Stages and treatment of osteoarthritis of the knee joint. What does the diagnosis of doa mean, symptoms and treatment Osteoarthritis of the knee joint, stage 3 treatment

Osteoarthritis of the hip joint is a destructive process of the joint; cartilage plastics, which are its internal covering, are susceptible to this disease. Among all joint diseases, osteoarthritis of the hip joint is the most common. This disease accounts for about 50% of all cases.

• What is osteoarthritis of the hip joint?
• Osteoarthritis at stage 1
• Osteoarthritis grade 2
• Osteoarthritis grade 3
• Deforming osteoarthritis
• Treatment of osteoarthritis

What is osteoarthritis of the hip joint?

The essence of the disease is as follows: inside the bones at the end of the joints there is cartilage, which ensures the natural mobility of the limb. It allows the bones to glide without unnecessary friction. But over time, the cartilage retains the fluid that is required to ensure normal movement less and less, and during “use” it begins to crack. The bones rub against each other, and certain growths appear on them, called osteophytes. Because of this, a person experiences pain and other signs of osteoarthritis of the hip joint.

The risk of getting this disease increases in people who have passed the age of 40 years. Moreover, women are more susceptible to osteoarthritis of the hip joint than men. This can be explained by the changes that occur in their body during menopause, when much-needed calcium for bones begins to be released due to hormonal changes. But not all the time women get sick more often than men; at a young age, it is men who suffer more from the disease.

Considering how much the disease has progressed, it can manifest itself with the following symptoms:

If left untreated, osteoarthritis can eventually lead to atrophy of the hip muscles.

Osteoarthritis at stage 1

At the first stage, diagnosis of the disease is very difficult, as a result of several factors:

• The symptoms of the disease are not clearly expressed, which makes it possible to confuse the disease with some other diseases or completely associate periodically occurring pain with other causes that are not related to any pathology.
• Patients are not in a hurry to see a doctor.

One way or another, X-ray examination already at this stage allows you to see certain changes in the joints. Small bone growths may be noticeable, but they are located in the area of ​​the bony lip. The location of the growths is along the inner and outer edges of the plane of the acetabulum. At this stage, the disease does not affect the head of the bone and neck of the femur, and visible pathologies do not appear.

The symptoms that are inherent at this stage of development of osteoarthritis of the hip joint include the following:

• Pain that occurs during increased physical activity. During rest, no symptoms of pain bother you.
• Decreased range of motion due to periodic pain.
• During sudden movements of the limb, sharp pain may appear.
• Sometimes you can hear small clicks when you move your hip.

At the same time, the person’s movements are almost unrestricted, the outline of the gait does not change, and muscle strength remains normal.

Osteoarthritis grade 2

Diagnosing grade 2 osteoarthritis is no longer so difficult. As a rule, people themselves come to the doctor with complaints of emerging pain. They appear during movements of the limb, even during easy walking. When palpating a sore limb, a person feels pain.

An X-ray image determines these conditions as: a narrowing of the joint space by approximately 50%, the synovial cartilage is deformed, which creates friction between the bones and, accordingly, pain. But most often it appears due to swelling that appears against the background of improper functioning of the joint.

Osteophytes are clearly visible in the image; they greatly aggravate the course of the disease and negatively affect the general condition of the patient who suffers from osteoarthritis of the hip joint. Often a “joint mouse” may be visible on an x-ray; this is the term doctors use to describe a fragment that comes off the bone and is located inside.

The main symptoms of stage 2 DOA are:

• A person gets tired quickly, it is difficult for him to remain in a standing position for a long time, and especially to perform any active actions.
• The surface of the joint is deformed.
• The pain is present all the time, and not just when the patient tries to make movements. In this case, it can radiate to the knee joint or to the groin area.
• Pain does not appear during, but directly at the beginning of movement of the affected limb.
• The joint is stiff, movements are significantly limited.

Although movements are slightly limited, the patient is still able to perform all self-care activities. Often at this stage the person begins to use a cane. At the very least, this makes a person’s life much easier and is a doctor’s recommendation.

Osteoarthritis grade 3

At this stage, the disease can be very easily diagnosed, but it should be noted that this is a very late time for detecting the disease. An X-ray examination shows that the gap between the joints has almost completely disappeared.

Symptoms that are characteristic of stage 3 DOA are:

Deforming osteoarthritis

This is a chronic disease that recurs slowly. Its result is persistent disturbances in the functioning of the joint. If we take all the bone diseases that are associated with degenerative-dystrophic changes in cartilage and bones, then deforming osteoarthritis is in first place. This is explained by the fact that the hip joint experiences the heaviest loads and is the largest in the human body.

The process goes like this: the hyaline cartilage is depleted, on which roughness and irregularities can be seen. Afterwards, the disease causes it to completely disappear, exposing bone tissue. When moving a limb, the bones rub against each other, since their natural shock absorber disappears between them. Over time, this leads to the joint becoming severely deformed and losing its functions.

There are 2 types of deforming osteoarthritis of the hip joint: that which appears against the background of functional load and completely affects a healthy joint (called primary osteoarthritis) and that which appears as a result of an existing disease (called secondary osteoarthritis).

Factors that influence the occurrence of this disease include:

Hidden and obvious injuries of the hip joint.

Hereditary disposition.

Arthritis.

Age over 40 years.

Overweight.

Hormonal imbalances, metabolic disorders.

Peters disease.

Whether hip dysplasia or congenital hip dislocation.

The disease destroys both one and two joints.

Treatment of osteoarthritis

Treatment requires, if not complete, then the maximum possible rest for the deformed limb. It is also necessary to treat the main symptoms of the disease: completely eliminate or alleviate pain, as well as restore freedom of movement to the patient. Hospitalization for treatment is usually not required.

Therapeutic treatment is selected individually, taking into account the stage of development of the disease, as well as the age characteristics of the person:

Chondroprotectors. Chondroprotectors can be prescribed, for example, such as Aflutop and Teraflex; these drugs will help the cartilage tissue begin to recover on its own.

Anti-inflammatory drugs. To remove painful symptoms, the patient is prescribed the use of standard analgesic drugs or non-steroidal anti-inflammatory drugs. Hormonal medications may be prescribed and injected into the affected joint. For this purpose, Dexazone or Kenalog is tried on, which significantly alleviates the person’s condition, allowing him to move freely.

Surgical intervention. As for surgical intervention, it is usually used at the third stage of development of the disease, when the joint is already permanently deformed and the patient is unable to produce normal movements. The surgical intervention is called endoprosthetics and consists of replacing the affected joint with an artificial one. After the operation, the patient can move independently and will no longer require bed rest.

Physiotherapy. Then, when the mobility of the joint is slightly restored and the pain is relieved, doctors prescribe a course of physiotherapeutic treatment. These procedures are great for relieving inflammation. For treatment, a special set of exercises may be prescribed, and electrophoresis may also be prescribed. Laser therapy and visiting a massage room show excellent results. Then, when the inflammation is relieved, many doctors advise patients to exercise in the pool. It is swimming that will help the tissues and muscles strengthen and better fix the affected joint.

Hirudotherapy. Hirudotherapy has proven itself to be excellent, but we must not forget that the effect of this procedure is not very long-lasting. Although, to facilitate the passage of the disease, many patients trust their affected limbs to leeches.

Proper nutrition. It is also imperative to combine the treatment of osteoarthritis of the hip joint with a specific diet, which is developed by the doctor on an individual basis. Its principle is that the patient should give up eating sweets, fatty foods and meat. There is no need to completely remove meat from your diet, but you should limit yourself to eating chicken and lean beef. It is necessary to eat vegetables, fruits and fish, as well as rye bread.

To reduce the load on the affected joint, especially during treatment, it is important to use a cane.

The method of stretching a deformed joint is also practiced. These manipulations are performed only in hospital conditions during inpatient treatment. The patient can move around during this therapy only with the use of crutches, so that the load on the affected area is as little as possible.

If you combine stretching with massage performed by an experienced therapist, the results can exceed all expectations. Upon completion of the course and the sick person returns home, you need to continue to carry out medical manipulations yourself. To record the effect obtained, it is necessary to engage in physical exercise, attend special classes in the pool, and also massage the affected limb.

It is necessary to understand that osteoarthritis of the hip joint is highly treatable thanks to modern medical advances. But the most important thing is to start therapy in a timely manner. If time is lost and the doctor advises an operation, then you should not refuse it. Surgical intervention shows excellent results and allows a person to live a full life without feeling discomfort in movements.

Deforming arthrosis of the knee joint grades 1, 2, 3: causes, symptoms, treatment

Deforming arthrosis of the knee joint is a very common disease that can occur in both young and old people. The fact is that the knee is considered one of the most mobile and loaded parts of the support system. Over time, the tissue wears out, and pain and stiffness appear in the affected joint. Treatment of the disease should be mandatory.

Features of the pathology

Arthrosis of the knee joint is characterized by the development of degenerative and dystrophic processes within it. The cartilage tissue is gradually destroyed. Untimely treatment leads to joint deformation and inability to move normally. In addition, due to the destruction of cartilage, the body turns on the immune response and begins to grow bone tissue - osteophytes. This further limits the functionality of the knee.

This disease is constantly progressing. Its treatment is necessary in order to stop further deformation of the joint. If the therapy was incorrect or untimely, then arthrosis will deform the knee joint, after which it will no longer be possible to change anything.

Causes of pathology

So, deforming arthrosis of the knee can be provoked by completely different factors, but the risk group includes people with a hereditary predisposition to diseases of the supporting apparatus, and with excessive body weight. Too much weight aggravates the condition of the joints. Moreover, deforming arthrosis of the knee can be unilateral or bilateral.

The following reasons can provoke knee joint disease:

• Meniscus injuries, knee fractures, dislocations, damage to ligaments or other components of the joint. They contribute to the development of gonarthrosis in young people. The victim feels severe pain and cannot move his leg. If you do not begin to treat the injured joint immediately, the risk of developing early arthrosis increases several times.
• Removal of the meniscus due to surgery.

• Too much stress on the knee joint. It is better to avoid intense training in old age. This can provoke the appearance of microtraumas, which at first do not make themselves felt.
• Weakness of the ligamentous and muscular apparatus.
• Other diseases of the knee joint.
• Obesity. In this case, heavy weight increases pressure on the knee and contributes to the development of the disease, and also deforms the bones.

• Disturbance of metabolic processes in tissues. In this case, they do not learn the necessary elements for normal functioning well enough. The cartilage gradually begins to deteriorate, and the knee begins to deform.
• Frequent stress and nervous tension.
• Circulatory disorders.

