Treatment of osteoarthritis of the knee joint (gonarthrosis)

With age, the vast majority of people face the acute question of how to treat osteoarthritis of the knee joint, with typical symptoms,inherent to this disease at its different stages.This includes the appearance of swelling in the knee area, redness around these swellings, cracking and rustling sounds, clearly audible silently when the knee moves, especially during squats, and a distinct pain syndrome of varying intensity.Pain may appear immediately after normal daily physical activity or after physical exercise inappropriate in duration and intensity for age.When addressing the underlying causes of this pain, it should be kept in mind that its appearance can also be the result of:

• Inflammatory process in the knee joint.That is to say 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, it loses its mobility and, if the course of osteoarthritis has been prolonged, it also causes deformation of the joint.
• Injuries.Most commonly, this results from a fall, a blow to the knee, or a blow to the knee on a hard surface.The joint may become deformed.
• Ligament damage.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 attention and rest for the injured leg are necessary.
• Damage to the meniscus of the patella.This protruding, round, movable cartilage of the knee can be injured even when squatting or turning suddenly.It is not always detected visually due to the swelling of the knee joint that often occurs in such cases.An accurate diagnosis is made by 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 inside the popliteal fossa, at the level of the tendons.
• Inflammation of 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 femoral ligaments and muscles, and below - into the lower leg.
• Ischemic pain, due to impaired blood circulation in the knee joints.They can appear as a result of a sudden change in weather, severe hypothermia for a long time.For example, sailors who work for a long time at high latitudes (Arctic).In most cases, the localization of pain is symmetrical, equally intense and, at the first stage, does not affect joint mobility.

The biggest mistake in such cases would be to ignore the pain and hope that if you rest, “it will all go away by itself.”Only a specialist can give treatment recommendations and make a correct diagnosis.Therefore, treatment of osteoarthritis of the knee joint at home is unacceptable only based on the advice of "knowledgeable people", and even using only traditional medicine.Effective treatment is possible only with a combination of medications in the form of tablets, frictions, 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 movement tests and a medical history.The following procedures are usually prescribed in addition to diagnostics:

• Relating to laboratory analyzes, such as a biochemical analysis of blood and bacterial microflora, a smear, a puncture of joint fluid and/or bone marrow, a serological analysis, that is to say a study of 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 entering the cavity through an incision.Most often, this method is used after injuries to the meniscus or in cases of cracks and significant wear of the cartilage tissue, as well as to restore the anterior cruciate ligaments.Although recently the anthroscope has rarely been used as a diagnostic tool, it has been successfully replaced by a completely non-invasive diagnostic method using MRI.
• Just “by ear” - with joint damage of the 3rd degree, extraneous sounds in the form of crunches, rustles and clicks are clearly audible in the joint.

The information obtained is put together into a general story and only on this basis can comprehensive and effective treatment begin.

How to treat knee osteoarthritis?

Restoring joint mobility cannot be done in a month.Treatment is complex, it is 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 work involves such stress, negotiate with management (if necessary, with the medical certificate in hand) to change your type of activity.For a moment or forever, life will tell us.Although often initially, bed rest may be necessary for initial restoration of joint function.Remember: a joint is not a muscle, you cannot “work” it with intense exercise, this will only make things worse.Activation of life through intense movements may be necessary later, after the most 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 osteoarthritis of the knee joint is also possible at home, using outpatient medications prescribed by a doctor - chodroprotectors, analgesics and anti-inflammatory drugs.Depending on the degree of damage to the joint and the type of inflammation, the doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs).But despite their effectiveness in relieving symptoms, they do not eliminate the causes of the disease.

Do not heat painful joints due to 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 take place 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 recognized internationally.

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

You can't come to a complete stop if your knee hurts.Additionally, in certain 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 lead to weight gain, which will further aggravate the situation, loading the joint.

Drug treatment is usually combined with physiotherapy courses, the most favorable for the treatment of osteoarthritis: magnetic and laser therapy (coherent laser radiation is used at safe frequencies), mechanical vibration and ultraphonotherapy, microwave installations with a deep effect on tissues - when therapeutically justified.

When diagnosing, three degrees of osteoarthritis of the knee joint are distinguished.

Osteoarthritis I degree

The mildest degree of the disease.It is characterized by the fact that treatment does not require a large degree of medicinal influence, the list of medications is small, and measures involving physiotherapy, massage and exercise therapy are effective.One of the most effective methods is considered to be 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.

Osteoarthritis degree II

It is characterized by more intense and acute processes of inflammation and degeneration of cartilage tissue.During the acute period, special medications are prescribed, a special diet is recommended, and physical therapy designed for such cases is recommended.Physiotherapy and massages 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 significantly limit its mobility.

