Gonarthrosis, arthrosis of the knee joint, deforming arthrosis of the knee joint - in fact, these are three names for the same disease. According to statistics, from 10 to 16% of the world's population suffer from deforming joint diseases. Deforming osteoarthritis of the knee joint occupies a leading place in the group of dystrophic joint diseases along with coxarthrosis and glenohumeral periarthritis. Knee arthrosis accounts for 30% of all forms of osteoarthritis. At the same time, the share of gonarthrosis among all diseases of the knee joint is 50%. In this article we will try to explain the causes, the mechanism of development as clearly as possible for a non-specialist, and talk about existing methods of treating this disease. As far as possible, the article deciphers special medical terms, and the information is presented in a form that is understandable to a non-specialist.
Gonarthrosis - what is it?
Gonarthrosis (deforming arthrosis of the knee joint) is a pathological condition in which irreversible changes occur in the knee joint, the cartilage of the articular surfaces of the femur and tibia wears out, and the structure of the menisci and ligaments changes.
X-ray showing a normal knee joint
This radiograph shows the left knee joint in a direct projection with damage predominantly to the internal parts of the joint (asymmetry of the joint space is visible)
The femur, tibia and patella (kneecap) take part in the formation of the knee joint.
How to treat arthrosis with massage?
Using the method of blows (through the palm, fingers, slaps) at home, you can work on a sore knee joint. It is important to know how certain movements affect the deforming joint:
- Massage in the form of spanking affects the nerve endings and promotes better blood circulation in the sore joint.
- Thanks to the blows through the pressed fingers, there is a positive effect on the tendons, muscles and all joint components. Due to the fact that the blows are softened, circulatory activity occurs without damaging the capillaries.
- The palm is pressed against the joint, and the blows are applied to the periarticular areas. Thus, the functionality of the internal parts of the joint increases.
- Initially, fingers lightly and carefully tap on the sore joint. As the condition improves, the force of the blows increases slightly. This procedure is accompanied by tolerable pain.
Anatomy of the knee joint
Two joints are formed: femorotibial and femoral-patellar. The bones are held together by the lateral ligaments (external and internal collateral ligaments) - they keep them from moving in the lateral planes, the anterior and posterior cruciate ligaments - they prevent excessive displacement in the anteroposterior plane. In addition, to increase the congruence of the femur and tibia, there are 2 menisci (external and internal).
More information about the anatomy of the knee joint can be found here.
The radiographs below show the right knee joint in frontal and lateral projections (above - the femur, below - the tibia, in front - the patella).
Changes in gonarthrosis can occur only in the internal parts, only in the external parts of the joint, only in the femoral-patellar joint and, most often, in each of the parts of the knee joint.
Diet
Complex treatment of this disease includes, in addition to the methods described above, also a strict diet. It requires an adequate approach. There is no need to go to extremes. But there are a number of restrictions that will have to be taken into account:
- Various pickles and fermented foods also need to be minimized.
- Remove animal fats from your diet.
- Avoid bread and rolls (you can eat brown bread, but in moderation), as well as chocolate and sugar. People with osteoarthritis do not need carbohydrates. Their use has an impact on weight gain. And this is a risk factor.
- At least exclude fatty meats. Avoid eating duck, goose, lamb, and pork.
- Limit salt intake. It’s not for nothing that arthrosis is also called “salt arthrosis.” Doctors advise only adding a little salt to dishes before eating and not during cooking.
- Minimize the use of spices, especially hot ones. They contribute to the feeling of thirst and whet the appetite.
- Alcoholic drinks and smoking are strictly prohibited. At least during therapy.
Sample menu:
- Breakfast: oatmeal with water without butter or sugar, fruit juice, boiled egg
- Second breakfast: a glass of low-fat natural yogurt
- Lunch: steamed meat or fish, stewed vegetables, tea without sugar
- Afternoon snack: cottage cheese casserole with nuts, glass of fruit juice
- Dinner: vegetable salad, apple, tea without sugar
- Second dinner: a glass of low-fat kefir
A dietitian will help you balance your diet. For example, here are a number of foods that you can eat, and this is even welcome with such a diagnosis. First of all, these are products containing chondoprotectors and collagen; they are the building blocks for bones, cartilage, and ligaments. Your diet should include broth made from beef, especially bones. The presence of jelly, aspic, and jellied meat in the menu is welcome.
