Gonarthrosis or deforming arthrosis 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 arthrosis of the knee joint develop gradually over years, and the main manifestation of the 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 group most prone to arthrosis of the knee joint is women and 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 that worsen with age and can ultimately lead to such a disorder.Medical science identifies the following mechanisms for the development of arthrosis:
Primary - occurs in old age due to the aging of body tissues, as well as against the background of some factors that provoke this disease (constant increased stress, heredity, obesity).
Secondary - accounts for 30% of all gonarthrosis, mainly after damage to the meniscus, rupture of ligaments, fracture of the tibia 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 arthrosis of the knee joint occurs when a person after forty years actively participates in exercise, namely squatting and running.But due to age, the weakening of the tissue tone of the knee joint and the characteristic age-related changes that occur during sudden loads can trigger rapid degenerative and dystrophic changes in the joints.
Another reason for the development of gonarthrosis in a person can be accompanying diseases - varicose veins, excess weight, ankylosing spondylitis, gout, psoriasis, rheumatic or reactive arthritis.
Constant critical loading of the knee, regular, long-term climbing of stairs in old age or heavy lifting, as well as professional sports can lead to arthrosis of the knee joint.The risk of arthrosis of the knee joint increases significantly in case of genetic weakness of the ligament system, diabetes mellitus and other metabolic disorders, neurological diseases and spinal injuries.
Muscle spasm of the front of the thigh occurs in 50-60% of cases of knee arthrosis.Such muscle spasms may not appear for a long time before the appearance of knee pain, while the person may feel heaviness in the legs, fatigue and lower back pain.When the iliopsoas and rectus femoris muscles are in constant spasm, as we age, this leads to "tightening" of the knee, which limits their free movement.
Grades of gonarthrosis
In most cases, the development of arthrosis of the knee joint occurs in one knee.Medicine distinguishes 3 degrees of gonarthrosis depending on the intensity of pathological processes:
The first is that there is no deformation in the bones of the joint;periodic dull pain in the knee is typical after physical stress on the joint.Minor joint swelling may develop, which will disappear after a while.
The second stage is characterized by an increase in the symptoms of arthrosis.The pain is long-lasting and intense, occurs with minimal exertion (lifting weights, walking), and a cracking sound may also appear in the joint.In the second stage of gonarthrosis, deformation may develop in the knee joint, as well as moderate movement restriction.
Third degree - there are pronounced symptoms of arthrosis of the knee joint.Noticeable deformation of the joint and constant pain lead to the patient's walking disorders, and the mobility of the joint is limited.In the third degree of gonarthrosis, the pain may increase depending on the weather and become so strong that the patient's sleep is disturbed, the mobility is reduced to a minimum, which makes it impossible to find a comfortable position for the foot.
Diseases and pathologies with which gonarthrosis is confused
Blockage of the knee joint in case of meniscus damage.
The disease develops after an unsuccessful movement, which is accompanied by a cracking of the knee, severe pain occurs, which disappears after 15 minutes, and the next day knee swelling appears.
Spondylitis ankylopoetica, gout, rheumatism, arthritis - psoriatic, reactive, rheumatic.
In order to distinguish between gonarthrosis and arthritis, a general blood test should be performed.In the case of arthritis, the test results indicate the presence of an inflammatory process in the body, while in the case of arthrosis, there is no change 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 knee.
The pain is characterized by symmetry and occurs in both knees at the same time.During the period of accelerated bone growth, it is typical for young people that they may appear during physical activity, colds or weather changes.Patients use the term "twisted knee" to describe their own condition.
Stages of arthrosis of the knee joint
The disease is insidious due to its gradual development.Initially, the patient only feels minor discomfort and pain when moving, going up or down stairs.In some cases, the patient's sensations are reduced to a slight stiffness of the joint and tension in the popliteal region.The characteristic feature of arthrosis of the knee joint can be considered as the symptom of initial pain, which consists in the fact that after a sharp transition from a sitting position to movement, a person feels pain during the first steps, which gradually disappears, and then reappears after a heavy load.
The appearance of the knee joint with the first degree of arthrosis does not differ from a healthy knee, only in some cases patients notice a slight swelling.In addition, in some cases, fluid accumulates in the knee joint, it becomes swollen and globular, and synovitis begins to develop, leading to stiffness and limited movement of the joint.
Such joint changes occur in the first stage of arthrosis due to disruption of blood circulation in the small intraosseous vessels that feed the hyaline cartilage.This leads to changes in the surface of the cartilage, dryness, loss of smoothness and the appearance of cracks.Because of this, unhindered and smooth movement between the cartilages is difficult and is accompanied by constant microtrauma when the cartilages stick together.In a state of constant microtrauma, the cartilage begins to lose its shock-absorbing properties and becomes thinner.