In the medical arsenal for the treatment of second-degree osteoarthritis, in addition to chondroprotectors containing glucosamine and chondroitin, steroid drugs, as well as non-steroidal anti-inflammatory drugs, may be present.It is possible to inject hyaluronic acid and other medications into the joint capsule to make it easier for the cartilage surfaces to slide relative to each other.

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

Osteoarthritis degree III

When the knee joint is affected by osteoarthritis of the third degree, the treatment is not much different from the previous condition - except that the frequency of drug use increases with a slight shift to glucocorticosteroid hormones.If there is no result, 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 appears when a person exceeds the age of 50 - when the flexibility of the ligaments is lost, the processes of tissue dehydration begin and the metabolism slows down.

Under these conditions, the development of gonarthrosis begins - deforming osteoarthritis 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 it appears, progresses very quickly.Refers to acquired age-related pathologies of the musculoskeletal system.To one degree or another, this is inherent in all patients after 50 years.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 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 regular running on a hard surface (most often asphalt): each step of such running causes a shock load on the knee joint.

This joint also includes the largest movable sesamoid bone - the patella, located at the top of the tendons of the quadriceps femoris muscle.The articular surfaces are covered with a thick cartilaginous membrane, up to 2.5 mm, made up of chondrocytes.Medicines under the general name chondroprotectors help to restore those cells of cartilage tissue, mainly affected by gonarthrosis.

There are primary and secondary osteoarthritis of the knee joints.The etymology of the former is not fully understood and may have different reasons.When - from a sedentary lifestyle, and when, vice versa, from excessive physical activity.Poor ecology, excess weight and addiction to tobacco or alcohol can also have an impact.Doctors consider the identification of the first stage of osteoarthritis 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.It is therefore better for people prone to such diseases not to choose professions related to cold (refrigerators, marines working in northern latitudes), etc.

In women over 45 years old, 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 provoked by strict weight loss diets, during which many useful minerals and vitamins are eliminated from the diet.

It is much easier to decide on ways to influence secondary osteoarthritis, which can be a consequence of:

• Defects in tissue development and formation;
• The influence of neurodystrophic processes in the cervical and lumbar spine;
• Arthritis of the knee joint;
• His injuries and microtraumas;
• Meniscectomy, i.e. surgical removal of the meniscus;
• Hormonal imbalances and chronic endocrine diseases;
• Intense and constant physical activity, including sports.To prevent joint injuries after 40 years, it is better to significantly limit and then abandon all exercises associated with extreme loads on the knee joint (in the form of running on hard surfaces or squats with 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 disease onset (stage or degree)

• Stiffness of the knee joint in the morning;
• The appearance of knee pain if you walk a distance of one and a half kilometers;
• Pain in the joint 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.

These signs should be paid the greatest 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.

Goranthrosis degree II

What is typical:

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

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

Goranthrosis grade III

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

The affected joint develops ankylosis, a condition in which the joint ends of adjacent opposing bones fuse together.The leg completely loses its mobility and the only way to regain it is to replace the joint with an artificial one.

The choice of drugs and methods of treatment 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.

When diagnosing, a distinction is often made between unilateral and bilateral osteoarthritis, as well as between unilateral, right-sided and left-sided osteoarthritis.The latter is often diagnosed in left-handed people.

Nutrition for knee osteoarthritis

First of all, doctors advise excluding red meats 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 or sugar.As well as fermented milk products, fish and nuts.

The last time you eat food should be no later than 7:00 p.m.The frequency of food intake may remain familiar because it has evolved 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 plentiful - it puts the body in the mood for work and maintains strength until lunch.

If, especially at the beginning, the feeling of hunger becomes unbearable, trick your stomach: eat an apple or chew a carrot.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 liquid per 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;
• Soft drinks containing sugar;
• Vegetables: white cabbage, tomatoes, red peppers.
• Potatoes, because they are high in calories (carbohydrates!) and help you gain weight.The Dukan diet will therefore be relevant.

Treatment of gonarthrosis in a sanatorium

The institution uses a wide range of physiotherapy, mud therapy, acupuncture and massages of all kinds as methods of treating osteoarthritis of the knee joint.

One of the advanced treatment methods is injecting hyaluronic acid into the joints.They compensate for the lack of production of their own hyaluronic acid, which serves as a lubricating element on 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 one month.Patients in the advanced stage of osteoarthritis feel from the first days a significant reduction in the pain that has tormented them for many years, and people with a moderate course of the disease, grade 1-2, after a course of 5 injections, in most cases completely forget about pain for about six months.