Grade 2 gonarthrosis of the knee joint can not only reduce a patient's motor activity, but also worsen his or her overall quality of life. The reason for this may be not only the pain and inability to exercise, which recently seemed insignificant.
Comparing the changes 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 to the second stage of the disease is irresponsible attitude towards treatment and non-compliance with the doctor's recommendations regarding physical activity and lifestyle changes.
Blood circulation and metabolic processes in the affected joint are slowed down to the point that tissues can not receive nutrients and oxygen without assistance. Refusing treatment or postponing it "later" accelerates the destructive processes in the joint and, as a result, turns their mild stage into a more severe disease.
Symptoms
Stage 2 gonarthrosis of the knee is characterized by the following manifestations:
- Increased pain: Pain attacks acquire a certain regularity (after a night's sleep, a long rest period, physical activity);
- Stiffness of the joints, usually in the morning, which disappears after a short walk;
- The knee joint increases in size, its relief is smoother - all physiological discharges and depression of the joint are no longer defined. In the standing position, it may look like the skin is “hanging” on the area. In the tingling condition it becomes apparent that one knee (affected by gonarthrosis) is much larger than the other, healthier, and has a spherical shape;
- A characteristic crunch is heard when moving the knee;
- Joint flexion and extension movements are severely limited.
People with grade 2 gonarthrosis can rarely do without taking painkillers because the knee pain bothers them during other periods as well. This is due to peak-like formations on the bone tissues of the joint that irritate and injure all structures of the knee.
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 your doctor suspects that other diseases are associated with gonorrhea, CT, MRI, and laboratory blood tests may be recommended. This is necessary to rule out infections that can penetrate the blood vessels in the joint and in the 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 to the final stage, in which the pain is constantly accompanied and the joints undergo irreversible changes and
In addition, weakened joint tissues become vulnerable to infections, and any viral or bacterial systemic disease can lead to 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
Treatment of grade 2 gonarthrosis focuses on relieving pain, slowing or stopping the degenerative process in the joint, preventing complications, and improving knee mobility.
Medications
Medications used to treat grade 2 gonarthrosis are divided into the following groups:
- Anti-inflammatory drugs.This includes the latest generation of nonsteroidal anti-inflammatory drugs (NSAIDs), which eliminate the inflammatory process in the joint and thus reduce pain.
- Chondroprotectors.Drugs in this group help protect cartilage tissue from further destruction and enhance their regeneration processes.
- Hyaluronic acid preparations,which are analogues of natural lubrication of the inner 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 have been shown (for example, very poor blood circulation in the joint, which prevents other forms of the drug from reaching the affected tissues).
- helps.This includes vitamin preparations, immunostimulants, bioactive extracts from plants (aloe, echinacea, etc. ) designed to improve blood circulation in the joint tissues and thus speed up metabolic processes in them.
Physiotherapy, Massage, Exercise Therapy
Methods of treatment such as physiotherapy, massage and exercise therapy can be considered in the treatment of grade 2 ancillary knee gonarthrosis and are rarely used as independent methods of treatment.
Physiotherapy (UHF, phonophoresis, ultrasound therapy, magnetotherapy) is used to improve blood circulation in the joint and stimulate recovery processes in it.
One of the most effective physiotherapy procedures for osteoarthritis is MLS laser therapy with the ability to adjust the power of the laser beam. Therapy uses a constant and pulsating wavelength, thus achieving deep penetration into the tissues and a pronounced clinical effect. The MLS laser treats diseases of the joints, osteochondrosis, hernia and other musculoskeletal systems.
Massage is recommended for 10-15 sessions, one session every day or every other day. Massage improves the blood supply to the joint, normalizes metabolic processes in it and provides a more effective effect of the medication on the tissues affected by the disease.
In the diagnosis of grade 2 osteoarthritis, massage is often prescribed using medications (chondroprotectants, anti-inflammatory or irritating ointments, cooling and external anesthetics). Factors
A set of physiotherapy exercises is assigned to the attending physicians after evaluating the effectiveness of the medical treatment and is selected taking into account the individual characteristics of the disease course and the general health of the patient.
Lifestyle Correction
Lifestyle correction is one of the most important conditions for effective treatment. With grade 2 gonarthrosis, you should follow these rules:
- Reduce the load on the diseased joint.This is done using orthopedic crutches that allow you to distribute the load during the movement so that the knee joint is minimally involved. It is important to choose a 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 foods containing animal proteins (eggs, meat, fish, whole milk), carbohydrates (baked goods, 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, excess weight 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 instructions which 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 that are inserted through small holes into the joint cavity.
Question:
- The presence of bone neoplasms (osteophytes) that impede joint mobility;
- Deformities of joint tissues that can be corrected without large-scale surgical intervention;
- The need for chondroplasty, which can significantly slow the progression of the disease and restore joint mobility.
Endoprosthesis
Endoprosthesis - replacement of the knee joint with artificial, 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 a normal life.
Question:
- No effect after a long course of conservative treatment;
- rapid progression of the disease;
- Changes in the joint significantly disrupt the patient's motor activity, causing severe and frequent pain and / or a risk of disability.
Among the absolute contraindications are only systemic diseases that make surgical manipulations impossible.
The attending physician evaluates the risks and benefits of surgical treatment and, based on the findings, makes a decision about the need for surgery or the continuation of a conservative course of treatment.