Gonarthrosis of the knee joint is one of the types of pathological processes that develops in the articular apparatus. The main characteristic of this disease is the destruction of articular cartilage. As a result of dystrophic-degenerative processes, the function of the knee joint deteriorates significantly. This disease most often develops in people after 50 years of age, since at this age irreversible changes occur in the joint tissues. The first stage of gonarthrosis is initial. As it develops, the symptoms are mild or almost invisible. At this stage, changes are already occurring in cartilaginous tissues.
What is gonarthrosis
Gonarthrosis (arthrosis of the knee joint) is a slowly progressive non-inflammatory degenerative disease. With the disease, there is a change in the quality and quantity (towards thinning) of the articular cartilage. The main complaint is pain, which usually occurs when bending the knee, when climbing stairs, and after prolonged sitting or lying down. Pain in the morning is a typical complaint in the early stages. In this case, patients complain of stiffness of movement, which goes away after some time of activity. If there are changes in the cartilage, the joint may become inflamed. Thus, gonatrosis, which initially had a non-inflammatory nature, acquires an inflammatory component. The goal of treatment is to reduce the frequency and duration of the inflammatory phases.
Causes of deforming arthrosis
Articular cartilage is very thin - only 3 millimeters, and has a low ability to recover. This causes frequent damage to it as a result of direct mechanical injuries or as a result of inflammatory diseases accompanied by inflammation of the joint (arthritis). A decrease in the thickness of the articular cartilage or cracking leads to disruption of the load distribution mechanism and damage to the underlying bone, which in turn responds with active growth with the formation of spines - osteophytes and joint deformation. The main manifestations of deforming arthrosis are pain during exercise, “starting” pain that goes away after some time of walking, and swelling of the joint. Patients note crunching and clicking in the affected joint.
Types of gonarthrosis
The knee joint is formed by three bones:
- Femur (lat. femur
) - Patella (lat. patella
) - Tibia (lat. tibia
)
Wear of articular cartilage occurs between the rubbing surfaces of bones. Friction between the femur and tibia occurs in two places: on the inner (medial) and outer (lateral) parts. The localization of arthrosis should be reflected in the doctor’s report.
- Medial gonarthrosis:
the inner part of the articular cartilage is worn out. - Lateral gonarthrosis:
the outer part of the articular cartilage is worn out
Arthrosis is the most common disease in adults in the world. According to the Koch Institute, gonarthrosis is the most common localization of the degenerative process in the joints. In second place is arthrosis of the hip joints.1,2 Age is a significant risk factor. Thus, more than half of women over the age of 60 have gonarthrosis.1
Symptoms of gonarthrosis
The following symptoms are typical for gonarthrosis:
- Knee pain when climbing stairs or walking on uneven surfaces
- Pain and stiffness in the knee joints after a long rest, which disappears/decreases as you walk
- Pain in the knee joints increases after intense exercise
- Possible swelling of the knee joints
- If the process is pronounced, a characteristic crunching sound may be heard during flexion/extension of the knee joint
- Specific aching pain in the knees occurs in cold and rainy weather
As gonarthrosis progresses, the frequency of symptoms and their severity increases. Joint pain can occur even at rest. At the same time, the range of motion of the knee joints gradually decreases.1
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.
Risk factors for gonarthrosis
Knee injuries
Knee injuries, especially meniscal and ligament injuries, accelerate the wear and tear of articular cartilage and the aging process of cartilage. Rupture of the anterior cruciate ligament (ACL) leads to instability of the knee joint, which contributes to the rapid destruction of cartilage and the development of gonarthrosis in a relatively short time.
Lack of physical activity
Physical activity improves the nutrition of cartilage. Considering that cartilage does not have its own blood vessels, and nutrients are supplied by diffusion from surrounding tissues, good blood circulation plays a key role in the nutrition of cartilage.
Heredity
Congenital conditions such as knee valgus, knee varus and different limb lengths increase local wear of the cartilage and accelerate the development of gonarthrosis.
Overweight
Excess body weight is the most significant risk factor. Daily additional stress on cartilage quickly leads to its aging. Then, gonarthrosis develops and progresses quite quickly.
Excessive loads
Cartilage wear occurs faster in people whose activities involve heavy physical labor, for example, builders.
Overload during sports
Professional athletes constantly subject their joints to high loads, so their articular cartilage wears out and ages faster.
Metabolic diseases
Typically, metabolic diseases involve disturbances in the nutrition of various body tissues, including articular cartilage.
Nutrition
To prevent the development of gonarthrosis of the knee joint, it is recommended to follow certain preventive recommendations:
- control body weight;
- wear correct and comfortable shoes;
- exercise;
- avoid hypothermia of the lower extremities;
- completely give up bad habits.
Instead of jumping, running or lifting weights, it is recommended to swim, walk, do yoga, fitness and aerobics. During sports training, especially if it is accompanied by heavy loads on the lower extremities, it is imperative to use special knee braces. This device will prevent injury.
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.
