30.10.2020
Among all types of arthrosis, gonarthrosis of the knee joint is the most common. Its only competition is from arthrosis of the hip joint.
Gonarthrosis, also known as arthrosis deformans, is a disease of the knee joint in which the tissue of hyaline cartilage, which is responsible for shock absorption during movement, reduces friction between the tibia and femur and softens impacts, becomes thinner and deformed.
Other names: arthrosis deformans, osteoarthritis, osteoarthritis, degenerative arthritis, hypertrophic arthritis.
Briefly about the disease
The disease is classified as degenerative-dystrophic and affects women more often than men. Although if a man has problems with being overweight, regularly gets cold, or often injures his knees while doing active sports, then he too is at risk.
According to WHO forecasts, in the coming decades, gonarthrosis will become the fourth cause of disability in women and the eighth cause in men. Thus, the problem of effective treatment of gonarthrosis acquires not only medical and social, but also economic significance. (Kosareva et al.)
As a rule, the pathology is chronic and progressive. The fact that the disease is developing is indicated by inflammatory processes that are not observed at the beginning. Late stages of gonarthrosis do not respond well to conservative treatment and, as a rule, lead to joint replacement.
Self-help is a way to improve your quality of life
Self-help has a huge impact on the outcome of gonarthrosis treatment. Be active in the fight against the disease: watch your weight, stay physically active and eat healthy foods.
Types of gonarthrosis
The knee joint is made up of three bones: the femur, tibia, and patella (kneecap). The greatest friction occurs between the femur and tibia, both on the inside and outside. It is in this place that the articular cartilage tends to wear away. Depending on the location, gonarthrosis is divided into two types:
- medial, that is, internal, when the inner part of the cartilage is erased;
- lateral, when the outer (lateral) part of the cartilage is damaged.
The exact location is determined by the doctor through diagnostics.
Infusions and decoctions
Other folk remedies can be used for treatment: water and alcohol extracts. They are most often used for compresses, because they contain burning or irritating substances.
Ficus tincture
The product is prepared with alcohol or vodka. To prepare, take 1 medium leaf of indoor ficus, chop it and pour alcohol. Leave for 2 weeks and filter. The tincture can be used for rubbing and compresses. You can't drink it.
Maclura (Adam's apple) tincture
Grind the maclura fruit on a grater and pour in an equal volume of alcohol. Place the mixture in a dark, warm place and leave the jar there for 2 weeks. The container must be shaken daily. When the tincture is ready, strain and use for rubbing. The medicine cannot be taken orally.
Causes of gonarthrosis
It is believed that deposits of calcium salts in the joint are to blame for the appearance of gonarthrosis. In fact, this is a secondary symptom and one of the causes of pain.
The real cause of gonarthrosis can be the structure of the cartilage and changes in the composition of the intra-articular fluid at the cellular level. Taken together, this forms a group of symptoms that have different origins and have different effects on the development of the disease. For this reason, gonarthrosis is divided into primary and secondary.
Primary (idiopathic) gonarthrosis has no obvious causes. For example, wear and tear of cartilage tissue is a result of joint aging. Most often in such cases we are talking about bilateral gonarthrosis, when the disease develops on both knee joints. It primarily affects elderly patients.
Secondary gonarthrosis occurs as a consequence of injury. For example, an intra-articular fracture with separation of small particles of bone tissue. The particles will provoke inflammation and cause pain, limiting joint mobility. Or improperly fused bones of the knee joint. In this case, the anatomical structure of the limb and its mechanics change, as a result of which the cartilage is deformed and destroyed.
Prerequisites for the disease may be other pathologies, such as arthritis or hemarthrosis, which change the viscosity and thickness of the synovial fluid, limiting the supply of nutrients to the cartilage tissue. The disease can be triggered by traumatic brain injuries and spinal injuries, weak ligaments, metabolic disorders, neurological diseases with innervation disorders.
Stages of gonarthosis
Depending on the severity, there are three stages of gonarthrosis (and arthrosis in general).
1 2 3
Gonarthrosis, stage 1
The articular cartilage is not yet damaged, but its density is insufficient and the surface is not perfectly smooth. Usually at this moment there are no manifestations of the disease and the function of the joint is not impaired.
Gonarthrosis, stage 2
There are small cartilage defects in the form of cracks. Pain appears when moving.
Gonarthrosis, stage 3
Loss of articular cartilage. Now the bone is not protected by cartilage and is in contact with another articular surface. Experts call this condition chondromalacia. This condition limits mobility and is very painful. Usually the knee joint is inflamed and swollen. In some cases, there is an effusion (excessive amount of fluid) in the knee joint.
Symptoms and stages of gonarthrosis
Symptoms depend on the stage of gonarthrosis of the knee joint. There are three of them:
- The joint is not yet deformed. The pain is intermittent, aching or tight, and most often occurs after exercise or direct impact on the knee joint. When getting up after a long rest, you need to walk around to relieve pain. The knee may swell, the swelling is small and goes away on its own. This occurs due to the accumulation of fluid in the joint capsule, and can limit mobility.
