Symptoms and treatment of grade 2 knee joint gonarthrosis

Reasons for the development of arthrosis

The following factors may contribute to the development of arthrosis of the knee joints:

• excessive physical activity that does not meet age requirements, leading to joint damage;
• sedentary lifestyle;
• previous injuries in the area of ​​the knee joints - knee dislocations, fractures, ruptures and tears of ligaments, damage to the body of the meniscus, strong falls on the knee, bruises;
• increased body mass index, which causes increased stress on joints and meniscal tears;
• heredity;
• arthritis or other joint diseases (inflammation can lead to swelling or the accumulation of large amounts of synovial fluid in the joints, causing the destruction of cartilage tissue);
• metabolic failures leading to the removal of calcium from the body;
• diabetes mellitus of any type, hormonal imbalances and other pathologies of the endocrine system;
• chronic or past diseases of an inflammatory and infectious nature;
• blood flow disturbance;
• lupus erythematosus, rheumatoid, gouty and psoriatic pathologies, ankylosing spondylitis;
• flat feet, due to which the center of gravity shifts and the load on the joint increases;
• nervous overload and stressful situations.

Why does arthrosis of the knee joint occur?

Most often, people themselves become the culprits in the development of such an intractable disease. Often, when pain occurs in the knee joint, people ignore the pain, preferring instead of going to the doctor to use any medications that simply mask the pain.

After a few years, you will still have to consult a specialist, since with such a diagnosis, self-medication will not work. However, the severity of arthrosis will be at least moderate. Here you can no longer get by with ointments, intra-articular injection of hyaluronic acid and preventive physical exercise, as could have been done in the early stages of the disease. Most likely, you will need to act radically, including sometimes using surgical intervention.

increase physical activity

increase physical activity

• lose weight if you are overweight;
• increase physical activity;
• strengthen the leg muscles, especially the quadriceps femoris;
• put less stress on the sore joint.

If arthrosis deformans already has clinical manifestations, then non-drug measures are used together with drugs. Physical therapy and physiotherapy are used. Patients are recommended to follow a low-calorie diet and use orthoses and tapes.

Symptoms and diagnosis of arthrosis of the knee joints

The disease can be distinguished by the following characteristics:

• Pain syndrome. Pain usually occurs suddenly, but most often during physical activity, even minor ones. The pain can be of different types. At first these will be weak shots (unfortunately, few people pay attention to them). Mild pain that occurs only periodically can continue for months, or even years, until the disease develops into a more severe stage.
• Noticeable deformity of the knee. A similar symptom is characteristic of the later stages. And at the beginning of the development of arthrosis, the knee swells and swells a little.
• The appearance of dense formations in the area of ​​the back wall of the knee joints. Accumulation of a large amount of joint fluid in the cavity of a Baker's cyst or in the joint itself.
• A sharp crunching of the joints, which is accompanied by pain.
• Decreased joint mobility. This is especially pronounced in the last stages of arthrosis. In this case, bending and straightening the knee causes severe pain, and in the final stages, movement becomes almost impossible.

REFERENCE! A patient with arthrosis changes his gait: it is characterized by wobbly legs and limping.



Chondroprotectors

Their action is mainly aimed at preventing further destruction of articular cartilage (chondroitin) and normalizing the properties of joint fluid (glucosamine). Most often used

Artra

Structum

Alflutop

Chondrolone

Pathogenesis of arthrosis of the knee joints

Experts distinguish between primary and secondary arthrosis.

Primary arthrosis of the knee joints

The following processes are characteristic of primary gonarthrosis:

1. Articular cartilage is able to constantly deteriorate and at the same time quickly renew itself. Under normal conditions, these two processes should balance each other. As we age, cartilage destruction occurs at the same rate, but its restoration slows down. The mass of a person plays an important role here. After all, if one person weighs 70 kg, then in 10 steps on one leg he will carry 700 kg, and someone who weighs 120 kg will carry as much as 1200 kg, which will be a significant load on the joints and cartilage, which will wear out faster because of this.
2. It is important to remember: the joint is fed with useful elements only when it moves. A sedentary lifestyle leads to a slowdown in metabolic processes, which is why the necessary nutrients do not reach their destination.
3. The likelihood of developing gonarthrosis increases in people whose parents suffered from this disease.

Secondary arthrosis of the knee joint

It develops for the following reasons:

• Numerous injuries. In a person at any age, they will cause excessive stress on the cartilage. When any bones covered with cartilage are broken, irregularities appear, the so-called “steps”. In this area, now with any movement the joint will wear out, leading to arthrosis.
• The development of rheumatoid arthritis, Koenig's disease, the appearance of purulent inflammation in the joint area.
• Vascular dysfunction.

Are injections effective: injection injections are different

Intra-joint injections today aim not only to reduce inflammation and alleviate the patient’s condition. Modern drugs are many times more effective than chondroprotectors in restoring articular cartilage by renewing synovial fluid. Today intra-articular injections of the following drugs are practiced:

• Glucocorticoids.

