Osteochondrosis when the knee does not unbend
What is it - gonarthrosis is called a diseasethe knee joint is not of an inflammatory nature, in which the blood supply of the cartilage covering the articular surfaces of the femoral and / or tibia is disturbed.
As a result, the cartilage is destroyed, the parts of the bones begin to rub against each other, as a result of which they become denser and expand. This is often accompanied by inflammatory phenomena.
Symptoms of the disease are due only tothe above processes; calcium salts, if they are deposited in the joints, the cause of the pathology is not. Pathology most often develops in individuals 40 years and older, mainly women and people who are engaged in professional sports or having knee injuries.
Articular cartilage does not regenerate, so the disease must be detected and treated early in the early stages.
The disease develops with a combination of several reasons:
- fractures of the bones of the lower leg with the involvement of the knee in them;
- injuries of the cartilage interlayers of the joint - meniscus;
- ruptures of ligaments of the knee joint;
- increasing the load on the joint - running, squatting, lifting weights from the vertical position of the body - after 40 years of age, especially if a person does not exercise regularly;
- excess weight
- varicose veins of lower extremities;
- inflammation of the joint (arthritis), which has a different - psoriatic, gouty, rheumatoid or reactive - etiology;
- genetically caused weakness of the ligamentous-capsular apparatus of the joint, because of which its loosening occurs;
- pathology of joint innervation, characteristic of craniocerebral and spinal cord injuries;
- metabolic diseases.
- 1) Primary. It occurs against the background of full joint health (without pre-injury or inflammation). It is based on metabolic diseases, long reception of hormonal means, genetic predisposition of articular cartilage. The process is usually two-sided (although it can begin as one-sided). It develops more often in the elderly.
- 2) Secondary. Develops due to injuries, inflammations, tumors transferred to the joint operations. Can develop at any age. The process is usually one-sided.
Symptoms of gonarthrosis of the knee joint
As a rule, the first degree of gonarthrosis of the knee joint is manifested by certain symptoms, which should be noted:
How the disease manifests itself will bedepend on how far the degenerative process progressed. Depending on this, three stages of the disease are distinguished, each of which has its own symptomatology.
- feeling of contraction under the knee;
- stiffness in the knee, which manifests itself after sleep, prolonged sitting or prolonged immobility of the joint;
- pain in the joint:
- stupid character;
- arising during long walking, squats, walking on stairs;
- Increased after standing or exercise
- swelling of the joint can occur for a short time, passes by itself.
- pain in the joint becomes more intense, lasts longer. It disappears after rest.
- Pain is felt inside the joint or on the inside of the knee.
- there is a crunch in the knee when walking.
- in the mornings it is impossible to unbend the knee.
- closer to the night and at night there are pains in the calves.
- The leg does not fully unbend.
- The joint swells, acquires signs of initial deformation.
- 1) Pain in the joint worries constantly, regardless of the physical activity of a person.
- 2) Pain syndrome increases with changing weather.
- 3) The mobility of the joint is limited, because of which the person limps.
- 4) The knee is enlarged in size and deformed. When the process progresses, the joint becomes an X-shaped or O-shaped.
The diagnosis is confirmed with the help of such instrumental studies:
To suspect the presence of gonarthrosis of the knee joint in the patient can already on the basis of his complaints and data of objective examination.
- 1) Radiography. This method may be uninformative at the first stage of the disease, but subsequently it visualizes the narrowing of the joint gap, the compaction of the bone zone below the articular cartilage, and the sharpening of the edges of the condyles.
- 2) Computed tomography of the joint. This is more expensive, but more informative (even at stage I) method based on x-ray radiation. Visualizes the joint itself and surrounding tissues in more detail and layer by layer.
- 3) Magnetic-resonance tomography - a method,based on a non-radiological, considered harmless radiation, which can be used for contraindications to CT. Also layer-by-layer displays the picture in the joint, but is more informative regarding the surrounding soft tissues.
