2 degrees of gonarthrosis of the knee joint can not only reduce the patient's motor activity, but also worsen his overall quality of life. The reason for this may be not only pain and the inability to exercise, which until recently seemed insignificant.
Comparing the changes that have occurred between the initial stage of the disease and its second stage, a person begins to understand: without proper treatment, the situation will only get worse.
Causes of the disease
Most often, the reason for the transition of the disease to stage 2 is an irresponsible attitude to treatment and failure to comply with the doctor's recommendations regarding physical activity and lifestyle changes.
In a joint already affected by the disease, blood circulation and metabolic processes are slowed down to the point that the tissues are unable to receive nutrients and oxygen without external help. When treatment is refused or postponed "for later", there is an acceleration of the destructive processes in the joint and, consequently, the transformation of the disease from their mild stage into a more severe one.
Symptoms
Stage 2 of knee gonarthrosis is characterized by the following manifestations:
- increased painful sensations: pain attacks acquire a certain regularity (after a night's sleep, a prolonged rest period, physical exertion);
- joint stiffness, usually in the morning, which disappears after a short walk;
- the knee joint increases in size, its relief is attenuated - all physiological swellings and depressions on the joint are no longer defined. In an upright position, this can manifest itself as "hanging" skin on the kneecap. In the squatting position, it becomes evident that one knee (affected by gonarthrosis) is much larger than the other, healthy and has a spherical shape;
- when moving the knee, a characteristic crunch is heard;
- the flexion and extension movements of the joint are severely limited.
People with grade 2 gonarthrosis are rarely able to avoid taking painkillers, as knee pain starts to be uncomfortable even during rest periods. This is due to spike-shaped growths on the bone tissues of the joint, which irritate and traumatize all structures of the knee.
How the doctor makes this diagnosis
In most cases, a patient complaining of worsening health conditions has already been diagnosed with gonarthrosis, and the attending physician may order an x-ray to evaluate the changes that have occurred in the joint.
If the doctor has reason to suspect that other diseases are associated with gonarthrosis, CT, MRI, and laboratory blood tests may be recommended. This is necessary to exclude infections that can penetrate the joint through the bloodstream and a complicated course of gonarthrosis, with damage to the soft tissues.
Complications of the disease
In the absence of treatment or insufficiently responsible attitude towards it, grade 2 gonarthrosis can quickly overcome the last "stage" and move on to the final stage, in which pain becomes a constant companion and the joints sufferirreversible changes and deformations.
In addition, weakened joint tissues become vulnerable to infection, and any viral or bacterial systemic disease can cause serious complications during gonarthrosis. The most common, but no less dangerous, is the infection of the joint cavity with the formation of purulent contents, which can spread to soft tissues: muscles, skin.
Treatment
In the treatment of grade 2 gonarthrosis, the goal is to relieve pain, slow or completely stop the degenerative process of the joint, prevent complications and improve knee mobility.
Medication
Medicines used in the treatment of 2nd degree gonarthrosis are divided into the following groups:
- Anti-inflammatory drugs.These include the latest generation of non-steroidal anti-inflammatory drugs (NSAIDs), which eliminate the inflammatory process in the joint and, consequently, reduce pain.
- Chondroprotector.This group of drugs helps protect cartilage tissues from further destruction and improves the regeneration processes in them.
- Preparations of hyaluronic acidwhich are analogues of the natural lubrication of the internal surface of the joint. By reducing friction in the knee joint, these drugs prevent further wear of the cartilage. In some cases, intra-articular injections of hyaluronic acid are indicated (for example, with very poor blood circulation in the joint, which prevents other forms of the drug from reaching the affected tissues).
- Help.These include vitamin preparations, immunostimulants, bioactive extracts of plants (aloe, echinacea, and so on), designed to improve blood circulation in the joint tissues and thereby accelerate metabolic processes in them.
Physiotherapy, massage, physical therapy
Such treatment methods as physiotherapy, massage and physical therapy can be considered auxiliary in the treatment of the 2nd degree of gonarthrosis of the knee and are rarely used as independent treatment methods.
Physiotherapy (UHF, phonophoresis, ultrasound therapy, magnetotherapy) is used to improve blood circulation in the joint and stimulate the recovery processes in it.
One of the most effective physiotherapeutic procedures for the treatment of osteoarthritis is MLS laser therapy with the ability to regulate the power of laser radiation. The therapy uses constant and pulsating wavelengths, due to which deep tissue penetration and a pronounced clinical effect is achieved. The MLS laser treats all diseases of the joints, osteochondrosis, hernias and other diseases of the musculoskeletal system.
It is recommended to perform the massage in cycles of 10-15 sessions, one session a day or every other day. Massage, improving the blood supply in the joint, normalizes the metabolic processes in it and provides a more effective effect of drugs on the tissues affected by the disease.
In the diagnosis of arthrosis of the knee joint of the 2nd degree, massages with the use of drugs (chondroprotectors, anti-inflammatory or irritating ointments, external refreshing and anesthetic agents) are often prescribed. factors.
The complex of physiotherapy exercises is assigned to the attending physicians after evaluating the effectiveness of drug treatment and is selected taking into account the individual characteristics of the course of the disease and the general health of the patient.
Lifestyle correction
Lifestyle correction is one of the most important conditions for effective treatment. With 2nd degree gonarthrosis, you must respect the following rules:
- Reduction of the load on the diseased joint.For this, orthopedic canes are used, which make it possible to distribute the load during movement in such a way that the knee joint is minimally involved. It is important to choose the right cane for your height - it should be wrist to floor when standing.
- Diet.For this disease, it is recommended to reduce the consumption of foods containing animal proteins (eggs, meat, fish, whole milk), carbohydrates (baked goods, confectionery) and any food and drink containing synthetic flavors, sweeteners, preservatives.
- Weight loss.Obesity is one of the risk factors that increases the likelihood of metabolic disorders in all tissues, including the tissues of the joints. Also, being overweight is unnecessary strain on your joints.
Surgical treatment
Surgical treatment can be divided into two types: arthroscopy and endoprosthesis.
Each operation has its own list of indications for which the intervention will be most effective.
Arthroscopy
Arthroscopy is a low traumatic surgical method in which the operation is performed using miniaturized lighting, surgical and video devices inserted into the joint cavity through small punctures.
Read:
- presence of bone neoplasms (osteophytes) that prevent joint mobility;
- deformity of the joint tissues, which can be corrected without large-scale surgery;
- the need for chondroplasty, which can significantly slow the progress of the disease and restore the mobility of the joint.
Contraindications to arthroscopy are acute infectious diseases, blood clotting disorders and a small range of motion in the joint - the inability to fully extend or flex the joint does not allow the surgeon to perform the necessary manipulations.
Endoprosthesis
Endoprosthesis - replacement of a knee joint with an artificial one made of resistant and hypoallergenic material, which has a structure identical to natural bone tissue.
Over time, the prosthesis assumes all the functions of the "native" joint and allows you to return to normal life.
Read:
- lack of effect after a long course of conservative treatment;
- rapid progression of the disease;
- changes in the joint significantly disrupt the patient's motor activity, cause severe and frequent pain and / or cause a risk of disability.
Among the absolute contraindications there are only any systemic diseases that make any surgical manipulation impossible.
The attending physician evaluates the risks and benefits of surgical treatment and, based on the conclusions drawn, makes a decision on the need for surgery or on continuing a course of conservative treatment.