They allow you to quickly eliminate pain and relieve inflammation, but do not improve the condition of the cartilage. They can be used only in the acute period, with synovitis, when other methods are contraindicated. The drugs are hormones, so their frequent administration stops the regeneration of cartilage, and with excess weight, hypertension, peptic ulcers and other diseases, side effects often occur.

• Hyaluronic acid.

Such preparations are also called “liquid prostheses”. Once inside the joint, they act as natural synovial fluid, lubricate the surfaces, and stimulate the restoration of cartilage. Products based on hyaluronic acid can cause allergies. Their validity period is only a few months, since immune cells in the human body contribute to the rapid breakdown and elimination of the drug.

• Synthetic synovial fluid substitutes, such as Noltrex

Noltrex is an artificial endoprosthesis that also replaces synovial fluid and restores its normal viscosity. Unlike natural-based drugs, it contains no components that would be broken down by phagocytes. That is why the medicine remains at the injection site for a long time and provides a long-lasting effect - up to one and a half to two years.

Synthetic Noltrex is absolutely safe and hypoallergenic

Classification and stages of development of arthrosis of the knee joints

Orthopedists divide gonarthrosis into stages, on which further treatment of the disease depends. Of course, the course of treatment will also depend on other factors, for example, the cause of development, localization and nature of arthrosis.

IMPORTANT! Only a doctor can prescribe quality treatment after a complete study of the disease picture. Self-prescribed therapy can only worsen the health situation.


The main classification divides gonarthrosis into four stages of development:

1. Initial stage. At this stage, the disease is just beginning. External symptoms are subtle or completely absent, the shape of the joint is in satisfactory condition. The symptoms include only mild discomfort or heaviness in the knee after long walks, as well as heavy physical exertion. An x-ray examination will be uninformative: an x-ray may show only a slight narrowing of the joint space. Unfortunately, at this stage a person does not seek medical help due to the insignificance of symptoms.
2. The second stage is characterized by noticeable pain, especially when walking and climbing stairs, as well as at night. The severity of pain decreases at rest. Joint movement becomes difficult. While walking, you hear a crunching or creaking sound in your knees. On an x-ray, a narrowing of the joint space, as well as osteophytes, becomes noticeable. The patient begins to limp.
3. When arthrosis has entered the third stage, pain will be felt constantly, even in the absence of movement. The processes of deformation and degeneration enter an irreversible stage. The distortion of the joint becomes pronounced, the distance between the articular surfaces is noticeably reduced, and numerous osteophytes increase in size. Painful sensations now disturb the patient even in a state of complete rest. The person becomes dependent on outside support (walkers, canes) and requires help from other people. Conservative treatment at this stage is less effective.
4. The fourth stage is characterized by constant debilitating pain. Osteophytic growths increase in number and size, the cartilage is completely destroyed, the joint space is barely visible or completely absent, and the bones are severely deformed. Even weak movements become torture for the patient. At this stage of gonarthrosis, the patient is considered disabled. Without surgical intervention, the disease can lead to disability.

Complications of arthrosis of the knee joints

Advanced arthrosis can lead to dislocations and subluxations of the knee joint. When a dislocation occurs, the epiphysis of the femur goes completely beyond the limits of the joint, which makes movements in the joint impossible, and the axis of the leg moves significantly to the side. Fortunately, such a negative variant of the development of the disease is quite rare.

Subluxations are more common. They are characterized by partial displacement of the joints relative to each other and a slight deviation of the tibia axis. In this case, subluxations are accompanied by severe pain and impaired functioning of the joints.

Neglect of the disease can lead to complete loss of functionality of the lower limb.

ATTENTION! The habit of sparing a sore leg sometimes causes deformation of the intervertebral discs and the appearance of hernias.



What EULAR – European League Against Rheumatism – recommends

If the patient experiences pain periodically and is characterized as moderate, with no inflammation, it is sufficient to use simple analgesics, such as paracetamol. If the pain is constantly present and pronounced, caused not only by physical activity, but also by inflammation, non-steroidal drugs are more effective.

When treating osteoarthritis, the analgesic dose of NSAIDs is usually lower than for rheumatism or arthritis. However, this drug cannot be taken constantly: it is indicated only when the pain intensifies. Experts recommend propionic acid derivatives - ibuprofen at a maximum dosage of 1200-1800 mg/day or ketoprofen 100 mg/day. Another acceptable option is phenylacetic acid, or diclofenac at a dosage of 50-100 mg/day.

Which painkillers are safe and which are useless? Answers to these and other questions about analgesics are in the video:

Treatment methods for arthrosis of the knee joint

The prescribed treatment depends on the degree of development of the disease. There are several treatment options.

Hormones

These drugs are prescribed for severe exacerbation, accompanied by synovitis and severe pain. Hormones are usually given by injection. The following drugs are most often used:

• Flosteron;
• Diprosfan;
• Hydrocortisone.