- 4) Arthroscopy is an invasive technique of joint research, when an optical fiber device is inserted into the hole made under local anesthesia, allowing the specialist to examine the joint from the inside.
- 5) The knee ultrasound is informative for diagnosing such complication of gonarthrosis as synovitis.
Treatment of gonarthrosis of the knee joint
The doctor involved in the treatment of this disease is an orthopedist. Medical treatment of the disease includes the following groups of drugs:
- 1) Non-steroidal anti-inflammatory and pain medications: Voltaren, Celebrex, Rofika, Nimesil, Movalis.
- 2) Chondroprotectors: "Artra", "Arthron", "Dona", "Teraflex", "Chondroitin complex". These drugs are taken for at least six months in the dosage prescribed by the doctor.
- 3) In the joint with pronounced inflammatory phenomena, enter "Hydrocortisone" or "Kenalog" no more than 3 times.
- 4) The preparations of hyaluronic acid are shown,which should be introduced into the joint when the inflammatory phenomena subsided in it: "Hyalurum", "Ostenil", "Sinocrom". These medications show a very good effect, they are administered only a few times, while having a fairly high cost.
- 5) Warming compresses with "Dimexide", "Bishofit", medical bile to improve the blood supply of the joint, increase the production of "lubricating" liquid in it.
- 6) Preparation on the basis of drawing from soybean plants andavocado - "Piascladin" - has also established itself as an effective tool in the treatment of gonarthrosis of the knee joint. At the same time, the treatment course is not less than six months.
Physiotherapy in gonarthrosis
In an acute period a person needs to provide complete peace for a diseased knee. Then proceed to the gradual introduction into his regime of the day of physical exertion.
Exercises are carried out in the position of the patient lying onback, they consist mainly in lifting the straightened legs, keeping them in the raised position. It is important to perform exercises smoothly, carefully, so that they do not cause pain.
Begin with 10 minutes, gradually, 2 minutes a day, increasing the duration of classes. Increase and the amplitude of movements, which should be selected by specialists individually for each.Contraindicated:
- flexion-extension in the knee;
- walking for a long time;
- movements in which there is pain in the knee.
In order to reduce the inflammatory phenomena in the joint, accelerate the regeneration of the articular cartilage, relieve the pain syndrome, in the treatment of gonarthrosis of the knee joint are used:
- electrophoresis with novocaine;
- diadynamic currents;
- phonophoresis with hydrocortisone;
- laser therapy;
- paraffin or ozocerite applications, mud treatment.
Surgical intervention. In gonarthrosis, joint replacement is performed with prostheses from biologically intact materials in such cases:
At the end of the acute period, the patient is allowedget up, but he will need to walk with a cane. For the knee, special orthoses can be selected (knee joints of rigid materials restricting movements in the joint) or orthopedic insoles.
- violation of joint function;
- a significant disability if the disease developed at a young or middle age.
In the future, during 3-6 months, rehabilitation activities are carried out, including physical therapy, exercise therapy, sanatorium treatment.
With gonarthrosis, massage, acupuncture, pharmacopuncture, acupressure, treatment with leeches in combination with medication, physiotherapy and exercise therapy are effective.
It is also necessary to pay special attention to thediet, achieving a reduction in excess weight. The menu should include an increased number of animals and vegetable proteins: low-fat varieties of meat and fish, boiled, steamed and steamed, cheeses, cottage cheese, bean products.
It is also recommended to use a cold more often. Most of the incoming fats should be of vegetable origin, you can eat a little butter. It is also important to eat foods rich in B vitamins.
In order to avoid the development of gonarthrosis, it is necessary:
- 1) Avoid significant physical exertion;
- 2) Perform exercises daily, while paying special attention to the correctness of the squats (especially if a person raises a load);
- 3) Follow the mass of your own body, not allowing the formation of excess weight;
- 4) In time, treat inflammatory or traumatic diseases of the knee joint.
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