Treatment of gonarthrosis (arthrosis of the knee joint) can be conservative (therapeutic) and surgical.
Surgical treatment of arthrosis of the knee joint (gonarthrosis) is used only in the most severe cases; the most popular method of surgical treatment for gonarthrosis is joint replacement.
The following methods and means are used in therapeutic treatment:
— Intra-articular injections of corticosteroid hormones. They quickly and effectively suppress pain and inflammation during synovitis (edema and swelling of the joint), which often accompanies arthrosis of the knee joint (gonarthrosis). arthrosis of the knee joint (gonarthrosis) itself is not treated with corticosteroids. However, they have a large number of contraindications; they cannot be used in the treatment of arthrosis of the knee joint for a long time.
— Intra-articular injections of hyaluronic acid preparations (sodium hyaluronate) are also used in the treatment of arthrosis of the knee joint (gonarthrosis). Sodium hyaluronate forms a protective film on cartilage damaged by gonarthrosis , protecting cartilage tissue from further destruction and improving the sliding of contacting cartilage surfaces. Hyaluronic acid preparations have virtually no side effects, but long-term treatment with injections is impossible - there is a risk of joint damage.
- Non-steroidal anti-inflammatory drugs. The use of NSAIDs in the treatment of arthrosis of the knee joint (gonarthrosis) reduces inflammation and reduces the intensity of pain. However, these drugs also have quite serious side effects, and there are numerous contraindications, especially with long-term and frequent use.
— Chondroprotectors are drugs for the restoration of cartilage tissue. Helps restore the cartilaginous surfaces of the joint in the treatment of arthrosis of the knee joint (gonarthrosis) , improve the production of joint fluid and normalize its “lubricating” properties. But it works only with long-term use (courses last at least 3 months, several courses are required).
- Vasodilators. In the treatment of arthrosis of the knee joint, they help restore the joint by improving articular blood flow and relieving spasm of small vessels.
A positive result, especially in the early stages of treatment of gonarthrosis , is achieved by therapeutic exercises, physiotherapeutic treatment, and balneotherapy.
According to the results of clinical trials, a new innovative drug, the NANOPLAST forte therapeutic patch, showed a good effect in the treatment of gonarthrosis.
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.
Treatment of arthrosis of the knee joint using the NANOPLAST forte therapeutic patch
In the therapeutic treatment of arthrosis of the knee joint (gonarthrosis) , various drugs are used, such as NSAIDs, corticosteroids, etc. All of these drugs are effective, but with prolonged use they can cause harm to the body. Therefore, it is very important to minimize side effects and increase the effectiveness of treatment. A new generation drug can help with this - the pain-relieving anti-inflammatory medical patch NANOPLAST forte.
In the treatment of gonarthrosis , the NANOPLAST forte medical plaster is very effective, it allows you to relieve pain and inflammation, improve blood circulation in the area affected by arthrosis of the knee joint , and allows you to reduce the dose of painkillers and anti-inflammatory drugs.
For gonarthrosis (arthrosis of the knee joint), the therapeutic anti-inflammatory pain-relieving plaster NANOPLAST forte is applied to the area of the knee joint, on the right or left, depending on the location of the pain. It is usually recommended to use the patch in the morning for 12 hours, but it can also be used at night. The course of application of the therapeutic patch for arthrosis of the knee joint is 15 days, with breaks between courses of 1 week. Typically a patch measuring 9x12 cm is used.
High efficiency, unique composition, long-term (up to 12 hours!) therapeutic effects, ease of use and affordable price make NANOPLAST forte the drug of choice in the treatment of gonarthrosis.
Read more about NANOPLAST forte
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
ARTRA and ARTRA® MSM
Today, the deficiency of chondroitin, glucosamine and methylsulfanylmethane can be compensated for by consuming the dietary supplement Artra MSM, which contains high concentrations of these substances. Hyaluronic acid is also included here. All this results in a symbiosis that has a synergistic effect. This means that each substance included in Atrta MSM has a complementary and reinforcing effect of each other.
The components help reduce inflammation and pain in the joints, promote the regeneration of cartilage and connective tissue, restoring them. Chondroitin sulfate sodium is part of the synovial fluid, which plays an important role as a lubricant and contributes to the normal functioning of all articular surfaces. Hyaluronic acid, like chondroitin, is part of the synovial fluid and is a lubricant. It prevents friction between joints, thereby reducing pain and inflammation by stimulating collagen production.
