Treatment of arthrosis 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.This includes the appearance of swelling in the knee area, redness around these swellings, creaks and rustles, clearly audible in silence during knee movement, especially during squats, and a distinct pain syndrome of varying intensity.Pain can appear immediately after normal daily physical activity or after physical exercise that is inappropriate in duration and intensity based on age.When touching on the underlying causes of this pain, we must keep in mind that its appearance can also be the result of:

• Inflammatory process in the knee joint.That is, be a consequence of arthritis.It occurs as an independent pathology or as a complication of other diseases.
• Osteoarthritis is a degenerative process during which the tissues of the joint are destroyed, mobility is lost, and if the course of arthrosis has been prolonged, it also causes deformation of the joint.
• Injuries.Most often it occurs due to a fall, a blow to the knee or a blow to the knee on a hard surface.The joint may become deformed.
• Ligament damage.The ligaments hold the joint in the correct position, preventing it from moving.But when they are damaged (stretched, displaced, broken), the joint also suffers - with severe pain and the appearance of a tumor.In order not to aggravate the injury, in such cases urgent medical care and rest for the injured leg is needed.
• Damage to the meniscus of the patella.This protruding, round, movable cartilage in the knee can also be injured when squatting or turning 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-ray and palpation by an experienced specialist.
• Popliteal cyst (Becker's cyst).As a result of inflammation, fluid is formed in the joint, which accumulates in the internal part of the popliteal fossa, in the area of the tendons.
• Inflammation of the ligaments and tendons (tendinitis).They cause unpleasant and painful 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, into the ligaments and muscles of the femur, and below - in the lower leg.
• Ischemic pain, due to reduced 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 long hours at high (arctic) latitudes.In most cases, the localization of pain is symmetrical, equally intense and in the first phase does not affect joint mobility.

The most serious mistake in these cases would be to ignore the pain and hope that, by resting, "everything will go away by itself".Only a specialist can give recommendations for treatment and make a correct diagnosis, so treatment of arthrosis of the knee joint is unacceptable at home only on the basis of the advice of "experienced people" and also using exclusively traditional medicine.Effective treatment is possible only with a combination of drugs in the form of tablets, rubbing, ointments and the use of physiotherapy.Sometimes, in severe or advanced cases, surgery cannot be avoided.

Make a diagnosis

An orthopedic surgeon can make a diagnosis of osteoarthritis of the knee joint after motor tests and medical history.The following procedures are usually prescribed as additions to diagnostics:

• Related to laboratory tests, such as biochemical examination of blood and bacterial microflora, smear, puncture of joint fluid and/or bone marrow, serological analysis, i.e. a 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 to penetrate the cavity through an incision.Most often, this method is used after damage to the meniscus or in case of cracks and severe wear of the cartilaginous tissue, as well as to restore the anterior cruciate ligaments.Although the anthroposcope has recently been rarely used as a diagnostic tool, it has been successfully replaced by a completely non-invasive diagnostic method using magnetic resonance imaging.
• 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 combined into a general anamnesis and only on the basis of it can a complete and effective treatment be started.

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 drugs, and the result depends only on the patient's desire 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 joints.If the job involves such stress, negotiate with management (if necessary, with medical records in hand) to change your type of activity.For a while or forever, life will tell.Although often initially, bed rest may be necessary for initial restoration of joint function.Remember: a joint is not a muscle, you cannot “train” it with intense exercise, you will only make things worse.Activating the waist with intense movements may be necessary later, after the more acute inflammation has subsided.But even when increasing the load, it is necessary to use means of support in the form of elastic bandages, a cane, a crutch, etc.Sometimes you can't do without special orthopedic insoles or even custom-made orthopedic shoes.

Treatment of arthrosis of the knee joint is also possible at home, using outpatient drugs prescribed by a doctor: chodroprotectors, painkillers and anti-inflammatory drugs.Depending on the extent of joint damage and the type of inflammation, your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs).But for all their effectiveness in relieving symptoms, they do not eliminate the causes of the disease.

Do not heat aching joints with arthrosis!Instead, apply an ice pack to the inflamed area - it will help relieve swelling, redness and inflammation.

The use of chondroprotectors, on the contrary, does not relieve pain.But the restoration of cartilage tissue will proceed slowly but surely.The only question is the effectiveness of the drug, but you should try to use proven and certified drugs for treatment.Preferably internationally recognised.

For some types and degrees of joint damage, it may be helpful to apply and permanently (or temporarily) wear a tight bandage that secures the joint.But this measure should be used only if the method is approved by the attending physician, since in some types of arthrosis wearing such a bandage can aggravate the course of the disease.

You can't completely immobilize yourself if you have knee pain.Additionally, with some types of inflammation, moderate physical activity only benefits the joint.An orthopedic doctor will tell you when and how much to exercise.In addition, complete passivity in terms of physical activity will cause weight gain, and this will further aggravate the situation, loading 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 is used at safe frequencies), mechanical vibration and ultraphonotherapy, microwave implants with deep effects on tissues - when this is therapeutically justified.

In the diagnosis, three degrees of arthrosis of the knee joint are distinguished.

