Gonarthrosis, or deforming arthrosis of the knee joint, is a degenerative-dystrophic disease in the hyaline cartilage of the knee, covering the condyles of the tibia and femur.
Symptoms of arthrosis of the knee joint develop over years, gradually, and the main manifestation of the disease is stiffness of movement and pain.Among arthrosis of other joints (phalanxes of the fingers, shoulder and elbow joints, hip joints), gonarthrosis is the most common disease.
The category of the population most susceptible to arthrosis of the knee joint is women, as well as people over 40 years of age.In some cases, gonarthrosis can develop in athletes (from increased stress) and young people (against the background of previous injuries).
Causes of gonarthrosis
Osteoarthritis of the knee joint does not develop from a single cause; in most cases, the development of the disease depends on a combination of several negative factors, which worsen with age and can ultimately lead to such a disorder.Medicine identifies the following mechanisms for the occurrence of arthrosis:
Primary – occurs in old age from the aging of body tissues, as well as against the background of some factors that provoke this disease (constant increased stress, heredity, obesity).
Secondary – accounts for 30% of all cases of gonarthrosis, occurring mainly after damage to the meniscus, rupture of ligaments, fracture of the tibia and other injuries.In most cases, symptoms of knee arthrosis begin to 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, after forty years, a person begins to actively engage in physical exercise, namely squats and running.But due to age, weakening of the tissue tone of the knee joint and characteristic age-related changes under sudden loads can provoke the appearance of rapid degenerative and dystrophic changes in the joints.
Another reason for the development of gonarthrosis in a person may be concomitant diseases - varicose veins, excess weight, ankylosing spondylitis, gout, psoriatic, 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 professional sports can lead to arthrosis of the knee joint.The risk of arthrosis of the knee joint increases significantly with genetically caused weakness of the ligamentous apparatus, diabetes mellitus and other metabolic disorders, neurological diseases, and spinal injuries.
Spasm of the muscles of the anterior thigh is the cause of 50-60% of cases of arthrosis of the knee joint.Such muscle spasm may not manifest itself for a long time before the appearance of pain in the knees, while the person may feel heaviness in the legs, fatigue, and experience lower back pain.When the iliopsoas and rectus femoris muscles are in a state of constant spasm, with age this leads to “tightening” of the knees, which limits their free movement.
Degrees of gonarthrosis
In most cases, the development of arthrosis of the knee joint occurs in one of the knees.Medicine distinguishes 3 degrees of gonarthrosis depending on the intensity of pathological processes:
The first is that there is no deformation of the bones of the joint; periodic dull pain in the knee is characteristic after physical stress on the joint.Minor swelling of the joint may develop, which disappears on its own after some time.
The second degree is characterized by an increase in symptoms of arthrosis.The pain is long-lasting and intense, and occurs with minimal exertion (heavy lifting, walking), and a crunching sound may also appear in the joint.In the second degree of gonarthrosis, deformation may develop in the knee joint, as well as moderate limitation of movement.
Third degree – has pronounced symptoms of arthrosis of the knee joint.Noticeable deformation of the joint and constant pain lead to disturbances in the patient’s gait, and there is limited mobility of the joint.In the third degree of gonarthrosis, the pain can intensify depending on the weather and reach such intensity that the patient’s sleep is disturbed, the limitation of mobility is reduced to a minimum, which makes it impossible to find a comfortable position for the leg.
Diseases and pathologies with which gonarthrosis is confused
Block of the knee joint in case of meniscus damage.
The disease develops after an unsuccessful movement, accompanied by a crunch in the knee, severe pain appears, which subsides after 15 minutes, and the next day swelling of the knee occurs.
Ankylosing spondylitis, gout, articular rheumatism, arthritis - psoriatic, reactive, rheumatoid.
To distinguish gonarthrosis from arthritis, it is necessary to take a general blood test.With arthritis, the test results will indicate the presence of an inflammatory process in the body, while with arthrosis, no changes in the blood test occur.
Inflammation of the knee tendons.
It develops in most cases in women over 40, when carrying heavy objects or going down stairs.The pain is localized on the inner surface, but the movement of the knee is not limited.
Vascular pain in the knees.
The pain is characterized by symmetry and occurs in both knees at once.Characteristic of young people during a period of accelerated bone growth, they can occur during physical activity, a cold, or a change in 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.Initially, the patient feels only minor discomfort, pain when moving, going up or down stairs.In some cases, the patient's sensations are reduced to slight stiffness of the joint and tightness in the popliteal region.A characteristic feature of arthrosis of the knee joint is considered to be a symptom of starting pain, which consists in the fact that after a sharp transition from a sitting position to movement, a person begins to feel pain during the first steps, which gradually disappears, only to arise again after a heavy load.
The appearance of the knee joint with the first degree of arthrosis is no different from a healthy knee, only in some cases patients note a slight swelling.Also, in some cases, fluid begins to accumulate in the knee joint, it swells and becomes spherical, and synovitis begins to develop, which leads to a feeling of heaviness and limited movement of the joint.
Such changes in the joint in the first degree of arthrosis occur due to disruption of the blood circulation 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 appearance of cracks.Because of this, unhindered and soft movement between the cartilages is difficult and is accompanied by constant microtrauma when the cartilages cling to each other.Cartilage tissue, being 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 articular area is flattened, and growths in the form of spines (osteophytes) appear along the edges.The joint capsule degenerates, the joint fluid thickens, and the synovial membrane shrinks.This leads to a significant deterioration in the nutritional process of cartilage and accelerates its degeneration.
