Gonarthrosis or deforming arthrosis of the knee joint is a degenerative-dystrophic disease of the hyaline cartilage of the knee, which covers the condyles of the tibia and femur.
The symptoms of osteoarthritis of the knee joint develop gradually over years and the main symptoms of the disease are stiffness and pain.In addition to osteoarthritis of other joints (fingers, shoulder and elbow joints, hip joints), gonarthrosis is the most common disease.
The group of the population most susceptible to arthrosis of the knee joint is women and people over 40 years old.In some cases, gonarthrosis can develop in athletes (due to increased stress) and young people (against the background of previous injuries).
Causes of gonarthrosis
Osteoarthritis of the knee joint does not arise from a single cause;In most cases, the development of the disease depends on a combination of several negative factors that worsen with age and can ultimately lead to such a disorder.Medicine identifies the following mechanisms for the development of osteoarthritis:
Primary – occurs in old age due to the aging of body tissues, as well as against the background of some factors that provoke this disease (constantly increased stress, heredity, obesity).
Secondary - accounts for 30% of all cases of gonarthrosis and occurs mainly after damage to the meniscus, rupture of ligaments, fracture of the tibia and other injuries.In most cases, symptoms of knee osteoarthritis appear after 3-4 years.However, if the injury is severe enough, it may take 2-3 months for symptoms to appear.
About 7-8% of cases of arthrosis of the knee joint occur when a person begins to engage in active physical activity after forty years, namely squats and running.However, due to age, a weakening of the tissue tone of the knee joint and characteristic age-related changes during sudden loading can provoke the appearance of rapid degenerative and dystrophic changes in the joints.
Another reason for the development of gonarthrosis in a person can be concomitant diseases - varicose veins, obesity, ankylosing spondylitis, gout, psoriasis, rheumatoid or reactive arthritis.
Constant critical loads on the knees, regular long-term climbing of stairs in old age or heavy lifting as well as competitive sports can lead to osteoarthritis of the knee joint.The risk of osteoarthritis of the knee joint increases significantly with genetically caused ligamentous weakness, diabetes mellitus and other metabolic disorders, neurological diseases and spinal injuries.
Spasms of the muscles of the anterior thigh are the cause of 50-60% of cases of osteoarthritis of the knee joint.Such muscle spasms may not manifest themselves for a long time before pain in the knees appears, while the person may experience a feeling of heaviness in the legs, fatigue and pain in the lower back.When the iliopsoas and rectus femoris muscles are constantly tight, this causes the knees to become “tight” as we age, limiting their range of motion.
Degrees of gonarthrosis
In most cases, osteoarthritis of the knee joint develops in one of the knees.Medicine distinguishes 3 degrees of gonarthrosis depending on the intensity of the pathological processes:
The first is that there is no deformation of the joint bones;Periodic dull pain in the knee after physical stress on the joint is characteristic.There may be slight swelling of the joint, which will disappear on its own after a while.
The second degree is characterized by an increase in osteoarthritis symptoms.The pain is long-lasting and intense and occurs with minimal exertion (heavy lifting, walking), and a grinding noise may also occur in the joint.In the second degree of gonarthrosis, deformation of the knee joint and moderate limitation of movement can occur.
Third degree – has pronounced symptoms of arthrosis of the knee joint.Significant deformation of the joint and constant pain lead to the patient's gait problems and limited mobility of the joint.In the third degree of gonarthrosis, the pain can increase depending on the weather conditions and reach such an intensity that the patient's sleep is disturbed, restriction of movement is reduced to a minimum and it becomes impossible to find a comfortable position for the leg.
Diseases and pathologies with which gonarthrosis is confused
Blocking the knee joint in the event of meniscus damage.
The disease develops after an unsuccessful movement, accompanied by a crunch in the knee, severe pain occurs, which subsides after 15 minutes, and the next day there is swelling of the knee.
Ankylosing spondylitis, gout, rheumatoid arthritis, arthritis – psoriasis, reactive, rheumatoid.
To distinguish gonarthrosis from arthritis, a general blood test is required.With arthritis, the test results indicate the presence of an inflammatory process in the body, while with arthrosis there are no changes in the blood test.
Inflammation of the hamstrings.
It most commonly occurs in women over 40 when carrying heavy objects or walking down stairs.The pain is localized to the inner surface, but movement of the knee is not restricted.
Vascular pain in the knees.
The pain is characterized by symmetry and occurs in both knees at the same time.They are characteristic of young people during a period of accelerated bone growth and can occur with physical activity, a cold or a change in the weather.To describe their own condition, patients use the term “twisted knees.”
Stages of arthrosis of the knee joint
The disease is insidious due to its gradual development.At first, the patient only feels mild discomfort, pain when moving, climbing or climbing stairs.In some cases, the patient's sensations are reduced to a slight stiffness of the joint and a feeling of tension in the popliteal area.The characteristic feature of arthrosis of the knee joint is considered to be the symptom of incipient pain, which consists in the fact that after a sharp transition from a sitting position to movement, pain is felt at the first steps, which gradually disappears and only appears again after heavy loads.
The appearance of the knee joint in first-degree osteoarthritis does not differ from that of a healthy knee; in some cases, patients only notice slight swelling.In some cases, fluid also begins to accumulate in the knee joint, it swells and becomes spherical, and synovitis begins to develop, causing a feeling of heaviness and limited movement of the joint.