Causes of gonarthrosis
The reasons why gonarthrosis of the knee joint may occur are:
1) idiopathic gonarthrosis - destruction of the knee joint when no apparent cause can be determined.
2) post-traumatic gonarthrosis of the knee joint - when a previous injury or surgery for injury accelerates the process of wear and tear of the joint.
3) rheumatoid polyarthritis is a chronic systemic disease that manifests itself in a variety of ways, ranging from mild forms of systemic vasculitis affecting one joint to severe damage to many joints.
4) osteochondritis cutoff (Konig's disease) - destruction of a section of cartilage gradually triggers a cascade of pathological reactions in the development of deforming arthrosis of the knee joint.
Deforming arthrosis
How often have each of us asked the question: “Why does pain occur in the knee joints? Is it bad if joints creak under load? Why does swelling appear in the joint area?
Most people have sedentary work, which does not imply absolutely no load on the knee joints; many suffer from varying degrees of obesity.
Modern society dictates its own rules of behavior and now there are countless fitness centers being built again and again; hundreds of thousands of people of different age groups flock to gyms and begin to load their joints, without even thinking about what irreparable harm this can cause.
On the other hand, it’s spring and thousands of summer residents rush to their “haciendas” to work all day long in the beds in unimaginable positions, and then experience pain in their knees, hoping for the Russian hope that everything will pass. But it doesn't work. Then all kinds of ointments, pills recommended by “good” neighbors and pharmacists, and advertising blocks in magazines promising a quick recovery come in.
Expensive clinics, joint blockades at exorbitant prices that can cripple. But nothing helps. Then new questions arise: “Why do my knee joints hurt and nothing helps?”
Meanwhile, the disease will go too far, and the patient will hear a threatening sentence from the doctor: “You have severe arthrosis deformans. You need to change the joint, in your case, nothing will help except endoprosthetics.” And it happens that it is too late to do endoprosthetics.
The knee joint is under constant pressure because it must support the entire weight of the body while ensuring sufficient mobility of the legs.
Over time, the hyaline cartilage begins to gradually thin out, which ensures the mobility of the joint surfaces and their shock absorption. When it disappears completely, the bone is exposed, which then begins to grow, forming exostoses (spines). As a result of these changes, the knee becomes deformed. This is a disease called deforming arthrosis of the knee joint.
In general, this disease is considered to be age-related; people whose age has exceeded 40 years are especially susceptible to it, and women get sick twice as often as men. Up to 20 percent of all people suffer from this disease in one form or another.
The main causes of deforming osteoarthritis of the knee joint (DOA)
- low physical activity
- overweight
- age factor (age-related changes)
- intense load on the legs (sports activities)
- injuries of the knee joint (torn ligaments, torn meniscus, etc.)
- some diseases (diabetes mellitus, gout, rheumatoid arthritis)
The symptoms of this disease are quite simple, and the degree of their severity directly depends on the stage of the disease. Deforming arthrosis can proceed sluggishly for a long time, or in a short period of time give a picture of severe damage to the joint.
Main symptoms of the disease
- local pain in the knee, the intensity of which increases as the disease progresses,
- restriction of joint mobility, which causes stiffness in movements in the knee,
- complete blocking of the joint, which leads to the impossibility of movement.
In the initial stages of the disease, there may be only slight pain, a feeling of tightness under the knee, difficulty walking after a prolonged stay in a static position (after sleep, or prolonged sitting), which quickly passes after a short movement, in other words, after the person “disperses” .
Gradually, the disease begins to progress, the pain becomes stronger, the pain in the calves is tormented at night and during the day, and deformation of the joint begins, which is noticeable from the outside. It is during this period of time that a person begins to think about going to the doctor, but only think about it.