These reasons cause defarthrosis even in youth. Naturally, treatment of all these pathological conditions will help to significantly slow down the development of the disease.

General symptoms and signs of the disease

The following symptoms are typical for deforming arthrosis of the knee joint:

1. Pain extending to the lower leg.
2. The discomfort becomes stronger when climbing stairs or after prolonged standing (walking).
3. Stiffness in the affected knee.
4. Swelling of the joint.

1. When bending the knee, a crunching sound is heard in it.
2. Morning stiffness of the joint lasts until the person moves away.
3. The patient cannot fully bend or straighten the leg, as he feels severe pain.
4. If the patient has an early stage of knee arthrosis, the pain syndrome disappears after a short rest and at rest.

It should be noted that each stage of the disease has its own symptoms. For example, the nature of the pain can be different:

• Morning pain goes away within 30-40 minutes.
• The inflammatory process provokes pain during certain movements.
• Unpleasant sensations that disturb sleep appear due to neuropathy or muscle spasm.
• Sudden severe pain due to pinching of the joint by muscles.

Each degree of knee joint disease is characterized by an intensification of the main manifestations.

Deforming arthrosis of the knee joint 1st degree: features of manifestation

Defarthrosis in this case is practically not noticed by the patient, since the symptoms and signs are practically not felt. Mild pain in the knee may only appear with intense movement. That is, the patient cannot yet suspect that he is developing arthrosis.

Even slight stiffness in the joint is not alarming. There is virtually no inflammation or acute onset of the disease. This stage is characterized by the accumulation of a small amount of synovial fluid, so the appearance of a Becker cyst is possible. However, most patients, even in this case, do not see a doctor.

Despite the fact that the cartilage is already undergoing pathological changes, they are not so serious as to deform the knee joint. At this stage of the disease, even X-ray examination does not always show any destruction. Therefore, additional instrumental diagnostic methods will be required.

Treatment of this stage of the disease is carried out not only with the help of anti-inflammatory drugs, but also with therapeutic exercises. Motor activity must be maintained so that the joint produces synovial fluid that nourishes cartilage and other tissues.

Associate Professor of the Department of Neurology and Manual Therapy of KSMA Olga Sergeevna Kochergina shares her knowledge about the disease:

Deforming arthrosis of the knee joint, grade 2

The second stage of arthrosis of the knee joint is characterized by increased pain, which sometimes impairs the ability to work, although the person can care for himself. This degree of gonarthrosis already forces a person to see a doctor.

More details

The emerging symptoms disrupt the patient’s normal life, as the pain becomes almost constant and occurs with any even slight movement. It only calms down when at rest. It is especially difficult for the patient to take his first steps after waking up in the morning. Since at this stage of the disease the osteophytes grow quite strongly, this increases the discomfort. Sometimes the pain appears even at night, disrupting sleep. The man begins to limp.

The knee bends and straightens with difficulty, and swelling appears in the affected area. The muscles of the joint go into spasm. The second degree of gonarthrosis is characterized by the development of an inflammatory process. The limitation in mobility becomes very noticeable. The patient practically cannot walk without additional orthopedic devices.

Treatment of deforming arthrosis in this case is carried out using various methods: drug therapy, therapeutic massage and physical education, physiotherapeutic procedures. Complex cases require surgical intervention. Further development of the disease is fraught with disability.

Deforming gonarthrosis of the third degree: features of manifestation

The pain in the knee joint becomes constant and does not disappear even at rest. Moreover, the unpleasant sensations intensify even with a sudden change in weather. Characteristic of this degree is gait disturbance. The lameness becomes very noticeable.

Swelling of the knee joint lasts quite a long time and is significantly expressed. The deformation of the joint becomes noticeable. It takes on an X- or O-shape. The mobility of the leg is very limited, to the point that it does not bend or extend at all. Even small movements are accompanied by an unpleasant crunching sound in the knee.

In this case, the cartilage is destroyed very much. The x-ray shows a strong narrowing of the interarticular space. Inflammation is caused by a large accumulation of fluid inside the knee. This degree of the disease is distinguished by the fact that all symptoms intensify several times. Often, drug treatment is no longer effective; surgery is required to replace the knee joint with an artificial prosthesis.

Arthrosis cannot be completely cured. The degenerative process deforms the joint so much that the person may already become disabled.

In order for the doctor to prescribe effective treatment, the patient must be examined. It uses not only radiography, but also MRI, ultrasound, and arthroscopy of the knee joint, which can also serve as a treatment.

Leading researcher at the Institute of Rheumatology of the Russian Academy of Medical Sciences, Elena Sergeevna Tsvetkova, will share useful information with you about treatment and prevention:

Features of treatment of the disease

Despite the fact that arthrosis cannot be completely cured, it should not be left to chance. You should try to slow down the development of the disease, eliminate the symptoms and restore the functionality of the joint.

Medication therapy involves the use of the following means:

• Non-hormonal anti-inflammatory drugs: Ibuprofen, Indomethacin. They help eliminate pain and inflammation. Typically, NSAIDs are used before massage or exercise therapy is applied. But these medications are not able to treat arthrosis itself. They only relieve symptoms.
• Chondroprotectors: “Teraflex”, “Dona”. These medications are the basis of treatment, as they restore damaged cartilage and improve its nutrition. Naturally, they cannot completely cure the disease, but they are quite capable of improving the patient’s quality of life. Without chondroprotectors, treatment of knee arthrosis will be ineffective. There are practically no other ways to restore cartilage.

• Injectable corticosteroids that are injected directly into the joint: Hydrocortisone, Diprospan. They allow you to eliminate pain as quickly as possible, and for a long time. However, injections can only be given a few times a year.
• Drugs for dilating blood vessels that will prevent the formation of varicose nodes: “Xanatinol”, “Trental”. They make it possible to restore blood circulation in the joint.
• Hyaluronic acid injection once a year. It is effective only in the first and second stages of arthrosis development.
• Local painkillers.

Diet is considered part of complex treatment. It does not involve fasting or strict food restrictions. However, the diet should promote weight loss if necessary. That is, meals should be frequent and fractional. It is best to follow a diet that involves eating half of the foods raw. Naturally, you should give up alcohol and tobacco.

Physiotherapeutic treatment

The use of medications is only part of the therapy. It is complemented by physiotherapeutic procedures, therapeutic exercises, massage and even folk remedies. As for exercise therapy, most exercises are performed in a lying or sitting position so that the load on the knee joint is minimal.

The most popular exercises are:

1. You should lie on your back, on the floor. The affected limb needs to be straightened and raised 20 cm above the floor. You should hold your leg in this position for as long as possible. This will make it possible to reduce symptoms and strengthen muscles.
2. While sitting on a chair, the right or left limb needs to be extended forward. Next, the foot moves up and down.

1. You should sit on a high pedestal and dangle your legs slightly. This exercise must be performed often and at a moderate pace.
2. While lying down, you need to bend your knees and pull them towards your stomach.

Each exercise is repeated at least 5 times. Moreover, gymnastics for gonarthrosis must be done very carefully so that it does not cause discomfort.

Laser therapy is a useful physiotherapeutic procedure. It is often more effective than medications. The laser perfectly relieves the inflammatory process. Oxygen therapy has excellent reviews.

In the most difficult cases, surgical intervention is used. Knee arthrosis should be treated in this way only in extreme cases. The operation involves removal of osteophytes, as well as complete replacement of the joint.

It will be effective to use shock wave therapy (SWT) when treating stages 2-3. How this process takes place at the medical center, watch the video:

Treatment of arthrosis Read more >>

Traditional treatment of pathology

Defarthrosis can also be treated with folk remedies. For example, the following recipes are considered useful:

• Compress made from horseradish root and blue clay. It should be applied to the right or left joint. Within a few hours the pain will go away.
• Dandelion tincture. It is used for rubbing, taken in the evening. This remedy perfectly relieves swelling.

• Celandine juice. It is used for compresses. Simply saturate the fabric with this liquid and apply it to the affected joint. Polyethylene is applied over the fabric. The procedure is repeated every day for at least a week. After this, you need to take a break for the same amount of time. The course of therapy must be repeated at least three times.
• Massage with honey. To begin with, the joints need to be steamed using a heating pad. Next, you need to apply honey to it and lightly rub it into the skin for 20 minutes. After completing the massage, apply a cabbage leaf to your knee and wrap it. A two-week course of such treatment will help the patient improve his condition.

An important step in the treatment of deforming knee arthrosis is sanatorium treatment. Here the patient will undergo a course of therapeutic aerobics and mineral baths. In addition, the treatment recommends the use of orthopedic devices that relieve the load on the damaged joint: canes, orthoses.

In any case, deforming arthrosis requires complex treatment. This will improve the patient's quality of life.

You can learn about the basics of exercise therapy for illness from this video:

Today, osteoarthritis of the hands is one of the most common diseases, which can lead to complete deformation of the joints and possible disability.

Due to metabolic disorders in the bones, cartilage, joint capsules and ligaments, deformation of the hand occurs. Cartilage tissue loses its elasticity, elasticity, becomes unable to retain the required amount of moisture and eventually collapses.

Deforming osteoarthritis is a common type of joint disease, which is the main cause of disability in older people. It can occur due to mechanical overload and age-related changes in cartilage tissue.

Osteoarthritis of the hands is a chronic disease. The resulting lesion in the cartilage of the joint is a long-term inflammatory process, at the very beginning of which no visible symptoms are detected. The next stage is the formation of nodules in the interphalangeal joints. They are painful, the hands gradually swell. If you do not see a doctor in time, various complications may occur. Osteoarthritis of the hand joints most often affects women, according to statistical data.

The main reasons why the disease appears are as follows:

1. Age.
2. Physical fatigue.
3. Completeness.
4. Heredity.
5. Failed operations.
6. Injuries.

Osteoarthritis of the small interphalangeal joints does not appear immediately. At the beginning, the patient feels increased fatigue in the hands, then pain begins to appear periodically, increasing each time. The growths prevent easy movement of the hands; a crunching sound is heard when bending. Then the pain becomes unbearable and the muscles lose their function.

This disease most often affects people over 40 years of age. You should pay attention to the condition of your hands. Swelling, puffiness, nodules are the first symptoms of the disease. A tingling sensation may be felt and the arms become asymmetrical.

The simplest actions with your hands cause a certain difficulty: it is difficult to move your fingers, hold a glass of tea, and more. People become disabled and lose their jobs if their profession involves precise hand movements.