Standardized substances are used in the production of ARTRA and ARTRA® MSM. Therefore, assessment of the molecular weight of chondroitin sulfate is a key factor related to pharmacological activity. ARTRA® MSM contains maximum concentrations of glucosamine and chondroitin, which are enhanced by a complex of hyaluronic acid and methylsulfonylmethane (MSM).
conclusions
Chondroitin sulfate products are obtained from different animal tissues and use different extraction and purification methods, resulting in different content, composition, purity, biological effects, clinical effectiveness and safety of the resulting product. Therefore, strict quality control for the production of chondroitin sulfate should regulate and standardize this process. ARTRA and ARTRA® MSM fully meet all requirements and are drugs that can truly eliminate problems of joints and cartilage tissue, thereby allowing patients to feel absolutely healthy.
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.
The use of physiotherapy in the treatment of arthrosis
Degenerative changes in joints are most often the result of mechanical wear and tear of tissues, injuries, concomitant diseases, as well as joint overload caused by heavy physical work, frequent and prolonged stay in one position, and sometimes excessive physical activity. The process of degeneration of joint tissue cannot be reversed, but the development of degenerative changes can be slowed down. Therefore, physiotherapy for joint arthrosis often plays a key role in the treatment of patients.
Treatment of joint arthrosis with physiotherapy prescribed by the attending physician will achieve the following results:
- slow down the progressive degenerative process;
- relieve pain;
- increase range of motion in joints;
- increase muscle strength;
- prevent muscle atrophy;
- improve the general condition of the patient;
- keep the patient in adequate physical shape.
Physiotherapeutic procedures are always selected individually, taking into account:
- the patient's current condition;
- severity of degenerative disease;
- the presence of concomitant pathologies;
- the patient's expectations and needs related to his daily life.
Physiotherapy
Physiotherapy for joint arthritis has a variety of directions; laser and ultrasound methods, as well as massage or therapeutic mud therapy can be used. Let's take a closer look at what kind of physiotherapy is prescribed for arthrosis .
Ultrasound
Ultrasound therapy or ultraphonotherapy involves exposure through the skin to deeper structures of an ultrasonic wave (mechanical, acoustic wave with a frequency above the hearing limit) in order to obtain therapeutic effects. Ultrasound physiotherapy for arthrosis is aimed at obtaining an analgesic effect and stimulating cellular restoration processes. Visible effects of ultrasound waves include vasodilation, relaxation of muscles and tendons, cessation of inflammation, improved healing, and slowing down the process of degeneration of joint tissue. In addition, ultrasound is considered as a factor that accelerates recovery processes in the chronic phase of inflammatory reactions
Mechanical
Physical therapy of the mechanical type usually means manual treatment. Manual therapy is a type of musculoskeletal treatment based on knowledge of the anatomy, physiology and biomechanics of the body. Manual treatment is the most effective rehabilitation method, which has a positive effect on improving joint mobility, reducing pain and restoring muscle balance.
The manual therapy method includes a variety of treatment techniques that allow you to perform traction, sliding or compression on the joint.
One of the modern, safe and frequently used methods of manual intervention is the Mulligan method, based on the use of painless passive techniques performed by the therapist in combination with simultaneous active movements performed by the patient.
Manual physiotherapy for arthrosis can be very effective if it is individually tailored to the patient's needs.
Contraindications to the use of manual treatment may be systemic acute inflammation with fever, bone fractures, ruptured ligaments or joint capsules, muscle damage, and instability of joint joints.
Magnetotherapy
Magnetotherapy is a technique that uses alternating low-frequency magnetic fields (up to 100 Hz) and magnetic induction from 0.1 to 10 mT in the treatment of certain diseases of the musculoskeletal system. The mechanism of action of a magnetic field on a body is very complex and has not yet been explained in many details, however, it allows one to achieve the following results:
- analgesic effect
- anti-inflammatory effect
- increased oxygen uptake by tissues
- stimulation of peripheral circulation
- decongestant effect
- acceleration of soft tissue regeneration processes
- accelerating the bone healing process
- influence on oxygen free radicals
Magnetic physiotherapy for arthritis and arthrosis is defined as an absolutely safe procedure. Using it even for a very long time does not cause side effects.