Physiotherapy
Physiotherapeutic procedures have proven themselves well in the treatment of gonarthrosis:
- shock wave therapy – involves the impact of a device with radial acoustic waves on the focus of the inflammatory process. As a result, blood microcirculation improves, regeneration processes of bone and cartilage structures are activated;
- myostimulation - involves the impact of weak current pulses on muscle tissue, the result is improved joint mobility, and pain relief;
- phonophoresis – involves the influence of medications and ultrasound. This combination is effective. The active components of the drugs are quickly absorbed into the tissues and begin their action inside the joint;
- ozone therapy - involves the influence of active oxygen on damaged structures, as a result, the severity of pain and the inflammatory process decreases;
- kinesitherapy - involves the use of special adhesive strips, they are applied to the skin in a special way. The result is an improvement in the condition of the muscular system and joint mobility;
- therapeutic exercises – daily therapeutic exercises help to gradually restore joint mobility, muscles are strengthened;
- massage and manual therapy - such methods of influence are passive. With their help, the condition of cartilage, bone and muscle structures improves. It is recommended to combine massage with other physiotherapy methods;
- joint traction – as a result of the procedure, the space between the cavities of the joint increases, pain decreases or completely disappears. The destruction of cartilage tissue slows down.
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.
What should I do?
Instead, you need to add dairy and fish dishes, buckwheat, beans, lentils, as well as products containing fiber and sulfur (flax seed, bran, onions, garlic) to the menu. They take an active part in the construction of cartilage and connective tissue.
Do your joints hurt? Eat less meat
4. Orthopedic shoes without prescription.
For arthrosis of the ankle, knee or hip, orthopedists often recommend wearing orthopedic insoles, or arch supports. They support the arch of the foot and reduce stress on the joints of the lower extremities. This is true provided the selection is correct. If insoles are chosen at random, they can cause harm.
Treatment of gonarthrosis
Despite the fact that gonarthrosis cannot be cured, there are many ways to relieve pain and improve the quality of life.
Conservative treatment
Non-drug methods
- Orthotics (insoles, bandages, orthoses)
- Therapeutic exercise and mechanotherapy
- Physiotherapy (magnetic field, ultrasound, electrical stimulation, high-frequency currents)
- Rehabilitation therapy
- Naturopathy (acupuncture, aqua aerobics, etc.)
Drug therapy
- Painkillers
- Anti-inflammatory drugs
Six exercises to do at home
Exercises that can be performed without pain will help fight the progression of gonarthrosis. The exercises described below are useful not only for the knee joint. They affect the entire musculoskeletal system and keep the muscular system in good shape.
Leg spread
Leg extensions using an elastic bandage
Hamstring stretch
Dynamic calf stretch
Rolling out the foot
Lunges
Surgery
Preserving your own joint
Arthroscopy
Arthroscopy is relatively rarely used to treat gonarthrosis. The operation is performed using mini-incisions through which endoscopic video cameras are inserted into the joint, and the surgeon can perform one or another manipulation inside the joint under visual control.
Corrective osteotomy
With a corrective osteotomy, the bone is cut at a certain angle and its integrity is subsequently restored. This method corrects the disturbed axis of the valgus or varus knee joint. Restoring the normal axis helps slow down the wear and tear of articular cartilage.
Joint replacement
Partial endoprosthetics
If only one part of the knee joint is affected, partial knee replacement can be performed. The affected joint element is removed and replaced with a metal or ceramic prosthesis.
Total endoprosthetics
Total arthroplasty is performed when the entire knee joint is affected and other types of treatment are ineffective. During the operation, articular surfaces affected by arthrosis are removed. Then the metal and plastic elements of the artificial joint are installed.
Treatment methods and prevention
If, after undergoing diagnostic procedures, a specialist confirms the diagnosis, you need to tune in to long-term therapy. At the first stage of the development of the disease, conservative treatment is most often prescribed - taking medications, undergoing physical procedures. It is not recommended to use any medications on your own to alleviate your condition. Only with strict adherence to medical instructions and all instructions will the treatment be successful.
The treatment regimen in each specific case is prescribed individually. This is due to the stage of development of the disease, the severity of clinical manifestations, and the presence of concomitant pathologies.
medi products
Orthoses that correct the position of the knee joint can be an effective alternative to endoprosthetics and pain medications.
Knee braces and orthoses: Genumedi, Collamed OA, M.3s OA and M.4s OA can be used to treat gonarthrosis at different stages.
Diagnostics
To determine what stage the disease is at, the specialist collects anamnestic data and complaints. The doctor assesses how severe the pain syndrome is, which could serve as a provoking factor in the development of the disease.
To confirm or refute his assumptions, the doctor prescribes instrumental diagnostics - radiography, computed tomography. Using such methods, it is possible to determine the degree of destruction of cartilage and joint tissues. Diagnostics allows you to find out how uneven the cartilage layer is. During the examination, various types of damage, internal violations of the integrity of the joint, cracks, changes and deformations can be detected.