The disease occurs in three stages, each of which has its own distinctive signs:

1. With grade 1 osteoarthritis, mild joint pain is most often observed in the evening or after certain strength loads. The phalanges of the fingers thicken a little, this can be seen with the naked eye.
2. In grade 2, pain in the joints gradually intensifies, movement becomes difficult, and they increase in size.
3. Joints at stage 3 are very swollen, deformed, constant pain occurs, difficulty moving, and growths form.

As soon as the first signs of the disease appear, it is recommended to consult a specialist. To identify the emerging pathology, the following diagnostic measures are carried out:

1. Blood tests are taken.
2. The level of synovial fluid is determined.
3. X-ray examination.
4. Arthroscopy.

A qualified specialist will tell you how to properly treat the disease and what medications should be taken. The best remedies in the fight against osteoarthritis of the hands are Diclofenac and Analgin. They will have an analgesic effect and relieve inflammation. But these drugs have their own specific contraindications and side effects. Therefore, in order not to harm your health, you should consult your doctor. Along with these drugs, you can take Phosphalugel or Venter.

They will prevent the occurrence of stomach and intestinal ulcers. In addition, anti-inflammatory drugs are prescribed. In the initial stages, it is recommended to use ointments, for example, Colchicine.

Before taking medications, you must make sure that they are compatible with each other. Proper treatment will help restore cartilage tissue, medications will relieve pain and return the patient to a full life. In some cases, doctors may prescribe additional therapy with bee venom. The course lasts 14 days.

Deforming osteoarthritis can be cured with the help of gymnastics, anti-inflammatory drugs, and glucocorticoid hormones.

If the disease is at the first stage, then you can get by with creams and ointments. In later stages, surgical intervention is possible. When treating osteoarthritis of the hand, doctors strongly recommend following a diet, since some foods can aggravate inflammatory processes in the joint. Diet for osteoarthritis:

1. You will have to completely eliminate flour products, too bitter and salty foods from your diet.
2. Eat more vegetables, dairy products, and you can make low-fat chicken broth.
3. To make your bones stronger, you need to take foods high in calcium.
4. Take vitamins.
5. If you want something sweet, you can make low-calorie jelly.
6. Try to drink as much water as possible.
7. You will have to give up various sauces (ketchup, mayonnaise).

Traditional methods of treatment

The disease can also be cured using folk remedies. The best effect will be if the treatment is carried out in the initial stages. Traditional methods will help relieve pain and restore cartilage:

1. Buy pharmacy white clay and dry it. Then take warm oil and add a few tablespoons of clay to it, constantly stirring the mixture. It should be a thick paste. Rub it on problem areas. Try not to press on the areas to avoid causing pain and damaging the cartilage further.
2. Grate the green potato tubers to a paste. Warm to room temperature. Apply this mixture to sore joints at night. It will help relieve pain and reduce inflammation.
3. Take young cabbage and divide it. Lubricate large leaves with natural honey and apply to sore spots. Be sure to do an allergy test, as honey can cause inflammation.
4. Buy essential oils, white clay and medicinal herbs at the pharmacy. Mix all the ingredients and rub the resulting ointment into the joints.
5. Take white chalk without adding dyes. Crush it to a powder and add to milk. After rubbing the mixture into the sore joint, leave it overnight.

Therapy with folk remedies can only be auxiliary and serve as an addition to the main methods of treating the disease.

It is necessary to try to reduce heavy loads on the interphalangeal joints. You should do hand exercises daily, for example, clench and unclench your fists, rub your fingers with massaging movements. This way the interphalangeal joints will be less susceptible to disease. Proper and rational nutrition will allow the body to retain beneficial micro- and macroelements necessary for cartilage and bones. Timely detection of the disease in the early stages helps to begin treatment on time and prevent its further development.

Osteoarthritis of the knee joint grade 3 is treated conservatively or surgically. In the first case, the patient is prescribed medications, drug blockades, and, in the second, they are performed.

Diagnosis by X-ray.

The presence of grade III deforming arthrosis of at least one large joint is a direct indication for surgical intervention. During the operation, doctors remove the destroyed joint and replace it with an artificial prosthesis.

The effectiveness of different methods of physiotherapy (Agency data, 2012):

• exercises to increase muscle strength. When performed correctly, they strengthen the leg muscles, relieve pain and improve joint mobility;
• myoneurostimulation. Ineffective in the fight against grade 3 osteoarthritis of the knee joint. Relieves pain for a short period. Soon after the end of the course of treatment, the pain intensifies;
• water gymnastics. Temporarily improves the general well-being of patients and removes some physical restrictions;
• wearing orthopedic devices, magnetic therapy, diathermy. As it turned out, these methods are ineffective in the treatment of arthrosis.

Physiotherapy methods are not able to restore damaged cartilage and bones. They only relieve unpleasant symptoms and make life a little easier for patients. It is impossible to cure arthrosis with their help (even with conscientious and regular completion of all prescribed procedures).

Why medications won't help

Drug groups	Representatives	Disadvantages of use for severe gonarthrosis
Symptomatic quick-acting remedies	, local anesthetics	They temporarily stop and, which is why in the later stages of osteoarthritis they need to be used almost constantly. They have only a symptomatic effect, but do not treat arthrosis itself. With prolonged use, they disrupt metabolic processes in articular cartilage, accelerating their destruction
Delayed action modifying agents		act slowly. To achieve a noticeable effect, you need to spend a lot of time and money on treatment. Ineffective in the treatment of grade 3 osteoarthritis of the knee joint. It is impossible to restore the structure of cartilage that is no longer there
Means for intra-articular administration	Hyaluronic acid	Hyaluronic acid injections are expensive. Not everyone can afford 2-3 injections a year. The introduction of medication into the synovial cavity is accompanied by tissue trauma and is associated with certain risks.

In addition to the negative effect on cartilage, they have a lot of other side effects. Regular use of these medications can be detrimental to your health. Therefore, if you have chronic pain syndrome, do not delay surgery. Know: after endoprosthetics, you can be completely off medications.

Innovative treatment methods

Scientists in America and European countries are developing innovative methods for effective. The main direction of their activity is the creation of cell-engineered structures that can... Some drugs are already used in clinical practice (BioSeed-C, Cartigel, Chondrolon, DeNovo-NT), but they are only effective.

The idea of ​​creating artificial cartilage that could be surgically implanted looks quite promising. Most likely, they could completely replace destroyed cartilage tissue. However, to “grow” such cartilage, mechanical stimulation is needed. Scientists have not yet been able to create the necessary conditions for this.

In the CIS countries, the listed treatment methods are not yet used. To create cell-engineered structures, we need special conditions that we do not have.

What you need to know about endoprosthetics

Today, surgery is the most effective method of treating grade 3 osteoarthritis of the knee joint. With its help, you can completely get rid of chronic pain and restore normal knee mobility. A properly installed modern implant can last at least 15-20 years.

The success of endoprosthetics depends on the surgeon's skill and quality. The implant must suit the patient according to a number of criteria. Negligent attitude of doctors towards the selection and installation of a prosthesis can lead to unpleasant consequences. Poor quality or its complete absence can also cause harm.

Degenerative-dystrophic changes in the cartilage of the knee joint are a disease called gonarthrosis. Advanced pathology threatens loss of ability to work. Only a doctor knows how to treat grade 3 gonarthrosis of the knee joint, so we strongly recommend that you consult him.

What is grade 3 gonarthrosis?

Many of our readers do not know what grade 3 gonarthrosis is, and are often scared when they hear the diagnosis. The disease is characterized by progressive changes and an inflammatory process. As a result of the appearance of cracks in the cartilage tissue, persistent pain develops.

Even at rest, pain bothers a person. In severe cases, dangerous and varus and valgus curvature of the legs may develop. The patient will no longer be able to move independently; crutches or a wheelchair are often required.

The disease is more often diagnosed in older women, but men are not immune from gonarthrosis.

Symptoms

It will not be possible to ignore the signs of the disorder, because grade 3 is characterized by constant debilitating pain inside the knee. The first symptoms include the following:

• severe pain does not go away on its own;
• local increase in temperature in the area of ​​the damaged knee;
• as a result of the accumulation of synovial fluid, severe swelling appears in the affected area;
• impaired joint mobility or complete blocking of the joint;
• appearance of lameness;
• deformation of joint tissues;
• crunching and clicking sounds when walking;
• deposition of salts around the sore joint.

Most often, gonarthrosis affects both knees, but it happens that the symptoms of the disease appear in only one joint.

Causes of the disease

The disease is divided into two main forms - primary and secondary. The primary type is observed in older people and most often affects both knee joints. The reasons for the development of this form have not been established, but experts associate it with age-related changes and general wear and tear of the body.

The causes of the secondary form have been established, including:

1. Age. In the elderly, all recovery processes proceed slowly. Cartilage tissue, exposed to adverse factors, does not regenerate and is destroyed.
2. Excessive physical activity. The cause of pathology is any type of activity associated with excessive stress.
3. High body weight. Excess weight puts more stress on the knee, thereby causing the development of the disease.
4. Injuries, operations. Surgery, minor injuries and damage to the knee can cause pathology.
5. Hereditary predisposition, congenital pathologies.

Disease prevention

To avoid the development of arthrosis, experts recommend starting the prevention of pathologies of the musculoskeletal system as early as possible. This is especially true for patients with a hereditary factor and degree 2. Preventive measures include:

• feasible (gentle) loads on the legs;
• refusal to lift heavy objects;
• knee protection during strength training;
• eating foods with sufficient amounts of vitamins and minerals;
• taking medications that nourish cartilage tissue;
• fight against excess weight;
• chronic disease control;
• regular examination of hormonal levels in case of thyroid dysfunction;
• visiting a rheumatologist and orthopedist for children who are actively involved in sports.

Following these simple rules will help stop or avoid the development of a serious illness.

Diagnostics

A rheumatologist will not have any problems making a diagnosis, since the symptoms, as a rule, are pronounced. To finally confirm the diagnosis, the doctor prescribes a series of examinations.

Instrumental

Instrumental diagnostic methods include:

1. X-ray examination. Examination of the affected joint by this method is the main one in diagnosing the disease. The third degree of gonarthrosis is characterized by narrowing of the joint space, bone damage, cartilage sclerosis, and salt deposition. All these symptoms are clearly visible in the picture.
2. Ultrasound (ultrasound examination). This method gives good results. But it is considered less informative than an x-ray examination.
3. MRI and CT (magnetic resonance and computed tomography). Modern methods with which you can study all joint parts and identify the disease at the initial stages of its development. The disadvantage of the methods is the high cost of the examination, but the advantage is high accuracy.