First degree osteoarthritis

The mildest degree of the disease.It is characterized by the fact that the treatment does not require large medicinal intervention, the list of drugs is small, and measures including physiotherapy, massage and exercise therapy are of great help.One of the most effective methods is considered laser therapy, which significantly reduces pain, stimulates the 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 arthrosis

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

Recommendations: reduce the load on the affected joint, limit walking, avoid any movements associated with squats.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 and non-steroidal anti-inflammatory drugs may be present.It is possible to inject hyaluronic acid and other drugs into the joint capsule to facilitate the sliding of the cartilaginous surfaces relative to each other.

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

Grade III osteoarthritis

When the knee joint is affected by third degree arthrosis, the treatment is not much different from the previous condition, except that the frequency of use of drugs increases with a slight shift towards glucocorticosteroid hormones.If no results are achieved, 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 passes the age of 50: when the flexibility of the ligaments is lost, tissue dehydration processes begin and the metabolism slows down.

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

This disease, once started, progresses very rapidly.Refers to acquired age-related 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 cartilaginous layer of the joints can be preserved both after 70 and after 80 years.

Possible onset of the disease

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

This joint also includes the largest mobile sesamoid bone: the patella, located on the crown of the tendons of the quadriceps femoris muscle.The joint surfaces are covered with a thick, up to 2.5 mm, cartilaginous membrane made up of chondrocytes.Medicines with the generic name of chondroprotectors help restore these cartilage tissue cells, which are mainly affected by gonarthrosis.

There are primary and secondary arthrosis of the knee joints.The etymology of the former is not fully understood and may have several reasons.When - from a sedentary lifestyle and when, vice versa, from excessive physical activity.Poor ecology, excess weight and addiction to smoking or alcohol can also have an impact.Doctors consider the identification of the first stage of arthrosis to be a great success, since 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 with a tendency to such diseases not to choose cold-related professions (refrigerators, navy working in northern latitudes), etc.

In women over 45 years of age, the frequent development of gonarthrosis is associated with long-term use of contraceptives due to a decrease in the natural synthesis of estrogens.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 caused by strict weight loss diets, during which many useful minerals and vitamins are removed from the diet.

It is much easier to decide how to influence secondary arthrosis, which can be a consequence of:

• Defects in the development and formation of tissues;
• The influence of neurodystrophic processes in the cervical and lumbar spine;
• Arthritis of the knee joint;
• His wounds and microtraumas;
• Meniscectomy, i.e. surgical removal of the meniscus;
• Hormonal imbalances and chronic endocrine diseases;
• Intense and constant physical activity, including sport.To prevent joint injuries after 40 years, 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 loaded squats);
• Abnormal joint mobility.This condition occurs when the ligaments that hold the joint in the correct position are underdeveloped or naturally weak;
• Constant stress and nervous tension.

Signs and symptoms of disease onset (stage or grade)

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

It is necessary to pay maximum attention to these signs, because if you do not consult a doctor during this period, the disease begins to progress rapidly, leading to the second stage of the disease.

Grade II gorantrosis

Which is typical:

• Night pain, as well as pain in the first minutes of the morning when getting out of bed.
• Pain when climbing flights of stairs.
• Possibility to use public transport with restrictions.
• Slightly pronounced lameness.
• The occurrence of pain when moving at a distance of up to 800-1000 meters.
• Limited ability to care for oneself.

Often, measures to simply increase the production of synovial fluid by the joint become an effective way to cure even the second degree of gonarthrosis.

Gorantrosis grade III

Characterized by:

• pain that begins immediately after rest or occurs after 500 meters of silent movement;
• severe lameness, when the help of improvised means (sticks, crutches) is required;
• stiffness after waking up to half an hour or more;
• inability to climb stairs or enter high-level vehicles independently or without assistance;
• night pain even without moving the joint.

The affected joint develops ankylosis, a condition in which the joint ends of adjacent opposing bones fuse.The leg completely loses mobility and the only way to return 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 the cartilage tissue, but also on the age of the patient, his ability to tolerate certain drugs and physiotherapeutic methods of influence.

In the diagnosis, a distinction is often made between unilateral and bilateral arthrosis and between unilateral, right and left arthrosis.The latter is often diagnosed in left-handed people.

Nutrition for gonarthrosis

First of all, doctors recommend excluding red meat and offal such as liver from your diet.Priority should be given to fruits and vegetables, cereals high in gluten and fiber, without salt and sugar.As well as fermented milk products, fish and nuts.

The last time you eat food should be no later than 7pm.The frequency of food intake may remain familiar, as it has developed over many years.But it is better to eat in fractions – in small portions 5-6 times a day in the morning.

Breakfast should be the most abundant: it puts the body in the mood to work and keeps you going until lunch.

If, especially at the beginning, 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 meats.Transport collagen to the body and joints: the raw material for building cartilage tissue.

Drink at least 2 liters of liquids a day: water and/or natural juices.

Eliminate from your diet:

• Red meat;
• Lard, smoked meats of all kinds;
• 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 weight.Therefore, the Dukan diet will be relevant.

Treatment of gonarthrosis in a sanatorium

As methods of treating arthrosis of the knee joint, the institute uses a wide range of physiotherapy, mud therapy, acupuncture and all types of massage.

One of the advanced treatment methods is intra-articular injections of hyaluronic acid.They compensate for the lack of production of their own hyaluronic acid, which acts as a lubricating element for the surface of the joint and protects it from abrasion.The effect of this procedure is felt from the first day.The effect of an injection lasts on average a month.Patients in the advanced stages of arthrosis feel a significant reduction in the pain that has tormented them for many years in the very first 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.