Such joint changes in the first degree of osteoarthritis arise from a circulatory disorder in the small intraosseous vessels that nourish the hyaline cartilage.This leads to changes in the surface of the cartilage, dryness, loss of smoothness and the formation of cracks.For this reason, unhindered and smooth movement between the cartilages is difficult and is accompanied by constant microtrauma as the cartilages adhere to each other.Cartilage tissue, which is in a constant state of microtrauma, begins to lose its shock-absorbing properties and become thinner.
The development of pathological processes leads to changes in bone structures.The joint area is flattened and growths in the form of spines (osteophytes) form at the edges.The joint capsule degenerates, the synovial fluid thickens and the synovial membrane shrinks.This leads to a significant deterioration in the cartilage nutrition process and accelerates its degeneration.
As the disease progresses to the second stage, the symptoms begin to intensify, pain occurs even with slight loads and is localized along the inner front side of the joint.Rest brings relief, but resuming movement causes severe pain.
The joint's mobility is significantly limited, attempts to bend the leg as much as possible cause stabbing pain and a clearly rough crunching sound can be heard when moving.Synovitis is more common;The joint enlarges and changes configuration due to a large accumulation of fluid.
The third degree of arthrosis of the knee joint is accompanied by a significant deformation of the bones, in which they appear to be pressed into one another.There is practically no cartilage tissue left and the restriction of joint movement increases.Straightening the joints becomes quite problematic and the patient begins to experience pain around the clock, both when walking and at rest.Due to the strong deformation of the joints, the legs take on an O or X shape, the gait becomes unstable, waddling and often the patient cannot do without a cane or crutches.
Diagnosis and treatment of gonarthrosis
A routine examination cannot determine whether a patient has first-degree knee osteoarthritis.With a grade 2 or 3, on examination there is swelling, edema (with synovitis), a crunching sound, stiffness of movements, a change in the axis of the limbs and deformation of the joints.
Nowadays, in addition to radiography, CT and MRI methods are often used to diagnose arthrosis, which allows disorders of bone structures to be examined in more detail and pathological changes in soft tissues to be examined.
Treatment of the disease includes a complex of orthopedic procedures and drug therapy.An orthopedist prescribes mud therapy, therapeutic exercises, massage and physiotherapy.
During drug treatment, chondoprotectors are used, which are drugs that replace the synovial fluid.In some cases, intra-articular injection of steroid hormones is performed.Patients are also recommended to undergo spa treatment.
If the treatment of a young patient with severe limitation of movement and pain remains ineffective, a joint replacement method can be used, which provides for a rehabilitation period of 3 to 6 months.
What happens to the knee joint with osteoarthritis?
Articular cartilage plays an important role in human movement and is a smooth, elastic and durable lining, thanks to which the articular bones move smoothly relative to each other, and also absorb and distribute the load during walking.
However, with excessive regular loads, genetic predisposition, metabolic disorders in the body, persistent muscle spasms and injuries, the cartilage loses its suppleness and begins to become thinner.The gentle sliding of the joint bones is replaced by strong friction and first-degree gonarthrosis occurs, in which the cartilage loses its shock-absorbing properties.
The degradation process continues and poor shock absorption leads to flattening of the bone surfaces with the formation of osteophytes in the form of bone growths.In this case, the disease is already of a second degree and is accompanied by degeneration of the synovial membrane and the joint capsule.Lack of pumping and lack of exercise atrophies the structure of the knee joint, the consistency of the knee fluid becomes more viscous, the nutritional process of the cartilage is disrupted, which leads to an even greater deterioration in the patient's condition.
The thinning of the cartilage reduces the distance between the joint bones by up to 80%.When walking, due to abnormal friction and the absence of a shock absorber, destructive processes in the joint quickly increase, which quickly leads to the development of third-degree arthrosis with pronounced symptoms:
Pain when moving, especially when climbing stairs.
Pain both with exertion and at rest, morning stiffness.
The patient begins to limp and tries to protect the painful joint.
In severe cases of the disease, the use of crutches or a walking stick is necessary.
The third degree of arthrosis of the knee joint is characterized by an almost complete absence of cartilage tissue, which leads to a limitation of joint mobility to a minimum.Therefore, no magical methods, super drugs or ointments can restore worn out cartilage tissue, and given the extent of bone deformation, normal functioning of the joint is impossible.In this case, only surgery can help.
Gymnastics for arthrosis of the knee joint
Treatment for osteoarthritis of the knee joint should only be carried out as prescribed by a doctor.Remedial gymnastics involves slow, measured exercises that exclude squats, joint rotations and jumps.It's best to do gymnastics in the morning while sitting or lying down for 20 minutes and repeat each exercise 10 times.
The main goals of therapeutic exercises are to relax painful muscle spasms, increase blood supply to the joint, slow disease progression, and prevent further destruction of cartilage.During the exacerbation of the disease, physical activity is prohibited.
Lying on your back, you can perform the bicycle exercise, but you need to stretch your legs parallel to the floor, make circular movements with your feet, move your legs to the sides, slide them alternately along the floor, straining your feet while counting to 10.
Sit on a chair with your legs down, straighten your legs, at the same time bend your feet and hold this position, count to 10, alternately pull each knee to your stomach with your hands and slowly return to the starting position.
Focus on the wall, stand on the floor and alternately swing your legs back and forth.
Place your straight leg on a chair and make springy oblique movements while resting your hands on your thigh, as if trying to straighten your leg more.
Lying on your stomach, alternately lift your straight leg and hold it up to 3 times.
Sit on the floor, spread your legs to the sides, move them along the floor, pull your knees towards your stomach as you inhale and return them to the starting position as you exhale.