Laboratory (tests)

For osteoarthritis, the blood count is examined. No specific changes are observed. In rare cases, a blood test reveals a slight increase in ESR or ROE (erythrocyte sedimentation rate) up to 20 mm. Such indicators indicate the presence of an inflammatory process in the body. If the number of leukocytes is still increased, this may indicate an infectious nature of the inflammation. Changes in the blood formula do not give clear answers, but only signal problems in the body.

A biochemical blood test, on the contrary, can help a doctor diagnose degenerative changes in joints. Thus, with joint diseases, the level of inflammatory markers in the blood increases, including:

• C-reactive protein;
• immunoglobulins;
• globulins.

But there are cases when these indicators do not change.

Traditional treatment

Osteoarthritis of the knee joint grade 3 is a severe form of the disease and is a complex pathology. Surgical treatment, i.e. surgery, is the main method of treating osteoarthritis. This type of treatment is intended to completely relieve the patient of all the consequences of deforming osteoarthritis of the knee joint. However, other treatments are also used to relieve pain or stop the progression of joint destruction.

To select treatment methods, you should consult your doctor. The effectiveness of stage 3 treatment largely depends on the experience of the specialist.

Medication

In the case of stage 3 gonarthrosis of the knee joint, the conservative method of treatment is ineffective. At this stage of the disease, the cartilage is almost completely destroyed and taking chondroprotectors does not produce results.

The use of non-steroidal anti-inflammatory drugs does not bring relief, the pain syndrome does not disappear. Instead, the doctor prescribes mild opioids and combination analgesics.

When fluid accumulates in the joint cavity, injections of hormonal drugs are indicated. But it is difficult to deliver the drug into the cavity using an injection, since the boundaries of the cartilaginous layer are violated. Therefore, the medicine is injected into the periarticular tissues. For the same reason, intra-articular injections of hyaluronic acid are rarely prescribed, which can help a little. It is impossible to eliminate and cure grade 3 gonarthrosis without surgery.

Surgical

Surgery is the only way to relieve pain and reduce the risk of disability. During the operation, the damaged joint is completely or partially replaced with a prosthesis. The endoprosthesis replacement procedure is highly complex and requires precision and accuracy. Therefore, it must be performed by an experienced surgeon.

Endoprostheses are made individually and only from high quality materials that take root well and can withstand several decades of use.

If the operation is performed well and the postoperative period passes without complications, the patient will quickly return to a normal rhythm of life.

Therapeutic gymnastics exercise therapy

Therapeutic physical education is an important component on the path to recovery. will help restore mobility, strengthen muscles, normalize blood flow, thereby improving the nutrition of cartilage. Even minimal physical activity on the affected areas is considered beneficial.

Only a specialist should select a complex of exercise therapy for weakened joints.

Therapy and procedures

Physiotherapy procedures help enhance the effectiveness of the main treatment. The patient is often prescribed the following procedures:

• electrophoresis;
• ultrasound therapy;
• mud wrap;
• magnetic therapy;
• paraffin applications;
• therapeutic baths (hydrogen sulfide, carbon dioxide).

Nutrition

It will be possible to slow down the development of degenerative-dystrophic changes in cartilage with the help of a therapeutic diet. Nutrition for grade 3 gonarthrosis of the knee joint should consist mainly of the following products:

• low-fat kefir, cottage cheese, cheese;
• chicken, turkey meat;
• sprouted grains;
• salmon fish;
• jelly, jellied meat;
• buckwheat;
• medicinal table water without gases.

• sweet carbonated and alcoholic drinks;
• coffee, strong tea;
• fried and smoked dishes;
• flour products;
• chocolate, spicy seasonings;
• semi-finished products, canned food.

All dishes should be steamed or baked. The more strictly the patient follows the diet, the lower the risk of disease progression.

Traditional treatment

For the treatment of gonarthrosis often. But we should not forget that traditional medicine is used only as a supplement to the main treatment. Also, before using any folk remedy, you should consult your doctor.

Rubs and baths

To relieve pain, it is recommended to take medicinal baths with the addition of fresh pine branches, sea salt and Jerusalem artichoke tubers. All elements are simply placed in a bath of hot water. You need to take this procedure for 20–30 minutes. If there are no fresh pine branches, they can be replaced with pine essential oil.

Soda-salt baths will also be useful. The affected joints are immersed in water with soda and salt (3 tablespoons each) for a few minutes, massaging them.

Shilajit-based ointment is an effective remedy for relieving swelling and pain. To prepare, you will need to thoroughly mix 100 g of honey and 5 g of mumiyo. The ointment is rubbed into the sore joint, being careful not to press too hard. It is allowed to use the product in the form of a compress.

Infusions and decoctions

Effective recipes for infusions and decoctions:

1. Infusion of elecampane. It is easy to prepare a remedy. Elecampane root (50 g) is placed in a glass container and poured with 125 ml of vodka. The composition is placed in a dark place and infused for 14 days. The finished tincture is filtered and rubbed into the affected tissue.
2. Dandelion infusion. Fill ½ of a dark glass container with dandelion flowers. Fill with vodka, close and put away to infuse for 1 month. The resulting infusion is rubbed on sore knees every evening.
3. Tincture of cinquefoil. Another remedy for the treatment of gonarthrosis of the knee joint. The crushed stems and roots of the plant (50 g) are poured with 500 ml of vodka. Infuse the composition in a dark place for a month. Use in the same way as all tinctures, rubbing into the sore knee.

Compresses

Therapeutic compresses based on natural ingredients are an indispensable part of any therapy. Popular recipes:

1. Honey and cabbage. The sore knee is covered with honey, and a fresh cabbage leaf is placed on top. The compress is fixed with a bandage or scarf. It is advisable to leave this compress overnight.
2. Clay. Blue or red clay is diluted in water until it becomes thick sour cream. The composition is applied to the knee in a thick layer. The clay can be kept for up to 2 hours.
3. Horseradish. The plant is ground on a grater. The resulting slurry is poured with water and placed on low heat to steam. The softened mixture is spread on a cloth moistened with a plant solution. Apply to the affected part. This compress copes well with pain and swelling.

We should not forget that the use of any folk remedies can cause allergic reactions. It is advisable that this treatment is also selected by a specialist.

Our feet suffer from a variety of diseases. Many of them strike a person at the most unpredictable moment. Thus, osteoarthritis of the knee joint (also called gonarthrosis) may appear suddenly, and at first the symptoms will not be very pronounced. You should definitely pay attention to the slightest manifestations of such an illness in order to quickly cure the disease and recover.

This chronic disease affects the cartilage of the knee joint. In this case, the mobility of the leg is noticeably impaired. And if the form is advanced, it can even lead to complete immobilization of the joint. Therefore, it is necessary to fight the disease seriously and in every possible way.

Causes

The true causes of osteoarthritis still remain a mystery. Experts suggest that the disease occurs as a result of certain external and internal factors.

Despite the fact that osteoarthritis of the knee joint appears due to unknown specific reasons, there are risk groups. This:

1. patients who have poor heredity. Thus, a disease such as generalized osteoarthritis can be transmitted through the maternal line;
2. Adults over 30 years of age are often susceptible to this disease. The fact is that by this age the joints become more sensitive to serious physical stress. And after damage has occurred once, the recovery period will last a very long time. Women more often need treatment for osteoarthritis of the knee joint. This is associated with the development of menopause.
3. Patients with large body weight are also at risk. After all, excess weight is an inevitable injury to the hip and knee joints.
4. Athletes most often suffer from osteoarthritis of the knee joint. Treatment for this disease usually awaits hockey players, football players and other players where the legs play a major role.
5. Finally, patients with leg injuries are susceptible to developing osteoarthritis. More than 40% of cases of the disease are the result of various injuries.

Symptoms

If you know the symptoms of the disease and begin to treat it at the very first stages of its development, you can get rid of it promptly and quickly. An important point here is the ability to “listen” to your body. In this case, you need to carefully pay attention to all the smallest changes.

Characteristic symptoms that are inherent in knee osteoarthritis:

Symptoms such as crunching in the knee area must be correctly differentiated. And healthy joints can “crunch.” The reason for this behavior may be either excessive human activity or weak ligaments. The so-called “soft crunch” does not threaten anything serious for a person, it does not cause pain.

You should definitely pay attention to all other symptoms of the disease. And at the slightest suspicion you should immediately go to a specialist.

After all, osteoarthritis of the knee joint of the first degree (initial) can lead to a worsening of the situation. It will develop into a problem of 2, and then 3 degrees.

Types of disease

Today there are 2 main types of knee osteoarthritis:

1. Primary, which appears due to poor heredity or develops with age-related changes in the body. Such a disease occurs “on its own”;
2. Secondary, which appeared due to harmful effects on the joint.

Depending on the complexity and severity of the disease, there are several degrees of it:

There is grade 1 osteoarthritis of the knee joint.

This is the initial stage of development of the problem. The articular cartilage begins to thin and loses its elasticity. This occurs due to the appearance of small cracks. For the patient, stage 1 is the easiest option, which does not cause any particular inconvenience or problems. However, over time, it can develop into a more severe disease, which will require long and difficult treatment.

Symptoms of the 1st degree of the disease are minor pain in the knees. Moreover, people often attribute these sensations to fatigue. If additional crunching occurs when walking and heavy physical activity, then seeing a doctor is already a necessity. The specialist will prescribe the correct and effective treatment. Usually, at the initial stage of the development of the problem, it comes down to losing body weight, eliminating pain with the help of medications, as well as massage and therapeutic exercises.

As the situation worsens, grade 2 knee osteoarthritis develops.

Here the symptoms appear more clearly. The pain occurs not only in the morning, but also during the day, intensifying in the evening. Even when at rest, pain is felt in the leg. Walking becomes slow. If swelling and deformation of the joint occurs, there is cause for concern. It is possible that an infectious reaction is developing in the knee.

To treat this stage of the disease, vasodilator drugs are necessarily prescribed. A course of physiotherapy will be required. The doctor will advise you to keep your leg at rest, walk less, and if you need to move, it is better to rely on a cane or use crutches. Exercise therapy classes will also be required. All exercises will be aimed at strengthening the leg muscles.

At this stage there is still an opportunity to return a full life to the patient. The leg can become healthy again if you follow all the doctor’s recommendations. Otherwise, the disease will continue to develop and the person may become disabled.

Grade 3 knee osteoarthritis is a borderline condition with disability.

At this stage, the symptoms are especially pronounced. Unbearable pain appears, the crunch can be heard even to the people around you, and your legs become noticeably bent. It is simply not possible to bend or straighten the affected limb. Salt deposition in the knee joint reaches its maximum. They “replace” cartilage.

Due to the worsening of the problem, the doctor prescribes not only medications and physical therapy, but also surgery. The operation is aimed at removing all elements that have been subjected to deformation, and growths are also removed. If necessary, it is even possible to replace the entire knee joint.