The development of pathological processes leads to changes in bone structures.The joint area flattens, and growths in the form of spines (osteophytes) appear at its edges.The joint capsule degenerates, the synovial fluid thickens, and the synovial membrane shrinks.This leads to a significant deterioration of the cartilage's nutritional process and accelerates its degeneration.
As the disease progresses to the second stage, the symptoms begin to intensify, the pain occurs even with light exertion and is localized along the inner front side of the joint.Resting 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 during movement a particularly harsh crackling sound is heard.Synovitis is more common;the joint becomes enlarged and changes in configuration due to the accumulation of large amounts of fluid.
The third degree of arthrosis of the knee joint is accompanied by a significant deformation of the bones, in which they seem to be pressed into each other.There is practically no cartilage tissue, and the limitation of joint movement increases.Straightening the joints becomes quite problematic, and pain begins to bother the patient day and night, both when walking and at rest.Due to severe deformation of the joints, the legs become O- or X-shaped, the gait becomes unstable, ducks, and often the patient cannot do without a stick or crutches.
Diagnosis and treatment of gonarthrosis
During the 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 creaking sound can be heard, stiffness of movements, changes in the axis of the limbs, and deformation of the joints can be detected during the examination.
Nowadays, in addition to radiography, CT and MRI methods are widely used for the diagnosis of arthrosis, thanks to which it is possible to study bone structure disorders in more detail and examine pathological changes in the soft tissues.
Treatment of the disease includes a complex of orthopedic procedures and drug therapy.The orthopedist prescribes mud therapy, therapeutic exercises, massage and physiotherapy.
Drug treatment includes the use of chondroprotectors, which are drugs that replace synovial fluid.In some cases, intra-articular injections of steroid hormones are performed.Sanatorium-resort treatment is also recommended for patients.
If the treatment of the young patient with severe limited mobility and pain is ineffective, then a joint replacement method can be used, which provides a rehabilitation period of 3-6 months.
What happens to the knee joint in case of arthrosis?
Articular cartilage plays an important role in human movement, it is a smooth, flexible and durable lining, thanks to which the joint bones move smoothly relative to each other and absorb and distribute the load during walking.
But in case of excessive regular loading, genetic predisposition, metabolic disturbances in the body, long-lasting muscle spasms and injuries, the cartilage loses its smoothness and begins to thin.The gentle sliding of the articular bones is replaced by strong friction, and first-degree gonarthrosis develops, in which the cartilage loses its shock-absorbing properties.
The decomposition process continues, and poor shock absorption leads to the flattening of the bone surfaces and 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 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 nutrition process of the cartilage is interrupted, which leads to an even greater deterioration of the patient's condition.
The thinning of the cartilage reduces the distance between the joint bones by up to 80%.During walking, due to abnormal friction and the lack of a shock absorber, destructive processes in the joint rapidly increase, which quickly leads to the development of third-degree arthrosis, with pronounced symptoms:
Pain when moving, especially going up or down stairs.
Pain during exercise and at rest, morning stiffness.
The patient begins to limp, trying to spare the painful joint.
Severe cases of the disease require crutches or a stick.
The third degree of arthrosis of the knee joint is characterized by an almost complete absence of cartilage tissue, which leads to a minimal decrease in joint mobility.Therefore, no magic method, super medicine or ointment can restore the worn-out cartilage tissue, and the normal functioning of the joint is impossible due to the degree of bone deformation.In this case, only surgery can help.
Gymnastics for arthrosis of the knee joint
Any treatment option for arthrosis of the knee joint can only be performed as prescribed by a doctor.Therapeutic gymnastics includes slow, measured exercises that exclude squatting, joint twisting and jumping.It is best to exercise in the morning, sitting or lying down, for 20 minutes, repeating each exercise 10 times.
The main goal of the therapeutic exercises is to relax the muscle spasms that cause pain, increase the blood supply to the joint, slow down the progression of the disease, and prevent further destruction of the cartilage.Physical exercise is prohibited during the period of exacerbation of the disease.
You can do the bicycle exercise lying on your back, but you need to straighten your legs parallel to the floor, make circular movements with your legs, move your legs to the side, alternately sliding them on the floor, and force your legs to 10.
Sitting on a chair with your feet down, straighten your legs, at the same time bend your legs and hold this position, counting to 10, alternately pull both knees 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.
With your straightened leg on a chair, perform a spring-like oblique movement while resting your hand on your thigh as if trying to straighten your leg more.
Lying on your stomach, alternately raise your straightened leg and hold for up to 3 counts.
Sitting on the floor, spread your legs to the sides, move them along the floor, pull your knees to your stomach when you inhale and return them to their starting position when you exhale.