- Joint deformation begins. Synovitis (inflammation of the synovium of the joint) often occurs. They are accompanied by large accumulations of fluid and last longer than in the first stage of the disease. The pain becomes stronger and is felt on the front and inside of the knee even with minimal loads. The range of motion is reduced, when trying to bend the leg, a sharp pain occurs, and a crunching sound is heard in the joint. The crunch of a healthy joint is the release of carbon dioxide accumulated in the joint cavity. A painful crunch is the result of abrasion of the cartilage layer.
- The joint undergoes significant deformation. Painful sensations bother me constantly, during movement and rest, and do not allow me to sleep. The deformation leads to a change in the shape of the legs: it becomes X or O-shaped. Accordingly, the gait changes, it becomes heavy, waddles, the person needs additional support - a cane or crutches, if the gonarthrosis is bilateral. It is very difficult or impossible to bend or straighten the leg.
If we talk about the general signs of the disease, then these are pain in the knee joint when climbing stairs, walking on uneven ground, after sharply straightening the knee, after physical exertion, swelling in the joint area, crunching when bending/extending the leg, aching pain in bad weather. Of course, the above cannot be used to make a diagnosis. But this is a reason not to delay contacting a specialist.
Rubs and baths
For rubbing, alcohol extracts from plant materials are used. Their action is based on the irritating and vasodilating effect of alcohol. In this case, the beneficial substances of the plants penetrate into the capillaries through the skin and have a local analgesic effect. Tinctures for rubbing can be prepared from cinquefoil herb, red elderberries, horse chestnut fruits or red pepper. You cannot drink such tinctures.
Healers especially recommend dandelion tincture. To prepare it you need a bottle of any capacity and triple cologne. The flower baskets of dandelions are poured into the bottle, filling it to ½ volume or a little more. Then the container is filled to the top with cologne, closed with a tight stopper and the liquid is infused for 1 month. After this, it is ready to use; the flowers can be strained or left in the bottle.
Dandelion tincture should be stored in a dark place at room temperature and used by rubbing it into the area of the sore joint 2 times a day for 1 month.
A good rub can be made from mumiyo (3 g) and honey (100 g). You need to mix the ingredients until smooth and rub the mixture with massage movements into the sore joint at night. Relief occurs after 1 week of treatment. The product is contraindicated for allergies.
Recipes for medicinal baths involve the use of decoctions of medicinal plants, salt or other components:
- Place 1 kg of salt, 2-3 handfuls of pine needles, 2-3 chopped Jerusalem artichoke tubers, 2 tbsp. l. honey and 1 tsp. turpentine. Pour hot water, let it brew for about 20 minutes and pour the infusion into a bath of hot water (+ 37°C). Take the procedure for 15–20 minutes, daily or every other day. The course of treatment is 10–12 baths.
- A bath infusion can be prepared from St. John's wort, oregano, calendula, nettle and burdock root. Each herb needs to be collected when it blooms, cut and take 3 tbsp. l. masses. Steam the collection with boiling water for 1 hour. Pour 500 g of clay and strain the liquid into a bath of hot water. Take a bath for 20 minutes, every 1 day. A total of 8 procedures are required.
- A decoction of Jerusalem artichoke leaves is prepared from the aerial part of the earthen pear. Place leaves and stems (2 kg) in a bucket. Pour boiling water over the herb and leave until it cools. Local baths are made with this decoction, immersing the joint in warm liquid until the pain goes away.
Risk factors
Knee injuries.
Damage to the meniscus and ligaments reduces the viability of cartilage - it wears out and ages faster. A rupture of the anterior cruciate ligament makes the knee joint unstable and too mobile, which is why gonarthrosis develops in a very short time.
Sedentary lifestyle.
Cartilage does not have its own circulatory system, so its nutrition depends entirely on the ability of the surrounding tissues to supply useful nutrients to it. Proper physical activity promotes good blood circulation, which means it supports healthy cartilage.
Heredity.
If there are congenital pathologies such as valgus of the knee joints, varus of the knee joints, dysplasia, then the development of gonarthrosis is accelerated.
Heavy loads.
Heavy physical labor combined with unfavorable environmental conditions also contributes to the rapid development of the disease.
Overload during sports.
Professional sports cause high stress on joints and increased trauma. Joints age and wear out just as quickly as with constant heavy physical work.
Metabolic diseases.
Metabolic disorders directly affect the nutrition of all body tissues.
Therapeutic exercises for arthrosis
Considering the cause of the development of the disease (wear and tear of cartilage), many people wonder what is better: doing exercises or resting more without putting stress on the joints? There is a one-word answer to this question: exercises are extremely useful both for those suffering from gonarthrosis and for the prevention of this disease! Usually, when pain occurs, people try to give their joints rest, but this is the wrong way. Lack of mobility is the main risk factor for arthrosis in general and gonarthrosis in particular.