Medical therapy

To make a diagnosis of osteoarthritis, the doctor must take a medical history. Laboratory tests will be required. If necessary, radiography is performed. And if the diagnosis is confirmed, the doctor prescribes complex treatment with a variety of means aimed at returning the joints to their functions:

Use of chondroprotectors

It is mandatory to prescribe medications that improve metabolic processes directly in the cartilage tissue. It is often necessary to take such medications for a long time, even for several years.

The effect of such medications can be seen within a few months. These medications are available either as tablets or as injections.

Anti-inflammatory therapy

The doctor also prescribes anti-inflammatory drugs. With their help you can relieve pain and reduce swelling. Modern medications of this type do not even cause side effects and can be tolerated by patients with gastrointestinal problems.

Anti-inflammatory drugs can not only be in the form of tablets or capsules. Often these are creams and gels, which, together with physiotherapy procedures, can significantly reduce the amount of medications taken orally.

If there is also fluid in the joint, corticosteroids will be required. They are available in the form of injections. They will have to be done once a year, more often it is impossible.

Non-drug therapy

In addition to medications, special restorative and health procedures are mandatory:

1. Exercise therapy will help strengthen your muscles. Usually all exercises are performed in a lying position. They must be prescribed only if there are no contraindications to them. Gymnastics takes place only under the supervision of a physiotherapist.
2. Manual therapy will restore the function of the joints, muscles and bones of the knee joint.
3. Massage is another procedure on the path to recovery from osteoarthritis of the knee joint. With its help, you can improve blood flow to the sore spot. This therapy is carried out when the disease is not in an acute stage.

Folk remedies

Such a problem with the knee joint can be cured using folk remedies that have been tested for centuries. They are especially effective for stage 1 disease. At subsequent stages, it is only an auxiliary agent in the complex of main therapy. You can resort to the use of decoctions, baths, ointments and rubs, which have an anti-inflammatory effect and saturate the entire body with vitamins.

The following easy-to-prepare remedies are considered folk recipes:

1. Boil onion peels in a liter of water until they become soft. You need to drink half a glass 30 minutes before meals.
2. You can steam dandelion leaves for exactly 10 minutes. This decoction should also be consumed half an hour before meals.
3. It is possible to apply compresses to the sore knee. To do this, fresh horseradish is grated, which is then filled with warm water. This mixture is brought to a boil. The resulting composition is applied to gauze and then applied to the sore spot.
4. There is an ointment, it is prepared according to an old recipe from 200 g of mustard and the same amount of salt. A small amount of paraffin is added there until the consistency becomes creamy. The ointment is applied at night and rubbed in until it is completely absorbed into the knee joint.

Herbal teas, which should be drunk constantly, are also effective folk remedies. A decoction of rose hips and gooseberries has an excellent effect on the body.

Diet

You will have to change your diet if you have this disease. Here are some important tips:

• The diet should exclude “invisible” fats. They are found in sausages and confectionery products.
• The meat should be lean and not fried.
• Such a healthy diet should contain dairy products. It is advisable that they be low-fat.
• You need to consume a maximum of vegetables, cereals, fruits and a variety of berries.
• Finally, the diet involves giving up sugar.

Only an effective combination of all treatment methods will help patients cope with the problem of knee osteoarthritis. But at the same time, you should always consult with your doctor and not try different remedies on your own.

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Provoking factors

Reasons that provoke the development of osteoarthritis of the knee:

Symptoms of the disease

Naturally, the diagnosis must be made by the attending physician, but in order to seek help from him, you need to know the main symptoms that indicate the development of deforming osteoarthritis of the knee joint.

This will help you seek medical help in time and not miss the moment in order to start treatment in a timely manner to preserve and maintain normal joints and their cartilage tissue.

So, the following signs may indicate the development of osteoarthritis:

• pain in the knee joints cannot suddenly occur, so initially discomfort and unpleasant sensations will be felt in the problem area;
• then painful sensations may appear, which are accompanied by stiffness in the joint and limited movement;
• if treatment is ignored and in the absence of seeking qualified medical help, the joint is completely immobilized;
• muscle atrophy is observed;
• there is a rough crunch in the knee joint;
• there is a feeling of wobbly legs;
• valgus (X-shaped) or varus (O-shaped) joint deformity occurs in 50% of cases.

But that’s not all, since advanced osteoarthritis of the knee joint grades 2 and 3 may be accompanied by some other symptoms:

• pinched meniscus: thus, any movement is accompanied by severe pain and attempts to bend and straighten the knee become impossible;
• sudden internal bleeding in the joint(hemarthrosis);
• inflammatory processes of the synovial membrane: characterized by a local increase in temperature, swelling, the appearance of fluid and enlargement of the joint;
• osteonecrosis of the femur(possibly separation of the bone segment).

Stages of development and their symptoms

Each stage of arthrosis is accompanied by characteristic symptoms. Thus, in medicine there are three degrees of development of osteoarthritis of the knee joint.

The first stage is characterized by the following symptoms:

• Leg fatigue occurs quickly;
• when the load increases, pain occurs;
• due to pain, range of motion decreases;
• After exercise, discomfort occurs in the knee.

In the photographs of the 1st stage of the development of the disease, one can observe a narrowing of the articular cavity (so far insignificant).

The second stage is characterized by the following manifestations:

• discomfort is constantly felt, even if the person is at rest, including after rest in the morning;
• gait becomes slow due to constant pain, stiffness of movement, subsequent deformation of the joint, which leads to inflammatory processes and the appearance of edema.

The photographs of the second stage will show a significant narrowing of the articular cavity, bone growths, and bone thickening. It is at this stage that patients often seek medical help.

Stage 3 of the disease is the most severe and cannot be treated. A patient with grade 3 osteoarthritis of the knee joint receives disability. The situation can be corrected at this stage only by implanting an artificial joint.

Establishing diagnosis

As a rule, a person, having discovered symptoms of destruction of the knee joint, goes to see not a specialist - an orthopedist, but a surgeon or therapist. But even these specialists will prescribe the necessary minimum of research, the results of which will require an appointment with an orthopedist:

After these mandatory studies, the orthopedist can add a few more points to confirm or clarify the diagnosis:

1. Ultrasound: allows you to assess the condition of soft tissues. The only negative: only a specialist with extensive experience in this field and this research can really assess the condition of the tissues, since practice in this case plays a key role.
2. MRI: the study is more expensive than ultrasound, but it allows you to accurately assess the condition of the menisci, capsule, cartilage, and ligaments on multiple sections.

Complex of therapeutic measures

Treatment of osteoarthritis of the knee joint (if its cause is precisely known) is aimed, first of all, at getting rid of the provoking factor.

If the disease develops as a result of metabolic failure, it is necessary to use a diet and normalize nutrition. If the cause of the disease is excess weight, it needs to be lost. It is necessary to treat a disease that has arisen due to hard work only after changing the workplace to a more gentle one.

Drug treatment of osteoarthritis of the knee joint occurs through the use of several groups of drugs:

• analgesics(painful joints);
• chondroprotectors(substances that enter the body nourish and restore cartilage tissue);
• drugs that improve blood circulation;
• anti-inflammatory drugs(hormonal or non-steroidal).

To achieve an effect, drug therapy should be supported by some other methods:

• lower leg and thigh massage courses (2-3 times a year);
• physical therapy aimed at preventing contractures;
• when exercising, use a knee brace and orthopedic shoes;
• physiotherapy (UHF, ultrasound, laser, amplipulse);
• acupuncture;
• surgery.

ethnoscience

At home, treatment of osteoarthritis can be supported and strengthened with the help of folk remedies and methods.

Decoctions for oral administration:

• tea with ginger will help relieve inflammation and eliminate pain;
• before eating, you must take a decoction of willow bark, birch, nettle, calendula in equal parts;
• Half a glass on an empty stomach, take a decoction of onion peels and dandelion leaves;
• Rosehip infusion will help relieve pain.

Compresses:

A bath with sea salt and turpentine has proven itself well in the treatment of arthrosis of the knee joint. This composition helps to get rid of pain and inflammatory processes, while restoring motor function to the diseased joint.

Complications and prevention

An advanced disease is fraught not only with increased pain, which simply will not allow you to perform everyday activities and lead a normal lifestyle, but can also ultimately lead to disability (complete immobilization of the knee joint).

In order to reduce the likelihood of developing osteoarthritis, you need to monitor your weight and lifestyle. Do not carry heavy objects and overload your legs.

It is important to perform simple physical exercises that are not aimed at the knee joint - this will strengthen the body and its resistance to various diseases. This prevention should be supported by folk methods in the form of decoctions, ointments and baths, which will reinforce the effect.

osteocure.ru

Symptoms

Signs of the development of gonarthrosis vary depending on the degree of development of the disease. In the initial stages, the symptoms are not clearly expressed, and seeking help is rare.

More often, the disease is diagnosed already at the third stage of deforming gonarthrosis. In such a condition, the patient experiences:

• Constant and excruciating pain, especially intensified when going up and down stairs, in the morning.
• The patient and others hear a constant loud crunching sound in the patient’s knee joint.
• The deformation of parts of the joints is visually visible, the range of motion becomes minimal.
• Joint enlargement occurs due to the constant accumulation of fluid in the interarticular capsule.
• Varus curvature of the legs becomes noticeable, the limbs take an O or X-shape.
• When diagnosing with x-rays, destruction of ligaments and menisci is noticed, and cartilage is noticeably abraded. Cartilage fusion is already observed. Treatment becomes more complicated.

The development of grade 3 osteoarthritis in most cases means immediate disability. In advanced cases, only implantation can save. If surgery is not performed in time, it is possible:

• Complete fusion – ankylosis;
• The appearance of an irregular pseudarthrosis is neoarthrosis.

When the described consequences develop, movements become impossible, and the person does not have long to live in a wheelchair.

Osteoarthritis of the knee joint is complicated by sanovitis. The phenomenon is characterized by flattening of the knee joint and protrusion of tissue from the side. The phenomenon does not affect body temperature or blood tests during diagnosis. The signs are exclusively external.

General provisions for treatment

Knee gonarthrosis is quite easy to treat at the onset of the disease; with stages 3 or 4 of deforming gonarthrosis, the situation is much more complicated. It is difficult to completely restore the joint; there are degrees of deformation.

When drawing up a scheme according to which treatment of third-degree gonarthrosis is carried out, first of all the necessary measures are taken to relieve pain. Then doctors work on stopping the inflammatory process and restoring mobility. If the medicinal measures taken do not produce results, in the third degree, in the fourth, surgical intervention will be required.