Massage (isometric)
This type of massage involves performing exercises to fix the muscles in tension without subsequent movements in the joint. Isometric massage is performed when muscle weakness occurs due to arthrosis or after a long recovery. It is also performed as a massage, helping to increase muscle mass, strength and improve the motor capabilities of the joint. Thanks to isometric massage, blood circulation in the joint improves, pain and inflammation are reduced.
Mud therapy
This type of therapy involves the use of healing mud - formations of natural origin consisting of water, minerals and organic substances. Mud treatment of joints helps eliminate swelling, restores their mobility, and increases the range of motion. Dirt activates a huge number of biochemical reactions in the body. Moreover, it does this at the cellular level, which allows it to normalize the functioning of various organs and strengthen the immune system - both general and local.
Laser therapy
Laser therapy, that is, light treatment, naturally stimulates tissue regeneration at the cellular level. A very weak beam of visible or infrared light generated by a laser causes the atoms in the irradiated cells and tissues to vibrate. This effect improves blood circulation, nutrition and cell regeneration, stimulates protein synthesis, regenerates blood vessels, causes the growth of fibroblasts and collagen fibers, which has a beneficial effect on the condition of joint tissue. The additional laser has an anti-inflammatory and analgesic effect.
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.
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.
The use of medications and dietary supplements in conjunction with physiotherapy
It should be understood that physical therapy is only part of the treatment and cannot be used as an independent method of therapy. To achieve the best possible therapeutic results, you should resort to drug treatment, which should consist of medications and dietary supplements.
The most recommended drugs for arthrosis, complementing physiotherapy, are chondroprotectors. One of these is ARTRA® MSM, a dietary supplement based on glucosamine and chondroitin sulfate. Chondroprotectors improve cartilage metabolism, slow down or stop its destruction, and have an anti-inflammatory effect. It is especially important that such drugs have virtually no side effects.
Let us say right away that none of the methods of physiotherapy can completely stop the process of destruction of cartilage tissue, but will help slow down the process of its destruction, eliminate pain and inflammatory processes. It is worth noting that physiotherapy very often complements classical treatment; it is also recommended for some patients after orthopedic surgery.
Many musculoskeletal disorders that were initially diagnosed as surgical interventions can be corrected through the teamwork of orthopedists and physical therapists, as well as the patient. The ability to avoid surgery, which always carries the risk of complications, is one of the greatest successes of physical therapy.
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.
Gel electrophoresis of cholesterol in a number of nutraceuticals
Electrophoresis is a galvanization method. It has long ago gained great popularity and no less importance among physiotherapeutic treatment methods. Electrophoresis has several names, such as iontophoresis, ionogalvanotherapy, ionotherapy, galvanotherapy.
This method consists in the fact that with the help of alternating currents of different strengths and penetration depths, medications are delivered to the lesion through the layers of the skin.
There are many positive aspects to this procedure. It allows you to stimulate metabolism in the affected joint tissues, activates the restoration of cartilage and prevents further destruction of the joints. But a serious disadvantage is that the effectiveness of electrophoresis at the advanced stage of joint disease is practically zero. The time allotted for the course will be lost, and the result will most likely be negative. Or completely negative. There are also a number of serious contraindications for which electrophoresis cannot be used.
Gel electrophoresis of cholesterol in a number of nutraceuticals
- General serious condition of the patient;
- Malignant neoplasms or benign formations at the site;
- Lack of an accurate diagnosis (if arthrosis is only suspected, but diagnosis has not yet been carried out);
- Poorly tolerated previous electrophoresis procedures (not necessary for arthrosis);
- Intolerance to medications that will be used in the procedure.
A method that used capillary electrophoresis to determine chondroitin sulfate concentrations showed significant changes in disaccharide content. Determining the bioavailability of chondroitin sulfate is challenging, but in general its bioavailability is around 10–20%.
CS (chondroitin sulfate) has a high percentage of safety. Studies have shown that it has powerful health benefits for joints and cartilage and connective tissue, but other studies have shown little or no benefit.
The reason may be, or one of them, is changes in the quality of the chondroitin sulfate used for a particular study. Chondroitin sulfate is available in the form of pharmaceutical and nutraceutical products. It is precisely the latter that have a wide range of their preparation, composition, purity and, accordingly, effects. Some products contain too little cholesterol.
Some products have shown anti-inflammatory effects, while others have shown weaker effects. But there were also those that became provocative for the disease. This may be due to contaminants, which depend on the origin, production and purification process. It is therefore vital that only pharmaceutical grade chondroitin sulfate is used to treat patients with musculoskeletal conditions.
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.