Performing special exercises can increase muscle strength and improve coordination. In addition, joint movement promotes the formation of synovial fluid, which acts as a lubricant and reduces friction between the joint surfaces.
Sports and gonarthrosis
What really helps? Does exercise help or is it better to rest? One thing is for sure: sports and exercise are invaluable both for those who already suffer from gonarthrosis and for those who want to prevent it! When people experience pain, they try to move the affected knee as little as possible. This is a fundamentally wrong approach, since insufficient physical activity is one of the main factors in the development of arthrosis.
Targeted training of joints affected by arthrosis helps strengthen muscles and improve coordination. When you move, more synovial fluid is produced, which contributes to less wear and tear on the articular cartilage.
The most preferred sports for patients with osteoarthritis
Preferred sports that are gentle on joints:
- Swimming
- Water aerobics
- Cycling
- Golf
- Skiing
- Walking
Undesirable “contact” sports:
- Football
- Skiing
- Tennis
- Volleyball
Determine the type of sports activity that suits you best. Avoid strenuous exercise associated with sports. If you are unsure whether you can participate in any sport, seek advice from your doctor.
Diagnostics
Gonarthrosis is diagnosed based on patient complaints, palpation of the diseased area and additional studies: X-ray, CT, MRI. As a rule, an x-ray is ordered first to ensure that there is no fracture and to rule out tumor or inflammation in the bone tissue.
Computed tomography and magnetic resonance imaging examine the condition of soft tissues. But if no study has given an accurate picture of the disease, arthroscopy is prescribed - an instrumental intervention that combines diagnostic and therapeutic functions.
Contraindications to the use of traditional methods
Traditional medicine is not used in the treatment of grade 2 gonarthrosis in pregnant and breastfeeding women. They should be used with caution in old age, in the presence of severe pathologies of the liver and kidneys. External agents should not be applied to the skin of the knee with microtraumas - burns, cuts, cracks. An absolute contraindication to such treatment is hypersensitivity to the components.
Treatment of gonarthrosis
Based on the data obtained during diagnosis, treatment is prescribed, the main task of which is to reduce the progress of the disease, relieve pain, restore the shape of the joint and the ability to load on it. Simply put, to make life as easy as possible for the patient and return him to full movement, achieving complete or partial remission of the disease.
There are four directions for the treatment of gonarthrosis in orthopedics:
- treatment without medications: a conversation is held with the patient, based on the results of which exercise therapy is prescribed to create a muscle frame, a diet for weight loss, the use of orthoses and injury prevention;
- drug treatment: anti-inflammatory non-steroidal drugs are prescribed both in the form of ointments and in the form of tablets and injections. The treatment regimen is selected by the doctor, taking into account the patient’s characteristics and existing contraindications;
- physiotherapy: paraffin and ozokerite applications, laser, magnetic, ultrasound, microwave therapy, hydrogen sulfide, radon, sulfur baths, phonophoresis with hydrocortisone, etc. Modern methods of physiotherapy can effectively relieve inflammation and pain in the joint;
- surgical intervention: prescribed when conservative treatment has failed. In connection with the development of endoscopic technologies, arthroscopy is often used, less often - osteotomy, and in extremely severe cases - joint replacement, complete or partial. In a hopeless situation, resection (removal of the joint) or arthrodesis (complete immobilization) is used.
When choosing the appropriate treatment, the doctor considers the following:
- are there any injuries, problems with weight and what is the amount of physical activity;
- general risks – age and chronic diseases;
- how severe the pain is and how unstable the position of the joint is;
- whether there are inflammatory processes in the joint;
- how much the tissue surrounding the joint has been damaged.
The treatment regimen is selected individually for each patient, taking into account his lifestyle and standard of living, concomitant diseases and characteristics.
Cautions
When using traditional recipes, it is worth considering concomitant diseases. Taking alcohol tinctures is contraindicated for people for whom doctors do not recommend drinking alcohol. Treatment with external remedies can be harmful if there are skin diseases, and some herbs have a negative effect on the heart and blood vessels.
Before starting to take tinctures or decoctions, or use ointments and compresses, you should consult your doctor to avoid side effects.
If a specialist has prescribed medications, then it is impossible to do without therapy and treat gonarthrosis only according to folk recipes. Any use of non-traditional means is only an auxiliary method. It can be included in the general treatment regimen if there are no contraindications. It is also worth understanding that folk remedies are especially effective in the first stage of the disease.
With gonarthrosis, painful symptoms appear for a long time. Taking medications and folk remedies has to be carried out in long courses. You need to drink decoctions or tinctures for 1–2 months, then take a break for 2–4 weeks and resume taking them. The general course can be 6–12 months. You can use folk remedies to quickly relieve symptoms. Use them as needed.