At the first stage, the patient is prescribed anti-inflammatory drugs that relieve pain and make movement possible. After the inflammation and pain are relieved, the doctor prescribes procedures to restore joint mobility. Eg:

• Physiotherapeutic procedures;
• Massotherapy;
• Gymnastics.

To restore cartilage tissue, doctors will prescribe chondroprotectors that act on the affected joint and restore it. Thanks to the intake, the production of joint fluid is stimulated, which helps the restoration processes of cartilage tissue. In advanced forms of the disease, the third and fourth stages, taking protective drugs turns out to be completely useless; there is simply nothing to restore after the destruction that has occurred. Any treatment should last for three months. Drugs, especially anti-inflammatory drugs, cause sensitive harm to the stomach, causing the development of gastritis or ulcers.

In the treatment of deforming knee osteoarthritis, it is effective to use injections of hyaluronic acid, which at the third stage no longer provides a therapeutic effect and is used only to reduce symptoms and alleviate the condition.

The maximum result can be achieved in the treatment of third degree osteoarthritis using the traction method, which is combined with physiotherapy. The method involves physical separation of the joints, which increases the size of the joint space and reduces the load on the joint. Thanks to parallel physiotherapy procedures, improved blood circulation and tissue condition are achieved. Pain syndrome is relieved when a spasm occurs.

To relieve stress on the joints, when treating the disease, the patient is recommended to regularly use a cane, which reduces it by up to 40%. It is important to choose the right cane according to your height; it is better if the model has a rubber non-slip tip.

Surgery

If treatment of knee joint gonarthrosis fails with conservative methods, the doctor refers the patient to surgery. The choice of type of surgical intervention depends on the type of lesion and the goals achieved. Signs of damage are important.

Performed:

1. Puncture. This type of operation involves removing excess fluid in the interarticular space with further administration of hormonal drugs.
2. Transcondylar osteotomy of the tibia. With this option, the axis of deformation of the joint is restored.
3. Arthrodesis. The operation is rarely performed when fused bone surfaces are observed.
4. Arthrolysis. During the operation, the fused synovial membranes and walls are removed. Thanks to this surgical intervention, a greater range of motion of the affected knee joint is achieved.
5. Arthroplasty. Reduction of the cartilage layer in the joint. Thanks to the procedure, a flattened surface of the knee joint is formed. Manipulation is used extremely rarely, the joint becomes unstable.
6. Endoprosthetics. As a result of the procedure, the damaged joint is replaced with an implant. In advanced stages of the disease, this is the only way to restore partial mobility of the joint.

When performing the last operation, it is important to follow the recommendations of the rehabilitation period. To obtain the maximum effect, in the first days it is necessary to make gradual movements under the strict supervision of medical personnel. If the patient's condition after the operation is satisfactory, it is indicated to get up on the second day.

To develop the joint, the patient is gradually introduced to special exercises that will help to recover faster. If there are no complications, the rehabilitation period reaches six months. You will need to constantly be in touch with your doctor and report changes occurring in the knee joint. Sometimes unusual knee pain or sensations are caused by poor circulation, nerve or vascular damage.

Treatment is most effective if done on time and in the early stages.

Consequences of the disease

If you start the process of the disease up to stage 3, then stage 4, the cartilage tissue will be completely erased. The bone becomes exposed and becomes severely deformed. Arthrosis, which progresses to stage 4 of development, leads to complete immobilization of the knee joint.

Neglected treatment in the third stage provokes the disease to flow into the fourth stage and makes a person disabled who is no longer able to fully move the knee joint. If, when going to the hospital, grade 3 arthrosis is diagnosed, doctors talk about a negligent and inattentive attitude to health. Treatment at an early stage is easy and quick.

otnogi.ru

Characteristics of the disease

What is gonarthrosis? A pathological condition in which discomfort, crunching when bending the knee and an inflammatory process is felt is known as deforming osteoarthritis of the knee joint. In this case, cracks in the cartilage tissue appear, and the patient feels pain. Elderly women are more susceptible to this disease, but men are not immune from grade 3 gonarthrosis of the knee joint. Osteoarthritis of the knee joint treatment involves complex treatment.

The disease is divided into two main types. The primary form usually occurs in old age and affects two knees at once. The exact reasons for the development of the primary form of the disease are unknown, and are usually associated by doctors with general wear and tear of the body. The secondary form of the disease, which can develop into grade 3 arthrosis of the knee joint, has established causes.

• Knee injury resulting in damage to the joint tissue.
• Genetic or hereditary predisposition.
• An inflammatory process or disease affecting the synovial fluid.
• Heavy stress on the knees in everyday life. The load may be associated with professional activities, sports, or the patient's excess weight.

Stages of the disease

For the development of grade 3 knee arthrosis, a preliminary aggravation of this form of vascular damage in the early stages is required. When gonarthrosis appears, a gradual delamination of cartilage tissue begins due to disruption and imbalance in biochemical and metabolic processes. As the disease progresses, the cartilage tissue undergoes delamination. So that the doctor can know how to treat gonarthrosis, the activity of the disease should be determined. According to various classification data in medicine, there are three or four degrees of arthrosis.

1. The initial stage of the disease is characterized by pain in the joint, which a person feels after heavy loads on the knees. Periodically, swelling on the leg may appear and go away without any treatment. The disease does not interfere with living a normal life and the person may not see a doctor, but treatment is already necessary at this stage.
2. The second stage has pronounced characteristic signs of arthrosis. Pain and crunching in joints cause significant discomfort to a person. A crunching sensation is present while walking. Gonarthrosis cannot be ignored; it is necessary to seek medical help.
3. At stage 3, left- or right-sided gonarthrosis causes severe pain even without physical activity. X-rays are used to see how deformed the knee is. Osteoarthritis of the knee joint grade 3 must be treated to prevent the possible progression of the disease to the final stage.
4. The fourth stage of the disease is characterized by complete destruction of the cartilage inside the knee. At this stage, the prognosis for the patient is disappointing. Traditional therapy will no longer help restore motor abilities; surgical intervention is possible. After the transition of arthrosis of the 3rd degree of the knee joint to the 4th degree, lameness, deformation of the legs and subsequent disability appear.

Drug effects

To eliminate the inflammation characteristic of arthrosis, special anti-inflammatory drugs are used: Ibuprofen, Nurofen, Diklak, etc. Long-term use of these tablets for the treatment of grade 3 gonarthrosis can cause gastrointestinal disorders and also negatively affect the functioning of internal organs.

When grade 3 DOA is complicated by inflammation of the synovial membrane and accumulation of fluid inside the joint, the treatment process is supplemented by taking glucocorticosteroids: Hydrocortisone, Kenalog, etc. To prevent joint destruction, antienzyme agents are used: Ovomin, Gordox, etc.

To treat grade 3 arthrosis of the knee joint, chondroprotective drugs are widely used. These products contain complex chemicals that are part of cartilage tissue. Treatment without surgery is possible with the help of these drugs, as they stimulate the restoration of the damaged area. The most effective remedies for stage 3 DOA of the knee joint are Rumalon, Artra, etc.

External impact on the knee

To understand how to cure arthrosis of the knee joint, you should strictly follow the doctor’s instructions. We also must not forget that with the development of degenerative lesions of cartilage tissue, local agents (ointments and gels) are widely used. Stage 3 DOA of the knee joint responds well to drugs that activate metabolic processes and stimulate blood circulation at the site of gel application. For grade 3 arthrosis of the knee joint, treatment is selected in a comprehensive manner to ensure maximum effect.

Local effects on the knee can be supplemented with natural home remedies. It should be remembered that any drug or alternative medicine cannot be used without prior consultation with a qualified specialist. For grade 3 gonarthrosis of the knee joint, treatment may include Finalgon, Fastum gel, Menovasin, Voltaren gel, Dolobene and other drugs.

Additional Impact

In addition to providing a direct effect on the joint tissue, relieving the inflammatory process, to treat the third degree of the disease, means are used to improve blood circulation, namely vasodilators.

Actovegin or Trental help the movement of blood inside the blood vessels that are located near the affected area of ​​the body.

Products are also used to strengthen vascular tissue (Ascorutin or Upsavit).

Grade 3 deforming arthrosis of the knee joint can cause stiffness of movement, which is especially noticeable in the morning. So that a person can live a normal life at this stage of the disease, the doctor may prescribe special drugs, muscle relaxants. These remedies allow you to relieve tension and painful syndrome (No-spa, Baclofen, etc.).

One of the recognized and effective methods of treating stage 3 DOA of the knee joint is the introduction of a hyaluronic acid-based product into the affected joint. For this purpose, the drugs Hyalual, Fermatron and others are used. A distinctive feature of the treatment procedure is its safety, the absence of an allergic reaction or rejection by the body. Before stopping the symptoms of gonarthrosis, the inflammatory process should be eliminated.

Surgery

Grade 3 gonarthrosis almost completely destroys the joint tissue, and surgery may be indicated. Symptoms and treatment of degenerative joint changes are directly related. The more severe the symptoms, the greater the damage inside the knee. This disease can also affect the hip joint. Coxarthrosis of the 3rd degree is accompanied by tissue necrosis and surgical intervention cannot be avoided. There are several methods for treating arthrosis.

• Endoprosthetics. This type of operation is recognized as one of the most effective and common methods of treating arthrosis. What it is? The method involves replacing the affected area with a special prosthesis. As a result, activity and mobility of the knee are maintained. After the operation, the patient undergoes a rehabilitation course.
• Periarticular osteotomy allows you to eliminate all signs of arthrosis by filing the articular surface and securing them at a different angle. As a result of changing the load point on the cartilage tissue, the destruction process slows down. The therapeutic effect lasts from 3 to 5 years.
• Arthroscopic debridement involves the removal of deformed areas of cartilage. This type of surgery produces positive effects that last less than 3 years.
• Arthrodesis is the most radical method of surgical treatment of gonarthrosis. During the operation, the affected tissue is removed along with the joint.

Lifestyle

Despite the fact that gonarthrosis is a serious disease that should be treated by professional doctors, the patient himself can alleviate and improve the condition. Physical therapy and physiotherapy have a beneficial effect on joints. Specially designed gymnastics exercises can strengthen the muscles around the affected area, eliminate venous congestion and stimulate intracellular biological processes. You can do exercise therapy in a doctor’s office, in a special group of patients, or at home on your own after consultation with a specialist.

The rate at which joint disease develops is also very important.

A balanced diet helps stop the destructive inflammatory process and strengthen cartilage tissue.

