2-degree gonarthrosis of the knee joint can not only reduce the patient's motor activity, but also generally impair his quality of life. This may not only be due to pain and immobility, which until recently seemed insignificant.
Comparing the changes between the initial stage of the disease and its second stage, one begins to understand that without proper treatment, the situation will only get worse.
Causes of the disease
The most common reasons for the transition to stage 2 disease are irresponsible attitudes toward treatment and failure to follow your doctor's recommendations for physical activity and lifestyle changes.
Blood circulation and metabolism in the joints already affected by the disease are slowed to such an extent that the tissues are unable to receive nutrients and oxygen without external help. When treatment is refused or delayed later, the destructive processes in the joint are accelerated and, as a result, their mild stage disease becomes more severe.
Symptoms
Stage 2 of knee gonarthrosis is characterized by the following manifestations:
- increased pain: attacks of pain are given a certain regularity (after sleep at night, prolonged rest, after physical exertion);
- joint stiffness, usually in the morning, which disappears after a short walk;
- the size of the knee joint increases, its relief smooths out - all physiological bulges and depressions of the joint are no longer defined. When standing, it may appear that the skin is "hanging" over the patella. In a squatting position, it becomes apparent that one knee (affected by gonarthrosis) is much larger than the other, healthy and spherical;
- a characteristic crackle is heard when moving in the knee;
- The bending and stretching movements of the joint are sharply limited.
People with grade 2 gonarthrosis are rarely able to take painkillers because the knee pain begins to interfere even during rest. This is due to spike-like growths in the bone tissue of the joint, which irritate and traumatize all structures of the knee.
How your doctor makes this diagnosis
In most cases, patients with deteriorating health have already been diagnosed with gonarthrosis, and their doctor may order an x-ray to assess changes in the joint.
If your doctor has reason to believe that other diseases are associated with gonarthrosis, CT, MRI and laboratory blood tests may be recommended. This is necessary to rule out infections that can enter the joint through the bloodstream, as well as the complicated course of gonarthrosis that damages soft tissues.
Complications of the disease
Grade 2 gonarthrosis can quickly overcome the last "stage" and progress to the last stage, in which pain becomes a permanent companion and joints undergo irreversible changes and deformities, in the absence of treatment or inadequate responsible attitude. across.
In addition, weakened joint tissues become vulnerable to infections, and any viral or bacterial systemic disease can cause serious complications during gonarthrosis. The most common, but no less dangerous, infection of the joint cavity with the formation of purulent content, which can spread to soft tissues - muscles, skin.
Management
In the treatment of grade 2 gonarthrosis, the focus is on relieving pain, slowing or stopping the degenerative process of the joint, preventing complications, and improving knee mobility.
Medication
Medicines used to treat grade 2 gonarthrosis are divided into the following groups:
- Anti-inflammatory drugs.These include the latest generation of non-steroidal anti-inflammatory drugs (NSAIDs), which eliminate the inflammatory process in the joint and, as a result, reduce pain.
- Chondroprotectors.This group of drugs helps to protect cartilage tissue from further destruction and enhances the regeneration processes in it.
- Hyaluronic acid preparationswhich are analogues of the natural lubrication of the inner surface of the joint. By reducing the friction of the knee joint, these drugs prevent further wear on the cartilage. In some cases, intra-articular hyaluronic acid injections are indicated (e. g. , very poor blood flow in the joint, which prevents other forms of the drug from reaching the affected tissues).
- Utilities.These include vitamin preparations, immunostimulants, bioactive extracts of plants (aloe, echinacea, and so on), which aim to improve blood circulation in joint tissues and thus speed up the metabolic processes that take place in them.
Physiotherapy, massage, exercise therapy
Treatment methods such as physiotherapy, massage and exercise are considered adjunctive to the treatment of grade 2 knee gonarthrosis and are rarely used as a stand-alone treatment.
Physiotherapy (UHF, phonophoresis, ultrasound therapy, magnetotherapy) is used to improve blood circulation in the joint and to stimulate healing processes.
One of the most effective physiotherapy methods for treating arthrosis is MLS laser therapy, which can regulate the performance of laser radiation. Therapy uses constant and pulsating wavelengths that allow deep penetration into tissues and a pronounced clinical effect. The MLS laser treats joints, osteochondrosis, hernias and other diseases of the musculoskeletal system.
It is recommended to massage 10-15 times a day, one day or the next. Massage, by improving the blood supply to the joint, normalizes metabolic processes and provides a more effective effect of the drugs on the tissues affected by the disease.
When diagnosing grade 2 knee arthrosis, massages are often prescribed using medications (chondroprotectors, anti-inflammatory or irritating ointments, cooling and anesthetic external agents). factors.
A complex of physiotherapy practices is assigned to physicians after evaluating the efficacy of medication and selecting it based on the individual characteristics of the course of the disease and the patient's general health.
Lifestyle Correction
Lifestyle correction is one of the most important conditions for effective treatment. For grade 2 gonarthrosis, you must follow these rules:
- Reducing the load on the patient's joint.This uses orthopedic canes, which allow the load to be distributed during movement so that the knee joint is minimally affected. It is important to choose a comma that matches your height - standing from wrist to floor.
- Diet.For this disease, it is recommended to reduce the consumption of animal protein (eggs, meat, fish, whole milk), carbohydrates (baked goods, sweets) and foods and beverages containing synthetic flavors, sweeteners, preservatives.
- Weight loss. Obesity is one of the risk factors that increases the likelihood of metabolic disorders in all tissues, including joint tissues. In addition, being overweight puts unnecessary strain on the joints.
Surgical treatment
Surgical treatment can be divided into two types: arthroscopy and endoprosthetics.
Each operation has its own list of indications for which the intervention is most effective.
Arthroscopy
Arthroscopy is a low-traumatic surgical method in which the operation is performed with miniature lighting, surgical and video devices into the joint cavity with small punctures.
Reading:
- Presence of bone tumors (osteophytes) that impede joint mobility; deformity of joint tissue
- , which can be corrected without major surgical intervention;
- is the need for chondroplasty, which can significantly slow the progression of the disease and restore joint mobility.
Arthroscopy is contraindicated in acute infectious diseases, coagulation disorders, and the small range of motion of the joint — the inability to fully extend or bend the joint does not allow the surgeon to perform the necessary manipulations.
Endoprosthetics
Endoprosthesis - the replacement of a knee joint with an artificial one, which is made of a durable and hypoallergenic material, is similar in structure to natural bone tissue.
Over time, the prosthesis takes over all the functions of the "native" joint and allows it to return to normal life.
Reading:
- lack of effect after long conservative treatment;
- rapid progression of the disease; Changes in the
- joint can significantly disrupt the patient's motor activity, cause severe and frequent pain, and / or put them at risk for disability.
Absolute contraindications include only systemic diseases that make surgical manipulations impossible.
The treating physician will consider the risks and benefits of surgical treatment and make a decision based on the conclusions drawn about the need for surgery or the continuation of conservative treatment.