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.
Symptoms of arthrosis of the knee joint develop over years, gradually, and the main manifestation of the disease is stiffness of movement and pain.Of the arthrosis of other joints (finger phalanges, shoulder and elbow joints, hip joints), gonarthrosis is the most common disease.
The category of the population that is most sensitive to arthrosis of the knee joint is women, as well as people over 40 years old.In some cases, gonarthrosis can develop in athletes (from increased stress) and young people (on the background of previous injuries).
Causes of gonarthrosis
Osteoarthritis of the knee joint does not arise 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 ultimately lead to such a disorder.Medicine identifies the following mechanisms for the formation 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 cases of gonarthrosis, and occurs 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, 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, i.e. squats and running.But due to age, the weakening of the tone of the knee joint tissue and characteristic age-related changes under sudden loads can cause the appearance of rapid degenerative and dystrophic changes in the joints.
Another reason for the development of gonarthrosis in a person may be accompanying diseases - varicose veins, excess weight, ankylosing spondylitis, gout, psoriatic, rheumatoid or reactive arthritis.
Constant critical loads on the knees, 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 with genetically caused weakness of the ligament apparatus, diabetes mellitus and other metabolic disorders, neurological diseases and spinal injuries.
Spasm of the muscles of the front part of the thigh is the cause of 50-60% of cases of arthrosis of the knee joint.Such a muscle spasm may not manifest itself for a long time before the onset of pain in the knees, while a person may feel heaviness in the legs, fatigue and pain in the lower back.When the iliopsoas and rectus femoris muscles are in a state of constant spasm, with age it 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.Medicine distinguishes 3 degrees of gonarthrosis depending on the intensity of pathological processes:
The first is that there is no deformation of the bones of the joint;periodic dull pain in the knee is characteristic after physical stress on the joint.A minor swelling of the joint may develop, which disappears on its own after some time.
The second stage is characterized by an increase in arthrosis symptoms.The pain is long-lasting and intense, and occurs with minimal effort (lifting heavy legs, walking), and a creaking in the joint may also occur.In the second degree of gonarthrosis, deformation of the knee joint can develop, as well as a moderate restriction of movement.
Third degree - has pronounced symptoms of arthrosis of the knee joint.Noticeable deformations of the joint and constant pain lead to disturbances in the patient's gait, and there is also limited mobility of the joint.In the third degree of gonarthrosis, the pain can increase depending on the weather 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 with which gonarthrosis is confused
Block of the knee joint in case of meniscus damage.
The disease develops after an unsuccessful movement, accompanied by a creaking in the knee, severe pain occurs, which subsides after 15 minutes, and the next day the knee swells.
Ankylosing spondylitis, gout, joint rheumatism, arthritis - psoriatic, reactive, rheumatoid.
In order to distinguish gonarthrosis from arthritis, it is necessary to take a general blood test.In arthritis, the test results will indicate the presence of an inflammatory process in the body, while in arthrosis there are no changes in the blood test.
Inflammation of the knee tendon.
It develops in most cases in women over 40 years old, when they carry heavy objects or go 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 once.Characteristic for young people in the period of accelerated bone growth, they can occur during physical activity, colds or weather changes.To describe their own condition, patients use the term "twisted knees".
Stages of arthrosis of the knee joint
The disease is insidious due to its gradual development.At first, the patient feels only minor discomfort, pain when moving, climbing or descending stairs.In some cases, the patient's sensations are limited to mild joint stiffness and tightness in the popliteal region.A characteristic feature of arthrosis of the knee joint is considered to be the symptom of initial 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 steps, which gradually disappears, only to reappear after a heavy load.
The appearance of a knee joint with the first degree of arthrosis does not differ from a healthy knee, only in some cases patients notice 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 are caused by blood circulation disorders 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, the smooth and soft movement between the cartilages is difficult and is accompanied by constant microtraumas when the cartilages stick to each other.Cartilage tissue, which is in a constant state of microtrauma, begins to lose its cushioning properties and becomes thinner.