The patient must enrich his diet with dishes containing gelatin, salmon fish, low-fat fermented milk products, hard cheese, eggs, etc. Animal fats, alcoholic beverages, smoked meats, canned foods, sweets and fast food are excluded from daily consumption.

Traditional medicine

The disease known today as gonarthrosis appeared a long time ago, even before medicine achieved the ability to effectively relieve unpleasant symptoms with pills and injections. For treatment, folk natural remedies were used, which are available to every person. Many time-tested recipes and even doctors confirm their effectiveness.

• Compress made of honey and cabbage. For preparation, only natural flower honey and fresh, juicy cabbage leaves are used. A knee affected by arthrosis should be covered with honey and covered with a large leaf of cabbage. To secure the compress, bandage your knee or tie a scarf. It is usually recommended to leave this compress overnight. The cabbage leaf in the recipe can be replaced with a burdock leaf.
• Tincture for rubbing. It is very simple to prepare an infusion that helps relieve pain. To do this, you should buy elecampane root (50 grams) at any pharmacy, pour it into a clean, dry glass container and pour in 125 ml of vodka. The mixture is infused in a dark place for 2 weeks. After the specified time, the tincture is filtered and used to rub the knee damaged by arthrosis.
• Therapeutic baths. To relieve pain caused by arthrosis of the knees, pine baths are used. To prepare such a bath, you need to collect fresh pine branches, add a few Jerusalem artichoke tubers and sea salt. All ingredients should simply be placed in a bath of hot water. You should take a bath for no more than 20 minutes, and fresh pine branches can be replaced with essential oil, which is sold in pharmacies.

It should be remembered that when using non-traditional methods of treating gonarthrosis, the main treatment should not be neglected. Natural remedies can only be used as an additional treatment for damaged knees. Also, before using any of the alternative methods of treatment, you should consult with your doctor.

Is it possible to cure arthrosis of the knee joint? This question is asked by almost every patient after diagnosis. Grade 3 knee joint gonarthrosis is curable if we use a modern approach and a full range of medical advances. It is important to follow your doctor's instructions and take care of your own health.

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Features of the disease

Deforming osteoarthritis, which develops in the knee joints, has a separate name in medicine - gonarthrosis. The knees experience perhaps the greatest load, and therefore damage to cartilage tissue is common, especially in people over 40 years of age and athletes.

The mechanism of development of the disease is as follows. Under the influence of certain factors, the load on the articular joint increases, which leads to damage to the hyaline cartilage.

With constant negative impact, degenerative-dystrophic processes progress. As a result, the work of the joint becomes more difficult, and the person experiences unpleasant sensations. As cartilage thins, bone tissue suffers. Due to constant friction and pressure, the joint becomes deformed and specific growths – exostoses – are formed.

Symptoms of gonarthrosis

Deforming osteoarthritis is accompanied by severe pain, which over time develops into the inability to make simple movements of the leg and, accordingly, to move. Lack of sliding and overgrowth of the articulation elements with bone tissue leads to immobilization of the knee. In other words, as a result of the development of the disease, a person becomes disabled due to the inability to move independently.

Characteristic symptoms of gonarthrosis are:

• crunch in the knee;
• pain when moving, increasing as the disease progresses;
• decreased mobility of the affected leg;
• formation of bone spines;
• swelling in the knee area;
• tissue hyperemia;
• lameness;
• amyotrophy;
• curvature of the joint.

Pain can bother a person not only while walking, but also at rest. In particular, this problem is observed at night against the background of stagnant processes in the joint cavity.

Unfortunately, the prevalence of this pathology is quite high. Every fifth person suffers from knee problems to one degree or another. In recent decades, there has been a “rejuvenation” of this disease due to the sedentary lifestyle of modern youth.

Types of pathology

There are two main forms of gonarthrosis: primary and secondary. The primary type of the disease develops gradually, due to prolonged exposure to heavy loads on the knees, which leads to thinning of the cartilage. Age-related changes that occur throughout the body also have an effect, including a slowdown in metabolic processes in tissues.

Secondary deforming osteoarthritis of the knee is a consequence of exposure to external factors. In other words, damage to the knee joints in the future may result in a similar pathology. In addition, other diseases, such as diabetes, synovitis or gout, also play a role.

Causes

In general, many reasons can provoke deforming osteoarthritis.

The main factors predisposing to the disease are:

• any traumatic injury to the knee;
• unbalanced diet;
• obesity;
• alcohol consumption;
• joint surgery, meniscus removal;
• low physical activity;
• improper performance of sports exercises;
• transmission of diseases of the musculoskeletal system;
• the presence of other diseases, in particular endocrine ones;
• birth defects;
• estrogen deficiency in women;
• age-related changes.

People with a hereditary tendency to problems with the musculoskeletal system increase the risk of developing gonarthrosis.

Degrees of development

It is necessary to distinguish between three degrees of development of DOA. Many people do not even suspect that the existing discomfort in the knee is due to the presence of the first stage of this disease.

Take a closer look at the features of each stage:

• Deforming osteoarthritis of the 1st degree of the knee joint. If there is no movement for a long time, pain is observed inside the knee. The discomfort disappears during the day, but returns with heavy load.
• Deforming osteoarthritis of the 2nd degree of the knee joint. An increase in pain is observed, crunching and clicking appears when moving, the cartilage noticeably thins, and osteophytes begin to form. Unpleasant sensations occur on palpation.
• DOA 3 degrees. Dystrophic processes in cartilage tissue reach their climax, the bone is exposed, which leads to its growth and blocking the motor ability of the leg. The pain is very severe and does not stop without medication.

Diagnostic procedure

To identify the nature of the course of the disease, the doctor is obliged to conduct a comprehensive examination.

The following diagnostic measures are used:

• general and biochemical blood test;
• radiography;
• Ultrasound;
• arthroscopy;
• CT/MRI;
• biopsy of cartilage and synovium.

It is also important to find out in detail the patient’s complaints and the extent to which symptoms of gonarthrosis have appeared recently.

Treatment methods

To combat DOA, it is necessary to use the full range of available measures. An integrated approach to the problem will avoid complications and speed up the patient’s recovery. All methods can be divided into general health, conservative therapy and radical measures. Let's look at these categories in more detail.

Conservative approach

In the absence of critical damage to cartilage and bone tissue, conservative methods are successfully used for treatment. To eliminate the symptoms of the disease, relieve inflammation and protect cartilage tissue from destruction, the following drugs are used:

You should definitely read what the instructions say so as not to worsen your health.

Various procedures are also actively used in conservative treatment:

• electrophoresis;
• magnetic therapy;
• darsonvalization;
• ozone therapy;
• massage;
• hydrotherapy;
• mud therapy;
• exposure to dry heat, etc.

ethnoscience

In addition to the main treatment, with the approval of a doctor, you can use traditional medicine. Since the price of some pharmaceutical drugs is quite high, certain medications can be replaced with homemade medications.

It is worth paying attention to the following means:

• Blue clay. Steam the blue clay and apply a thick layer to the knee, cover with a bandage and plastic. You need to keep the compress for at least 6 hours.
• Beef hoof broth. Boil the shanks and hooves for several hours (they contain collagen), drain the broth and drink it in small portions daily.
• Jerusalem artichoke infusion. Chop the Jerusalem artichoke and pour boiling water over it. Let the product brew and cool slightly. Make baths for a sore joint.

Nutrition and gymnastics

It is extremely important to establish metabolic processes in the body and supply the tissues with the necessary nutrients. To do this, you need to start eating right. Thus, all junk food, alcohol, sweet soda, processed foods, sweets, etc. are excluded from the diet. Preference is given to lean meat, fish, jellied meat and aspic, vegetables and fruits, and dairy products. As for desserts, it is useful to drink jelly, eat jellies, fruit and milk mousses, and puddings.

Exercise therapy is used to develop joints. Daily exercise helps restore knee mobility, stimulates the production of joint lubrication and the restoration of cartilage. You can perform various exercises: walking, leg flexion-extension, cycling, etc. Avoid excessive strain and sudden movements.

Surgery

For advanced osteoarthritis, in addition to the methods described above, more radical ones are also used. The best way to restore the mobility of the knee and improve the patient’s quality of life is to undergo endoprosthetics.

The essence of the operation is to install special prostheses made of medical metal alloys, ceramics and polymer materials in place of the damaged elements of the knee joint. You can see what the endoprosthesis looks like in the photo.

The service life of such an endoprosthesis is 10-20 years, which is quite enough for most patients. After completion of the operational period, repeated endoprosthesis replacement is required.

The pathology of the knee joints with degenerative-dystrophic phenomena of the cartilaginous periosteal layer is called osteoarthritis. Pain syndrome manifests itself during movement of the knee joints in any projection, morning stiffness plus loss of motor ability. The listed symptoms depend on the depth of the lesion, but it is better to arm yourself with knowledge about grade 1 osteoarthritis of the knee joint - treatment and symptoms, and to prevent the pathology from becoming chronic, which predicts disability with irreversible processes.

Despite the polyetiological origin, the mechanism of development of osteoarthritis is exactly the same. The basis of the pathology is a disruption of the process of regeneration and reproduction of chondrocytes. Cartilage tissue has a low level of metabolism, is not endowed with blood vessels, is quite hydrophilic, strong and elastic. Chondrocyte cells and intercellular substance (fibers, amorphous substance, interstitial water) make up the structure of the periosteal cartilage of all joints.

In a healthy person, the cartilaginous covering of bones is smooth, elastic; in a patient, this covering is faded, with areas of abrasion and osteophytes. In osteoarthritis of the 1st degree of severity, osteophytes are not observed; they appear in the second degree of the disease.

A lack of nutrients leads to a stop in the reproduction process of chondrocytes. The layer of cartilage narrows, bare zones appear, which are covered with bone spines. The synovial bursa atrophies, at the same time the lubricating fluid decreases, the articular bones are left practically without shock absorption. The unhindered movement of bones relative to each other is aggravated; at the slightest movement, unbearable pain appears in the knee joints, and motor function is impaired. Stiffness in the joints appears due to the nightly accumulation inside the joints of remnants of cartilage fibers, pieces of osteophytes, which float freely in the synovial fluid, and during sleep settle on the damaged surfaces of the bones.

Constant physical activity accelerates the process of ankylosis of the knee joints. Over time, due to abrasion of the cartilage, its normal shape and function are disrupted. All articular components (bones, muscles, ligaments, bursae) are deformed. Bone spines appear on the edge of the knee bones. Ligaments and muscles are undergoing fibrinous degeneration. The joint structure of the knees becomes vulnerable to sprains, tears, ruptures, and fractures. Dislocations and subluxations are a common occurrence in osteoarthritis. Patients do not feel confident in their legs, they are afraid to walk due to instability of the joint (the bones move to the sides).

