Grade 2 gonarthrosis of the knee joint can not only reduce the motor activity of the patient, but also worsen his quality of life in general. The reason for this may be not only the pain and inability to exercise, which until recently seemed insignificant.
Comparing the changes that have occurred between the initial stage of the disease and the second stage, the person begins to realize: without proper treatment the situation will only get worse.
Causes of the disease
The most common reason for the transition of the disease to stage 2 is an irresponsible attitude towards treatment and non-compliance 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 such an extent that tissues cannot receive nutrients and oxygen without outside help. In the case of refusal of treatment or delay "for later", there is an acceleration of destructive processes in the joint and, as a consequence, the transformation of the disease of their milder stage into severity.
Symptoms
Stage 2 knee gonarthrosis is characterized by the following manifestations:
- increased feelings of pain: attacks of pain get a certain regularity (after a night's sleep, prolonged rest, physical exertion);
- stiffness of the joints, usually in the morning, which disappears after a short walk;
- The knee joint increases, its relief is smoothed - all physiological protrusions and depressions on the joint are no longer defined. In the standing position, it can seem like skin "hanging" over the patella. In the squat position, it becomes obvious that one knee (affected by gonarthrosis) is much larger than the other, healthy and has a spherical shape;
- a characteristic crunch may be heard when moving in the knee;
- joint movements when bending and stretching are severely limited.
People with grade 2 gonarthrosis can rarely do so without taking pain medication, as knee pain begins to bother them even during rest periods. This is due to the growths resembling prickly bone joints, which irritate and traumatize all knee structures.
How the doctor makes this diagnosis
In most cases, a patient who complains of deteriorating health has already been diagnosed with gonarthrosis, and the attending physician may order an X-ray to assess changes 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 rule out infections that can penetrate the joint through the bloodstream and the complicated course of gonarthrosis, along with soft tissue damage.
Complications of the disease
In the absence of treatment or insufficiently responsible attitude towards it, grade 2 gonarthrosis can quickly overcome the last "phase" and move to the final stage, in which pain becomes a constant companion and joints undergo irreversible changes and deformities.
In addition, weakened joint tissues become vulnerable to infections, and any viral or bacterial systemic disease can cause serious complications during gonarthrosis. The most common, but no less dangerous, is the infection of the joint cavity by creating a purulent content, which can spread to soft tissues - muscles, skin.
Treatment
In the treatment of grade 2 gonarthrosis, the focus is on relieving pain, slowing or stopping the degenerative process in the joint, preventing complications, and improving knee mobility.
Medications
Drugs used to treat grade 2 gonarthrosis are divided into the following groups:
- Anti-inflammatory drugs.These include the latest generation of nonsteroidal anti-inflammatory drugs (NSAIDs), which eliminate the inflammatory process in the joint and, as a result, reduce pain.
- Chondroprotectors.This group of drugs helps protect cartilage tissues from further destruction and improves regeneration processes in them.
- Hyaluronic acid preparations,which are analogs of natural lubrication of the inner surface of the joint. By reducing friction in the knee joint, these drugs prevent further wear and tear 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).
- Aids.These include vitamin preparations, immunostimulants, bioactive plant extracts (aloe, echinacea, etc. ), which are designed to improve blood circulation in joint tissues and thus speed up metabolic processes in them.
Physiotherapy, massage, exercise therapy
Such treatment methods as physiotherapy, massage and exercise therapy can be considered adjuvant in the treatment of grade 2 knee gonarthrosis 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 process in it.
One of the most effective physiotherapeutic procedures for the treatment of arthrosis is MLS laser therapy with the ability to regulate the power of laser radiation. The therapy uses constant and pulsating wavelengths, which results in deep tissue penetration and a pronounced clinical effect. 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 courses of 10-15 sessions, one session per day or every other day. By improving blood circulation in the joint, massage normalizes metabolic processes in it and provides a more effective effect of drugs on diseased tissues.
In the diagnosis of 2nd degree knee arthrosis, massages with the use of medications (chondroprotectors, anti-inflammatory or irritating ointments, cooling and anesthetic external agents) are often prescribed. factors.
A complex of physiotherapeutic exercises is assigned to physicians after assessing 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. In grade 2 gonarthrosis, the following rules must be followed:
- Reducing the load on the diseased joint.Orthopedic sticks are used for this, which enable the distribution of the load during the movement in such a way that the knee joint is minimally affected. It is important to choose a stick for your height - it should be from the wrist to the 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 (bakery products, sweets) and any foods and beverages that contain synthetic flavors, sweeteners, preservatives.
- Weight loss.Obesity is one of the risk factors that increases the likelihood of metabolic disorders in all tissues, including joint tissues. In addition, being overweight represents an unnecessary strain on the joints.
Surgical treatment
Surgery can be divided into two types: arthroscopy and endoprosthetics.
Each operation has its own list of indications for which the intervention will be most effective.
Arthroscopy
Arthroscopy is a low-trauma surgical method in which surgery is performed using miniature lighting, surgical and video devices inserted into the joint cavity with small stitches.
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- presence of bone neoplasms (osteophytes) that impede joint mobility;
- joint tissue deformities, which can be corrected without major surgery;
- the need for chondroplasty, which can significantly slow the progression of the disease and restore joint mobility.
Endoprosthetics
Endoprosthetics - replacement of the knee joint with an artificial one made of durable and hypoallergenic material that is identical in structure to natural bone tissue.
Over time, the prosthesis takes over all the functions of the "native" joint and allows you to return to normal life.
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- has no effect after long-term conservative treatment;
- rapid disease progression;
- changes in the joint significantly disrupt the patient's motor activity, causing severe and frequent pain and / or risk of disability.
Among the absolute contraindications are only all systemic diseases that prevent any surgical manipulations.
A doctor who weighs the risks and benefits of surgical treatment and based on the conclusions made decides on the need for surgery or continuation of conservative treatment.