2 degrees of gonarthrosis in 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 inability to exercise, which seemed insignificant until recently.
Comparing the differences that have occurred 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 passing 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 disease, blood circulation and metabolic processes are slowed down to the point that tissues are unable to receive nutrients and oxygen without outside help. In case of refusal of treatment or postponement of it "for later", there is an acceleration of destructive processes in the joints and, consequently, the transformation of their mild stage disease into a more severe one.
Symptoms
Stage 2 of knee gonarthrosis is characterized by the following manifestations:- increased pain: pain attacks gain a certain regularity (after a night's sleep, prolonged period of rest, physical exertion);
- joint stiffness, usually in the morning, which disappears after a short walk;
- the knee joint increases in size, its relief softens - all physiological bloating and joint depressions are no longer defined. In a standing position, it may seem as if the skin "hangs" over the patella. In a squat position, it becomes clear that one knee (affected by gonarthrosis) is much larger than the other, healthy, and has a spherical shape;
- when moving on the knee, a characteristic crack can be heard;
- bending and elongation movements of the wrist are severely restricted.
People with grade 2 gonarthrosis are rarely able to do without taking sedatives, as knee pain starts to bother even during rest periods. This is due to rivet-like growths in the bone tissue of the ankle, which irritate and traumatize all knee structures.
How does the doctor make this diagnosis
In most cases, a patient complaining of a deteriorating health condition 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 in order to rule out infections that can penetrate the joints through the bloodstream and a complicated course of gonarthrosis, with soft tissue damage.
Complications of the disease
In the absence of treatment or insufficient response to it, grade 2 gonarthrosis can quickly cross the final "stage" and go into the final stage, in which the pain becomes a constant accompaniment and jointsundergo irreversible changes and deformations.
Furthermore, weakened joint tissue becomes susceptible 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 main focus is on relieving pain, slowing down or completely stopping the degenerative process in the joint, preventing complications, and improving knee mobility.
Medications
Medications used in the treatment of 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 joints and, as a result, reduce pain.
- Chondroprotectors.This group of medicines helps to protect cartilage tissue from further destruction and to improve the regeneration processes in it.
- 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 medications prevent further consumption of cartilage. In some cases, intra-articular injections of hyaluronic acid are indicated (for example, with very poor blood circulation to the joints, which prevents other forms of the drug from reaching the affected tissues).
- Helps.These include vitamin preparations, immunostimulants, bioactive plant extracts (aloe, echinacea, etc. ), which are created to improve blood circulation to articular tissues and thus speed up metabolic processes in them.
Physiotherapy, massage, exercise therapy
Treatment methods such as physiotherapy, massage and exercise therapy can be considered helpful in treating second-degree knee gonarthrosis and are rarely used as independent treatment methods.
Physiotherapy (UHF, phonophoresis, ultrasound therapy, magnetotherapy) is used to improve blood circulation to the joints and to 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 adjust the power of laser radiation. The therapy uses constant and pulsating wavelengths, due to which deep penetration into the tissues is achieved and a pronounced clinical effect. 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 every day or every other day. By improving blood circulation to the joints, massage normalizes metabolic processes in it and provides a more effective effect of the medication on diseased tissues.
When diagnosing second-degree osteoarthritis of the knee joints, massages with the use of medications (chondroprotectors, anti-inflammatory or irritating oils, cooling and external anesthetic agents) are often prescribed. 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 evaluating the effectiveness of the drug treatment and is chosen 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. With grade 2 gonarthrosis, you must adhere to the following rules:
- Reducing the load on the diseased joint.For this, orthopedic sticks are used, which allow you to distribute the load while moving in such a way that the knee joint is minimally involved. It is important to choose the right stick for your height - it should be from the key to the floor when you are standing.
- Diet.For this disease, it is recommended to reduce the consumption of foods containing animal protein (eggs, meat, fish, whole milk), carbohydrates (baked goods, cakes) and any foods and beverages that contain synthetic, sweetening flavors, preservatives.
- Weight loss. Overweight is one of the risk factors that increases the likelihood of metabolic disorders in all tissues, including joint tissues. In addition, being overweight is an unnecessary strain on the joints.
Surgical Treatment
Each operation has its own list of indications for which intervention will be most effective.
Arthroscopy
Arthroscopy is a low-trauma surgical method in which surgery is performed using miniature lighting, surgical equipment, and video inserted into the joint cavity through small drills.
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- presence of bone neoplasms (osteophytes) that impede joint movement;
- deformities of joint tissues, which can be corrected without large-scale surgical intervention;
- the need for chondroplasty, which can significantly slow the progression of the disease and restore joint movement.
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.
Endoprosthetics
Endoprosthetics - the replacement of a knee joint with an artificial one made of durable and hypoallergenic material, which is the same in structure with 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 a long course of conservative treatment;
- rapid disease progression;
- changes in articulation 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 systemic diseases that make surgical manipulations impossible.
The attending physician weighs the risks and benefits of surgical treatment, and, based on the conclusions made, makes a decision about the need for surgery or continuing a conservative course of treatment.