2 degrees of gonarthrosis of the knee joint can not only reduce the patient's motor activity, but also worsen his quality of life in general. The reason for this may not only be pain and inability to exercise, which until recently seemed insignificant.
When comparing the changes that have taken place between the initial stage of the disease and its second stage, a person begins to understand: without proper treatment, the situation only gets worse.
Causes of the disease
The reason for the transition of the disease to stage 2 is most often 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 a disease, blood circulation and metabolic processes are lowered to the extent that the tissues are unable to receive nutrients and oxygen without outside help. When one refuses treatment or postpones it "until later", there is an acceleration of destructive processes in the joint and as a consequence the transformation of the disease in their mild phase into a more severe one.
Symptoms
Stage 2 of knee osteoarthritis is characterized by the following manifestations:
- increased pain: pain attacks have some regularity (after a night's sleep, prolonged rest, physical exertion);
- joint stiffness, usually in the morning, which disappears after a short walk
- the knee joint increases in size, its relief is smoothed - all physiological dents and depressions on the joint are no longer defined. In a standing position, this can manifest itself as the skin "hanging" over the patella. In a memory position, it becomes apparent that one knee (affected by gonarthrosis) is much larger than the other, healthy, and has a spherical shape;
- when moving in the knee, one can hear a characteristic crunch; The bending and elongation movements of the joint are severely limited.
People with grade 2 gonarthrosis can rarely cope without taking painkillers, as knee pain begins to plague even during rest periods. This is due to tip-like growth on the bone tissue of the joint, which irritates and traumatizes all the structures of the knee.
How the doctor makes this diagnosis
In most cases, a patient complaining of deteriorating health has already been diagnosed with gonarthrosis and the attending physician may order an X-ray examination 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 a complicated 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 "step" and go to the last step, where 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 infection of the joint cavity with the formation of purulent contents, which can spread to soft tissues - muscles, skin.
Healing
In the treatment of grade 2 gonarthrosis, the focus is on relieving pain, slowing down or completely stopping the degenerative process in the joint, preventing complications and improving knee mobility.
Medicine
Drugs used to treat grade 2 gonarthrosis are divided into the following groups:
- Anti-inflammatory drugs.These include the latest generation of non-steroidal anti-inflammatory drugs (NSAIDs), which eliminate the inflammatory process in the joint and as a result reduce pain.
- Chondro Protectors.This group of drugs helps protect cartilage tissue from further destruction and improve regeneration processes in them.
- Hyaluronic acid preparations,which are analogous to the natural lubrication of the inner surface of the joint. By reducing friction in the knee joint, these substances prevent further wear and tear on 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 tissue).
- Aids.These include vitamin preparations, immunostimulants, bioactive extracts from plants (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 as aids in the treatment of 2nd degree osteoarthritis and are rarely used as independent treatment methods.
Physiotherapy (UHF, phonophoresis, ultrasound therapy, magnetotherapy) is used to improve the blood circulation in the joint and stimulate 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 laser radiation effect. The therapy uses constant and pulsating wavelengths, thereby achieving deep penetration into tissues and a pronounced clinical effect. The MLS laser treats all diseases of the joints, osteochondrosis, hernia and other diseases of the musculoskeletal system.
It is recommended to perform massage during 10-15 sessions, one session daily or every other day. Massage, improving the blood supply in the joint, normalizes metabolic processes in it and provides a more effective effect of medication on tissues affected by the disease.
In the diagnosis of second-degree knee arthrosis, massage is often prescribed using drugs (chondroprotectors, anti-inflammatory or irritating ointments, cooling and anesthetic external agents). The choice of a specific 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 physiotherapy 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 disease course and the patient's general health.
Lifestyle Correction
Lifestyle correction is one of the most important conditions for effective treatment. For 2nd degree gonarthrosis, follow the following rules:
- Reducing the load on the diseased joint.For this, orthopedic canes are used, 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 sugar cane for your height - it should be from wrist to floor when standing.
- Kost.For this disease it is recommended to reduce the consumption of foods that contain animal protein (eggs, meat, fish, whole milk), carbohydrates (baked goods, sweets) and 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 tissues in the joints. In addition, being overweight is an unnecessary strain on the joints.
Surgical treatment
Surgical treatment can be divided into two types: arthroscopy and endoprosthetics.
Each operation has its own list of indications for which the intervention is most effective.
Arthroscopy
Arthroscopy is a low-traumatic surgical method in which the operation is performed using miniature lighting, surgical and video devices inserted into the joint cavity through small punctures.
Reading:
- presence of bone oplasmas (osteophytes) that impede joint mobility;
- deformities of common tissue that can be corrected without large-scale surgery;
- the need for chondroplasty, which can significantly slow the progression of the disease and restore the mobility of the joint.
Contraindications to arthroscopy are acute infectious diseases, blood clots and a small area of movement in the joint - inability to expand or bend the joint completely does not allow the surgeon to perform the necessary manipulations.
Endoprosthetics
Endoprosthetics - replacement of the knee joint with an artificial one made of durable and allergy-friendly material, 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.
Reading:
- no effect after a long course of conservative treatment;
- rapid disease progression
- 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 are only systemic diseases that make surgical manipulations impossible.
The attending physician weighs the risks and benefits of surgical treatment and, based on the conclusions, decides on the need for surgery or the continuation of a conservative course of treatment.