As the disease progresses to the second stage, the symptoms begin to intensify, pain occurs even with light loads and is localized along the inner front side of the joint.Rest brings relief, but resuming movement causes severe pain.
The mobility of the joint is significantly reduced, attempts to bend the leg as much as possible cause sharp pain, and a distinct rough crunch is heard when moving.Synovitis is more common; the joint becomes enlarged and changes its configuration due to a large accumulation of fluid.
The third degree of arthrosis of the knee joint is accompanied by significant deformation of the bones, in which they seem to be pressed into each other.There is virtually no cartilage tissue, and the limitation of joint movement increases.Straightening the joints becomes quite problematic, and pain begins to bother the patient around the clock, both when walking and at rest.Due to severe deformation of the joints, the legs acquire an O- or X-shape, the gait becomes unstable, waddles, and quite often the patient cannot do without a cane or crutches.
Diagnosis and treatment of gonarthrosis
During a routine examination, it is impossible to determine whether a patient has first-degree arthrosis of the knee joint.If there is a 2 or 3 degree, upon examination there is swelling, edema (with synovitis), a crunching sound is heard, stiffness of movements is observed, a change in the axis of the limbs, and deformation of the joints is noticeable.
Today, in addition to radiography, CT and MRI methods are widely used to diagnose arthrosis, thanks to which it is possible to study disorders of bone structures in more detail and examine pathological changes in soft tissues.
Treatment of the disease involves a complex of orthopedic procedures and drug therapy.An orthopedist prescribes mud therapy, therapeutic exercises, massage, and physiotherapy.
Drug treatment involves the use of chondoprotectors, these are drugs that replace synovial fluid.In some cases, intra-articular injection of steroid hormones is performed.Patients are also recommended to undergo sanatorium-resort treatment.
If treatment of a young patient with severe limitation of movement and pain is ineffective, a joint replacement method can be used, which provides for a 3-6 month rehabilitation period.
What happens to the knee joint with arthrosis?
Articular cartilage plays an important role in human movement and is a smooth, elastic and durable lining, thanks to which articulated bones move smoothly relative to each other, and also absorbs and distributes the load when walking.
But with excessive regular loads, genetic predisposition, metabolic disorders in the body, prolonged muscle spasms and injuries, cartilage loses its smoothness and begins to thin out.The soft sliding of the articulated bones is replaced by strong friction, and the first degree of gonarthrosis develops, in which the cartilage loses its shock-absorbing properties.
The degradation process continues to progress, and poor shock absorption leads to flattening of bone surfaces with the formation of osteophytes in the form of bone growths.In this case, the disease already has a second degree and is accompanied by degeneration of the synovial membrane and joint capsule.Lack of pumping and movement atrophies the structure of the knee joint, the consistency of the knee fluid becomes more viscous, the process of nutrition of the cartilage is disrupted, which leads to an even greater deterioration of the patient’s condition.
Thinning cartilage leads to a reduction in the distance between articulated bones by up to 80%.While walking, due to abnormal friction and the absence of a shock absorber, destructive processes in the joint rapidly increase, this quickly leads to the development of the third degree of arthrosis with pronounced symptoms:
Pain when moving, especially when going up or down stairs.
Pain both during exercise and at rest, morning stiffness.
The patient begins to limp, trying to spare the sore joint.
Severe cases of the disease require the use of crutches or a cane.
The third degree of arthrosis of the knee joint is characterized by an almost complete absence of cartilage tissue, which leads to a decrease in joint mobility to a minimum.Therefore, no magical methods, super medicines or ointments can restore worn-out cartilage tissue, and given the degree of bone deformation, normal functioning of the joint is impossible.In this case, only surgery can help.
Gymnastics for arthrosis of the knee joint
Any treatment option for arthrosis of the knee joint should only be carried out as prescribed by a doctor.Therapeutic gymnastics involves slow, measured exercises that exclude squats, twisting of the joint, and jumping.It is best to do gymnastics in the morning, sitting or lying down, for 20 minutes, repeating each exercise 10 times.
The main objectives of therapeutic exercises are to relax muscle spasms that cause pain, increase blood supply to the joint, slow down the progression of the disease, and prevent further destruction of cartilage.During the period of exacerbation of the disease, physical exercise is prohibited.
Lying on your back, you can perform the bicycle exercise, but you need to straighten your legs parallel to the floor, make circular movements with your feet, move your legs to the sides, alternately sliding them along the floor, strain your feet for a count of 10.
Sitting on a chair with your legs down, straighten your legs, simultaneously bending your feet, and hold this position, counting to 10, alternately pull each knee to your stomach with your hands and slowly return to the starting position.
Focusing on the wall, standing on the floor, alternately swing your legs back and forth.
Putting your straightened leg on a chair, perform inclined movements of a springy nature, while leaning your hands on your thigh, as if trying to straighten your leg more.
Lying on your stomach, alternately lift your straightened leg and hold it for up to 3 counts.
Sitting on the floor, spread your legs to the sides, moving them along the floor, pull your knees to your stomach as you inhale and return them to their starting position as you exhale.