Important! Osteoarthritis develops more quickly in limbs that are exposed to high and frequent vertical loads. In the first degree of the pathological process, morphological changes can appear in only one knee joint; later, osteoarthritis affects the second limb. Therefore, there is no need to wait for bilateral damage to the knees, and at the first symptoms of gonarthrosis, be examined at the clinic at your place of residence.

Causes

The disease develops gradually; over the years, the chronic inflammatory process leads to the destruction of cartilage, pathological changes in the synovial capsules, ligaments and muscle corset. The main trigger for these reactions is improper metabolism, hormonal imbalance or autoimmune diseases, as well as constant physical activity or mechanical injury.

The pathology of the knees of the inflammatory-destructive type or osteoarthritis of the lower extremities is polyetiological in origin. But there is a triad of causes leading to the disease. It is this that puts the destructive mechanism into operation and limits the movement of the knee joint. The first degree of osteoarthritis is also caused by this triad of reasons. But the symptoms are erased, only a slight pain with variable manifestations and its exact manifestation in a certain period of time (in the morning) can indicate joint pathology.

A triad of causative factors leading to the development of knee osteoarthritis:

• Infection + inflammation + swelling.
• Injuries (mechanical, chemical, physical).
• Degenerative + dystrophic reactions.

The inflammatory-destructive process of the knee joints or joint (osteoarthritis) affects the majority of the population; this is associated with the rhythm of life, high physical activity and the structure of the musculoskeletal system. As a percentage, this figure is equal to 69-70% of incidents of pathologies of skeletal biomotility. In second place after osteoarthritis of the knee is rheumatism. Autoimmune reactions of rheumatoid arthritis spread to larger joints after the pathology becomes chronic and the disease is aggravated by other chronic pathologies such as diabetes mellitus, toxic goiter, blood diseases, hepatitis B-C, as well as metastases in the bones with cancer in other organs.

Pathologies that cause destruction of the knee joint:

1. Genetic abnormalities in the development of musculoskeletal segments.
2. Pathological changes at the cellular level of cartilage and collagen.
3. Strokes (hemorrhagic, ischemic, combined).
4. Neurodysfunction of the central nervous system, peripheral system.
5. Obesity.
6. Dysfunction of the reproductive system.
7. Pathologies of the endocrine system with manifestations of thyrotoxicosis, hypothyroidism, diabetes mellitus, acromegaly, dysfunction of the adrenal glands.
8. Infectious and inflammatory processes in the kidneys, liver, gastrointestinal tract.
9. Autoimmune systemic diseases (rheumatoid arthritis, diffuse autoimmune toxic goiter, systemic lupus erythematosus, psoriasis, allergic dermatitis, hepatitis, cirrhosis).
10. Bronchial asthma.
11. Diseases of the blood and lymph.

With laboratory plus instrumental research such as computed tomography, it is possible to identify the main cause and begin timely treatment of grade 1 osteoarthritis under the supervision of specialists, as well as treat the concomitant disease, preventing further development.

Attention! To avoid the appearance of pathologies of the motor system, it is recommended to be promptly examined by an arthrologist, traumatologist, endocrinologist, as well as a rheumatologist, gynecologist (or andrologist), whose consultation will help in stopping osteoarthritis at the 1st stage of its development, as well as in getting rid of a wheelchair.

Symptoms and signs

The clinical manifestation of osteoarthritis depends on the severity, the depth of the lesion, chronic diseases, as well as the immune system and the body’s reactivity in response to inflammation. Symptoms of osteoarthritis correspond to the stages:

• Osteoarthritis of the knee joint 1st degree: There are no morphological manifestations, that is, the cartilaginous periosteal layer is normal, but slightly narrowed at the edges of the articular covering, the synovial bursa is not changed, it corresponds to the anatomical dimensions. The only thing that can be relied on to suspect the onset of pathology is a reduced amount of lubricant. Synovial fluid is involved not only in cushioning the knee joint, but also in metabolism, feeding the joint with the necessary amount of amino acids, micro and macroelements of inorganic origin, as well as the necessary material for the renewal of cartilage and bone tissue with calcium and phosphorus. The first symptom at this stage is joint fatigue after a long walk, sometimes tingling and pain during movement.
• The remaining three degrees of severity of osteoarthritis are completely tied to the mechanism of destruction and inflammation. As the distal zones of the bones are exposed from cartilage, the area of ​​formation of bone spines increases. Destruction of the knee joint, with the formation of osteophytes, begins at the edges and then spreads over the entire area of ​​the bones. The cartilaginous layer narrows until it is completely abraded, and sharp spines grow in its place. Appears sharp pain in the morning, which gradually subsides, but does not completely disappear with grades 2 and 3 of osteoarthritis.

The next symptom is joint inflammation(swelling of muscles, ligaments, redness of the epithelium over the area of ​​inflammation, local temperature). The synovial bursa thickens in size and completely loses its main activity of producing synovial fluid. The amount that it produces leaks into the interstitial space of the joint, so it occurs swelling and limitation of movements in all projections.

Further, as metabolism is disrupted by the destroyed innervation and blood supply system, atrophy of the muscles and ligamentous system occurs. Dystrophy of the muscular corset and leaching of calcium from the bones leads to complete changes in the anatomical shape of the joint: it becomes thick, immobile and painful. Ankylosis appears at the last stage of complications of osteoarthritis.

Advice! If a specific click occurs during squatting, it is recommended to consult an arthrologist; this symptom is characteristic of the onset of grade 1 osteoarthritis.

Exacerbation of the pathology occurs after increased physical activity. Remissions, if the pathology develops against the background of trauma, and the patient is young, can last a long time, until the body ages without exacerbations. In the case when the patient is elderly, remissions often alternate with exacerbations. Contractures muscles and ligaments cause acute pain, except for the knee joints in elderly patients, all other joints crunch, right up to the vertebrae. Often present muscle cramps , appears lameness or complete paralysis of motor function. Support for movement is a cane or crutches. In the last stage, the patient is bedridden.

Diagnostic measures

Accurate determination of pathology at early or subsequent stages of development will be helped by diagnostics using ultra-modern equipment.

List of diagnostic measures:

Diagnostic methods	Purpose of the survey
X-ray of knee joints in three projections	At stage 1 of osteoarthritis, there are no changes on the x-ray, except for a slight narrowing of the intra-articular space. The following stages are characterized by a thin layer of cartilage covering or its absence. In the photographs of patients with complications of 2-4 degrees, specific anatomical disturbances of parameters and ankylosis of the joints are visible.
Ultrasound	Shows the degree of depth of damage to muscles, ligaments and the condition of the synovial bursa.
Magnetic resonance imaging	The condition of soft tissues, ligaments + functionality of the synovial bursa is assessed.
CT scan	The cross-section shows changes in the articulation of the knees and the muscular-ligamentous corset, as well as disruption of the innervation and blood supply systems.
Arthroscopy	The most effective method for identifying the source of infection. This method is used for further surgical treatment.

Consultation with a rheumatologist, nephrologist and endocrinologist will help in identifying systematic pathologies and timely elimination of the causes of osteoarthritis, and will also help in choosing an effective type of treatment.

Advice! A solid formation at the back of the articulatio genus is a clear sign of a cyst or tumor formation. In this case, contact your oncologist immediately.

Treatment and patient management tactics

Before starting treatment therapy, the exact cause of the pathology is determined. Having identified the source, they proceed to eliminate it and stabilize the general condition. The therapy consists of a complex of drug treatment, physiotherapy (for medical reasons), exercise therapy, massage, plus time-tested folk remedies.

Medication

The therapeutic tactics of articulatio genus osteoarthritis are based on medications. The choice of medications is made after laboratory and instrumental results.

List of medications:

• Anesthetics or analgesics.
• Anti-inflammatory.
• Antihistamines.
• Broad-spectrum antibiotics.
• B vitamins to improve the functioning of the nerves of the knee joint.
• Antispasmodics.
• Mirelaxants.
• Chondroprotectors.
• Hepatoprotectors.
• Antacids.
• Preparations based on calcium, magnesium and vitamin D.
• Droppers (saline solutions, detoxifiers, amino acids).

From the entire list, for the treatment of grade 1 osteoarthritis of the knee, anti-inflammatory, analgesic, B vitamins, calcium and chondroprotectors are recommended. The remaining points from the treatment regimen are prescribed for osteoarthritis of 2-3-4 degrees of pathological complication.

Surgical treatment

Arthroscopy is the most effective treatment for osteoarthritis of the knees. Using a special probe, the joint is examined, necrotic masses are removed, and then treatment is performed. When the articular surfaces are destroyed, endoprosthetics is performed with the implantation of artificial or cadaveric material. The first degree of joint destruction does not require surgery; drug treatment for this stage is quite sufficient.

Folk remedies

The effectiveness of folk remedies will occur only after using them in parallel with medications. They will improve blood supply, innervation, and metabolic processes in inflamed knees.

Well-known and strong remedies based on herbs and excipients:

• Baths + compresses of celandine, honey, mint, burdock. Take tsp. each component, pour 200-500 ml of boiling water. Baths or compresses are made.
• Oak bark: crushed bark in the amount of 200 g is poured with 500 ml of vodka, infused for a month, then compresses (lasting 20 minutes) or rubbing are performed 2 times a day.
• Vinegar compresses: use apple or wine vinegar as a basis.
• Propolis-honey compresses: propolis 50 g, honey 2 tbsp. l., diluted medical alcohol 200 ml. Leave for 5 days. Recommended for rubbing sore knees.

Before using each of these recipes, you should check for allergies, and it would be better to consult with your doctor.

Exercise therapy, massage and manual therapy

A daily set of exercises from the arsenal of exercise therapy with active and passive movements of the knees will bring sore joints back to normal. Massage of the lower extremities with the addition of anti-inflammatory drugs on a gel or ointment basis, plus analgesic components, will restore lost mobility of the knees over a full course (1-1.5 months). A chiropractor will use acupuncture and pressure on certain points in the body to bring joints affected by osteoarthritis to ideal condition. All of these types are widely used for the rehabilitation of the operated knee.

Prognosis and possible complications

The results of treatment for grade 1 osteoarthritis of the knee joint are only positive. In a month you can forget about pain and fatigue. But there are disappointing forecasts when factors such as rheumatism, allergies, oncopathologies and diabetes mellitus are involved in the pathology mechanism. In these situations, the disease slowly progresses, leading the movement organs to such complications as suppuration of the joint, rigidity of muscles and ligaments, ankylosis and disability.