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 be not only the pain and the inability to exercise, which seemed insignificant until recently.
Comparing the changes that occurred between the initial phase of the disease and its second phase, the person begins to understand: without the proper treatment, the situation will only get worse.
Causes of the disease
Most of the time, the reason for the transition from the disease to stage 2 is an irresponsible attitude towards 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 to the point that the tissues are unable to receive nutrients and oxygen without outside help. In case of refusal of treatment or postponement "until later", there is an acceleration of the destructive processes in the joint and, as a consequence, the transformation of the disease from its mild stage into a more severe one.
Symptoms
Stage 2 of knee gonarthrosis is characterized by the following manifestations:
- increased pain: pain attacks acquire a certain regularity (after a night's sleep, prolonged rest, physical effort);
- joint stiffness, usually in the morning, which disappears after a short walk;
- the knee joint increases in size, its relief is smoothed - all the physiological bumps and depressions in the joint are no longer defined. In the standing position, this can appear as skin "hanging" over the patella. In the crouched position, it is obvious that one knee (affected by gonarthrosis) is much larger than the second, healthy and spherical in shape;
- when you move your knee, you can hear a characteristic click;
- the joint flexion and extension movements are quite limited.
People with grade 2 gonarthrosis are rarely able to go without painkillers, as knee pain starts to bother even during rest periods. This is due to spine-like growths in the bone tissue of the joint, which irritate and traumatize all knee structures.
How the doctor makes this diagnosis
In most cases, a patient with a complaint of worsening health status has already been diagnosed with gonarthrosis and the attending physician may order an X-ray exam 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 exclude infections that can penetrate the joint through the bloodstream and a complicated course of gonarthrosis, with damage to soft tissues.
Complications of the disease
In the absence of treatment or an insufficiently responsible attitude towards it, grade 2 gonarthrosis can quickly overcome the last "stage" and go to the final stage, in which pain becomes a constant companion, andjoints undergo irreversible changes and deformations.
In addition, weakened joint tissues become vulnerable to infections and any systemic viral or bacterial 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 content, which can spread to the soft tissues - muscles, skin.
Treatment
In the treatment of grade 2 gonarthrosis, the focus is on pain relief, slowing down or totally interrupting the degenerative process of the joint, preventing complications and improving knee mobility.
Medication
The drugs used to treat 2nd degree gonarthrosis are divided into the following groups:
- Anti-inflammatories.They 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.
- Chondroprotectors.This group of drugs helps to protect cartilaginous tissue from further destruction and increases the regeneration processes in them.
- Hyaluronic acid preparations,which are analogous to the natural lubrication of the internal surface of the joint. By reducing friction in the knee joint, these drugs prevent wear and tear of the cartilage. In some cases, intra-articular injections of hyaluronic acid are indicated (for example, with very little blood circulation in the joint, which prevents other forms of the drug from reaching the affected tissues).
- Aid.This includes vitamin preparations, immunostimulants, bioactive plant extracts (aloe, echinacea and so on), which are designed to improve blood circulation in joint tissues and thereby speed up the metabolic processes in them.
Physiotherapy, massage, exercise therapy
Treatment methods such as physiotherapy, massage and exercise therapy can be considered auxiliary in the treatment of 2nd degree of 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 recovery processes in it.
One of the most effective physiotherapeutic procedures for treating osteoarthritis is MLS laser therapy with the ability to adjust the power of laser radiation. The therapy uses constant and pulsating wavelengths, due to which deep tissue penetration 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 daily session or on alternate days. Massage, improving the blood supply in the joint, normalizes the metabolic processes in it and provides a more effective effect of the drugs on the tissues affected by the disease.
In the diagnosis of 2nd degree knee joint arthrosis, massages using medications (chondroprotective, anti-inflammatory or irritating ointments, refreshing external agents and anesthetics) are often prescribed. The choice of a specific medication is left to the doctor - the consultation depends on the clinical condition of the disease, the severity of the symptoms, among other factors.
The physiotherapy exercise complex is assigned to medical assistants after evaluating the effectiveness of 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. With 2nd degree gonarthrosis, you must follow the following rules:
- Reducing the load on the diseased joint.For that, orthopedic walking sticks are used, which allow to distribute the load during the movement so that the knee joint is minimally involved. It is important to choose the right cane for your height - it should go from wrist to floor when you are standing.
- Diet.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 any foods and drinks 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 is unnecessary pressure 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 non-traumatic surgical method in which the operation is performed using miniature lighting, surgical and video devices inserted in the joint cavity using small punctures.
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- presence of bone neoplasms (osteophytes) that prevent joint mobility;
- deformities of articular tissues, which can be corrected without large-scale surgical intervention;
- the need for chondroplasty, which can significantly slow the progress of the disease and restore the joint's ability to move.
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 the knee joint with an artificial one, made of durable and hypoallergenic material, with a structure identical to natural bone tissue.
Over time, the prosthesis takes on all the functions of the "native" joint and allows you to return to normal life.
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- with no effect after a long course of conservative treatment;
- rapid progression of the disease;
- changes in the joint significantly disturb the patient's motor activity, cause severe and frequent pain and / or cause risk of disability.
Among the absolute contraindications are only any systemic diseases that make any surgical manipulation impossible.
The attending physician weighs the risks and benefits of surgical treatment and, based on the conclusions drawn, makes a decision on the need for surgery or the continuation of a conservative course of treatment.