The course of treatment with hormones is usually short; injections are performed only during periods of severe exacerbation. Hormones are administered at an average frequency of once every 10 days.

Chondroprotectors

Chondroprotectors are prescribed at the initial stage of disease development. This therapy is currently considered the most effective and safe: there are practically no contraindications, and side effects occur in the rarest cases.

The drugs are aimed at restoring cartilage, improving metabolic processes, nourishing cartilage tissue and protecting it from further destruction. But in the last stages of arthrosis, chondroprotectors are also powerless.

This group of medications is produced in the form of injections, ointments, gels, and tablets.

Vasodilators

These funds are necessary to eliminate spasm of small vessels, increase blood circulation and supply nutrients to the area of ​​the affected joint. Vasodilators are prescribed together with chondroprotectors.

If joint fluid does not accumulate during gonarthrosis (no synovitis), it is recommended to use warming ointments.

Hyaluronic acid

In another way, this product is called an intra-articular fluid prosthesis, since the composition of the acid is similar in composition to the intra-articular fluid. When acid is introduced into a joint, it forms a film that prevents strong friction of cartilage during movement, affects the extracellular matrix, improving metabolic processes in the joint, and also triggers the production of its own hyaluronic acid in the joint - i.e. returns the functioning of the joint to normal, stopping pathological processes that destroy cartilage. .

Treatment with acid is prescribed only when exacerbation of synovitis is eliminated. The following drugs have shown effectiveness:

• HYAL-SIN: high molecular weight hyaluronic acid, concentration 1%, course of treatment: 3 injections with an interval of 7-10 days;
• HYAL-SIN PROLONG: also high molecular weight hyaluronic acid, concentration 2%, effect lasts up to 12-24 months, single use (can be repeated after 2-3 weeks);
• GIAL-SIN PROLONG PLUS. A new drug that allows you to achieve maximum results with one injection. Its main advantage is that during the production process, intermolecular cross-linking of hyaluronic acid chains is additionally performed to extend the restorative effect and increase resistance to destruction.

These drugs are in stock and can be purchased at any pharmacy in the city, or on our website at the best possible price.

Physiotherapy

A course of physical therapy will bring positive results only on the condition that it was prescribed by a doctor after a complete study of the medical history, and all exercises are carried out under the supervision of a specialist.

Self-medication often leads to a worsening of the situation with the joint. Exercise therapy is prescribed for the following purposes:

• slowing down the development of stiffness;
• prevention of further destruction of cartilage tissue;
• elimination of muscle spasm leading to pain.

Physiotherapy

Various procedures can be prescribed as additional therapy: electrophoresis, acupuncture, laser therapy, UHF, as well as diadynamic currents. Local massage will also give good results.

Physiotherapy is aimed at reducing the severity of pain, eliminating inflammation, normalizing metabolic processes within the affected joint and restoring its normal function.

IMPORTANT! It is important for the patient to monitor his diet and avoid strenuous physical activity.



Nutrition for gonarthrosis

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 content of gluten and fiber, without salt and sugar. As well as fermented milk products, fish and nuts.

The last time you eat food should be no later than 19:00. The frequency of food intake can remain familiar, as it has developed over many years. But it’s better to eat in fractions – in small portions 5-6 times a day in the morning.

Breakfast should be the most plentiful - it sets the body in the mood for work and maintains strength until lunch.

If, especially at first, the feeling of hunger becomes unbearable, trick your stomach - eat an apple or chew a carrot. Just don't eat high-calorie bananas and grapes!

Don't give up jellied meats. Carrying collagen to the body and joints - the raw material for the construction of 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 any kind;
• Everything is spicy;
• Semi-finished products of unknown origin;
• Carbonated drinks with sugar;
• Vegetables: white cabbage, tomatoes, red bell peppers.

Potatoes because they are high in calories (carbohydrates!) and help you gain excess weight. Therefore, the Dukan diet will be relevant.

Forecast. Prevention

At an advanced stage of the disease, the prognosis is disappointing. Therefore, it is recommended that if even minor symptoms of arthrosis occur, consult a doctor for advice.

People at risk (elderly people, athletes, and overweight people) must follow the doctor’s recommendations and adhere to the following rules:

1. Eat right and watch your weight. If necessary, follow a diet to lose weight.
2. When playing sports, reduce the load on your joints and constantly monitor it.
3. Treat infectious diseases in a timely manner, preventing them from becoming chronic.
4. Get plenty of rest and avoid stressful situations if possible.
5. Increase the protective functions of the body (periodically take vitamins, harden yourself).
6. Avoid hypothermia of the body, especially the lower extremities.

Indications

• osteoarthritis;
• arthritis;
• bursitis;
• synovitis;
• tendinitis.

Joint diseases are very common, especially among older people. If you are one of them, or the time has come to repeat the course of treatment, call us. Our center employs high-level specialists with extensive experience, making patients feel comfortable and confident. If necessary, you will be prescribed one or more intra-articular injection procedures and a drug will be selected based on the indications.