat food should not be after 7 pm.The frequency of food intake may remain familiar as it has evolved over many years.But it is better to eat in fractions – in small portions, 5 to 6 times a day, in the morning.

Breakfast should be the most filling - it leaves the body wanting to work and keeps you strong 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 meat.Transporting collagen to the body and joints - raw material for building cartilage tissue.

Drink at least 2 liters of liquid per 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 rich 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 massages as methods of treating arthrosis 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 its 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 on the first day.The effect of an injection lasts an average of one month.Patients in advanced stages of arthrosis feel a significant reduction in the pain that has tormented them for many years in the first few days, and people with a moderate course of the disease, grade 1-2, after a course of 5 injections in most cases completely forget about the pain for about six months.