A massive intake of all kinds of medications begins, mountains of tubes of ointments. Later, visits to dubious doctors and the introduction of expensive drugs, which for the most part are simply contraindicated for joint blockades. But a visit to a qualified doctor at this stage of the disease in a high percentage of cases allows you to prevent the progression of the disease and avoid future joint replacement.
Nonsteroidal anti-inflammatory drugs are prescribed and hormonal blockades are performed. Severe stages of the disease require surgical intervention. The pain becomes severe and does not go away with painkillers, the knee joints become deformed and almost full movement in them is no longer possible.
It is important to know that any physical activity should not be excessive for your joints, eat properly, try to prevent the development of obesity, in case of joint injuries - complete and timely treatment, and treatment of already developed deforming arthrosis should be carried out only in a specialized medical institution and as early as possible .
Early treatment is the key to success, proper treatment is the key to recovery.
Surgeon, Ph.D. Papsheva Victoria Valerievna
Symptoms of gonarthrosis (deforming arthrosis of the knee joint)
The main symptoms of knee gonarthrosis are:
1) pain in the knee joint - first occurs during physical activity, then at rest and at night. Pain at rest and the nature of the pain at night indicate serious changes in the knee joint.
2) violation of farrowability - a condition in which, due to pain, the static load (axial load) is extremely limited.
3) dysfunction of the knee joint - limitation of flexion and extension in the knee joint.
4) violation of the axis of the limb - X or O - shaped lower limbs, that is, curvature of the lower leg relative to the knee joint outward or inward. It develops gradually, especially when the pathological process prevails in one of the parts of the joint.
Surgery
When the functioning of the joint is clearly impaired and conservative treatment does not help, surgical intervention is used. But it comes to this extremely rarely. The affected joint can be replaced with an artificial one (endoprosthetics). But more often it is used at stage III.
The axis of the limb is restored or bone changes are removed (osteotomy). Arthroscopic intervention is performed through skin punctures. Through punctures in the knee, destroyed cartilage is removed from the joints. Then medications are administered.
Determining the diagnosis of gonarthrosis
To make a diagnosis of deforming arthrosis of the knee joint or gonarthrosis, ordinary radiographs of the knee joint in 2 projections (direct and lateral) are often sufficient for the doctor. Gonarthrosis is clearly visible on the radiographs above.
Sometimes it is necessary to perform load radiographs (also in 2 planes, but standing with an axial load).
The destruction of the cartilage of the condyles of the femur is schematically shown; normally the cartilage is white, strong, but with pathology, the cartilage is partially absent, and the underlying bone is visible in places.
Computed tomography (CT) or magnetic resonance imaging (MRI) is rarely needed. These expensive studies should be prescribed by a doctor if there is any doubt about the diagnosis; in most cases, I repeat, ordinary radiographs of the knee joint are sufficient.
The pathological process is clearly visible, manifesting itself more in one of the parts of the joint
Diagnosis of the disease
- 1. X-ray. Uninformative for the initial degree of arthrosis. It is a screening test for injuries.
- 2. Ultrasound. They provide an opportunity to carefully examine tendons, ligaments, and cysts with extensive damage.
- 3. MRI. Magnetic resonance imaging is well suited for viewing all structures.
- 4. CT. Computed tomography is based on X-rays, similar to outdated X-ray diagnostics, but in this study, images are taken layer by layer, and accordingly, its information content is high.
- 5. Diagnostic arthroscopy. Makes it possible to clearly and in detail visualize all changes in tissues.
Diagnostic arthroscopy
Arthroscopy makes it possible to most accurately diagnose the clinical picture. Thanks to this method, the damaged knee can be seen in great detail from the inside and immediately, if necessary, all possible therapeutic measures can be taken to restore the functions of the joint and eliminate the pathology. The risk of complications is minimal, and the patient is discharged within a few hours. Return to activity is much faster than with an open surgical approach. This method of treatment and diagnosis has become the method of choice for specialists from leading clinics in the world.
