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 pain and inability to exercise, which until recently seemed insignificant.
Comparing the changes that occurred between the initial stage of the disease and its second stage, one begins to understand: 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 irresponsible attitude to treatment and non-compliance with the doctor's recommendations regarding physical activity and lifestyle changes.
In a joint already affected by disease, blood circulation and metabolic processes slow down to the point where tissues cannot absorb nutrients and oxygen without outside help. In case of refusal of treatment or its postponement "for later", there is an acceleration of the destructive processes in the joint and as a consequence transformation of the disease from their mild stage to a more severe one.
Symptoms
Stage 2 of knee gonarthrosis is characterized by the following manifestations:
- increased pain: attacks of pain acquire a certain regularity (after a night's sleep, prolonged rest, exercise);
- joint stiffness, usually in the morning, which disappears after a short walk;
- the knee joint increases in size, its relief is smoothed - all physiological bulges and depressions of the joint are no longer defined. In the upright position, this may look like skin "hanging" over the patella. In the squatting position, it becomes apparent that one knee (affected by gonarthrosis) is much larger than the other, strong, and has a spherical shape;
- a characteristic crunch is heard when moving in the knee;
- The flexion and extension movements of the joint are sharply limited.
People with grade 2 gonarthrosis can rarely cope without taking painkillers, as knee pain begins to bother them even during rest periods. This is due to spike-like growths on the bone tissue 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 poor health is already diagnosed with gonarthrosis and the doctor may order an X-ray to assess the 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 a complex course of gonarthrosis with soft tissue damage.
Complications of the disease
In the absence of treatment or insufficiently responsible attitude to it, grade 2 gonarthrosis can quickly overcome the last "stage" and move to the last stage in which pain becomes a constant companion and the joints undergo irreversible changes. and deformations.
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 with the formation of purulent contents, 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.
Medicine
Drugs used in the treatment of 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 reduce pain as a result.
- Chondroprotectors.This group of drugs helps to protect cartilage tissue from further destruction and to intensify the processes of regeneration in them.
- Preparations with hyaluronic acid,, which are analogs of the natural lubrication of the inner surface of the joint. By reducing friction in the knee joint, these drugs prevent further wear and tear on the cartilage. In some cases, intra-articular injections of hyaluronic acid have been shown (for example, with very poor blood circulation in the joint, which prevents other forms of the medicine 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 the joint tissues and thus accelerate metabolic processes in them.
Physiotherapy, massage, exercise therapy
Treatments such as physiotherapy, massage and exercise can be considered adjuvant in the treatment of grade 2 gonarthrosis of the knee and are rarely used as independent treatments.
Physiotherapy (UHF, phonophoresis, ultrasound therapy, magnetic therapy) is used to improve blood circulation in the joint and stimulate the recovery processes in it.
One of the most effective physiotherapy 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 a deep penetration into the tissues and a pronounced clinical effect are achieved. The MLS laser treats all diseases of the joints, osteochondrosis, hernias and other diseases of the musculoskeletal system.
Massage is recommended to be performed in courses of 10-15 sessions, one session per day or every other day. Massage, which improves the blood supply to the joint, normalizes metabolic processes in the joint and provides a more effective effect of drugs on the tissues affected by the disease.
When diagnosing osteoarthritis of the knee of the 2nd degree, massages with the use of drugs (chondroprotectors, anti-inflammatory or irritating ointments, cooling and anesthetic external means) are often prescribed. The choice of a particular drug remains with the doctor - the appointment depends on the clinical picture of the disease, the severity of symptoms and other factors.
The complex of physiotherapeutic exercises is assigned to the attending physicians after evaluation of the effectiveness of the drug treatment and is selected taking into account the individual characteristics of the course of the disease and the general health condition of the patient.
Lifestyle adjustment
Lifestyle adjustment is one of the most important conditions for effective treatment. In grade 2 gonarthrosis, the following rules should be followed:
- Reducing the load on the diseased joint.Orthopedic canes are used for this, which allow you 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 from the wrist to the floor when you are 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, pastries) and all foods and beverages containing synthetic flavors, sweeteners, preservatives.
- Weight loss.Obesity is one of the risk factors that increases the likelihood of metabolic disorders in all tissues, including joint tissues. In addition, being overweight puts extra strain on the 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-trauma surgical method in which the operation is performed using miniature lighting, surgical and video devices inserted into the joint cavity through small holes.
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- presence of bone neoplasms (osteophytes) that impede joint mobility;
- deformities of the joint tissues, which can be corrected without large-scale surgery;
- the need for chondroplasty, which can significantly slow down the development of the disease and restore the mobility of the joint.
Endoprosthesis
Endoprosthesis - replacement of the knee joint with an artificial one, made of durable and hypoallergenic material, identical in structure to the 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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- no effect after a long course of conservative treatment;
- rapid disease progression;
- changes in the joint significantly impair the patient's motor activity, cause severe and frequent pain and / or cause a risk of disability.
Among the absolute contraindications are only all systemic diseases that make any surgical manipulations impossible.
The attending physician assesses the risks and benefits of surgical treatment and, based on the conclusions made, decides on the need for surgery or the continuation of a conservative course of treatment.