Development of pathological processes leads to changes in bone structures.The joint area is flattened, and 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 of the cartilage nutrition process and accelerates its degeneration.
As 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 continued 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 when moving, a pronounced coarse grinding is heard.Synovitis is more common;the joint enlarges and changes its configuration due to the large accumulation of fluid.
The third stage 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 torment the patient 24 hours a day, both while walking and at rest.Due to the severe deformation of the joints, the legs take on an O- or X-shape, the gait becomes unstable, he stumbles, and often the patient cannot do without a stick or crutches.
Diagnosis and treatment of gonarthrosis
During a routine examination, it is impossible to determine whether a patient has first-degree knee arthrosis.If there is a 2nd or 3rd degree, during the examination swelling, edema (with synovitis), creaking is heard, stiffness of movements is observed, a change in the axis of the limbs and deformation of the joints is noticeable.
Today, in addition to radiography, CT and MRI methods are widely used in the diagnosis of arthrosis, thanks to which it is possible to study bone structure disorders in more detail and examine pathological changes in soft tissues.
Treatment of the disease includes a complex of orthopedic interventions 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, an intra-articular injection of steroid hormones is performed.A sanatorium-resort is also recommended for patients.
If the treatment of a young patient with marked limitation of movement and pain is ineffective, a joint replacement method can be applied, which foresees a rehabilitation period of 3-6 months.
What happens to the knee joint in arthrosis?
Articular cartilage plays an important role in human movement and is a smooth, elastic and durable covering, thanks to which the articular bones move smoothly in relation to each other, and also absorbs and distributes the load during walking.
But with excessive regular loads, genetic predisposition, metabolic disorders in the body, long-term muscle spasms and injuries, the cartilage loses its smoothness and begins to thin.The soft gliding of the articular bones is replaced by strong friction and the first stage of gonarthrosis develops, in which the cartilage loses its cushioning 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 already has the second stage 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 cartilage nutrition process is disturbed, which leads to an even greater deterioration of the patient's condition.
Thinning of the cartilage leads to a reduction of the distance between the joint bones by up to 80%.When walking, due to abnormal friction and the absence of shock absorbers, destructive processes in the joint rapidly increase, which quickly leads to the development of the third stage of arthrosis with pronounced symptoms:
Pain when moving, especially when 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 the use of crutches or a cane.
The third stage of arthrosis of the knee joint is characterized by an almost complete lack of cartilage tissue, which leads to a reduction in joint mobility to a minimum.Therefore, no magical methods, super drugs or ointments can restore worn cartilage tissue, and given the degree of bone deformation, normal functioning of the joint 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 be carried out only according to the doctor's recommendation.Therapeutic gymnastics includes slow, measured exercises that exclude squats, twisting the wrist and jumping.It is best to do gymnastics in the morning, sitting or lying down, for 20 minutes, repeating each exercise 10 times.
The main goals of therapeutic exercises are to relax muscle spasms that cause pain, increase blood flow to the joint, slow down the progression of the disease and prevent further cartilage destruction.During the period of worsening of the disease, physical activity is prohibited.
Lying on your back, you can perform a bicycle exercise, but you need to straighten your legs parallel to the floor, make circular movements with your feet, move your legs to the side, alternately sliding them on the floor, strain your feet by counting to 10.
Sitting on a chair with your legs down, straighten your legs, while bending your feet, and hold this position, counting to 10, alternately pulling each knee towards 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.
Putting the straightened leg on the chair, perform inclined movements of a spring nature, while resting your hands on the thigh, as if you are trying to straighten the leg more.
Lying on your stomach, alternately raise your straight leg and hold it for 3 counts.
Sitting on the floor, spread your legs to the side, moving them across the floor, bring your knees to your stomach while inhaling and return them to the starting position while exhaling.