2 degree 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 pain and inability to exercise, which seemed insignificant until recently.
Comparing the changes 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 the transition of the disease to stage 2 is an irresponsible attitude towards treatment and non-compliance with the doctor's recommendations regarding physical activity and changes in lifestyle.
In a joint already affected by the disease, blood circulation and metabolic processes are slowed down to the extent that the tissues are unable to receive nutrients and oxygen without outside help. When refusing treatment or postponing it "for later", there is an acceleration of destructive processes in the joint and, as a consequence, the transformation of the disease of their mild stage into a more severe one.
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 period, physical exertion);
- joint stiffness, usually in the morning, which disappears after a short walk;
- the knee joint increases in size, its relief is smoothed out - all physiological bulges and depressions on the joint are no longer defined. In a standing position, this can appear as skin "hanging" over the patella. In a squatting position, it becomes obvious that one knee (affected by gonarthrosis) is much larger than the other, healthy, and has a spherical shape;
- when moving in the knee, a characteristic crunch can be heard;
- flexion and extension movements of the joint are sharply limited.
People with grade 2 gonarthrosis are rarely able to do without taking painkillers, since knee pain begins to bother even during periods of rest. This is due to spike-like growths on the bone tissues 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 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 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 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, 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.
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.
Medicines used in the treatment of 2nd degree 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.
- Chondroprotectors.This group of drugs helps to protect cartilaginous tissue from further destruction and enhance regeneration processes in them.
- Hyaluronic acid preparations,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 of 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 tissues).
- Aids.These include vitamin preparations, immunostimulants, bioactive extracts from plants (aloe, echinacea, and so on), which are designed to improve blood circulation in the articular tissues and thus accelerate metabolic processes in them.
Physiotherapy, massage, exercise therapy
Such methods of treatment as physiotherapy, massage and exercise therapy can be considered auxiliary in the treatment of the 2nd degree of 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 physiotherapeutic procedures for the treatment of arthrosis 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 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 carried out in courses of 10-15 sessions, one session daily or every other day. Massage, improving blood supply in the joint, normalizes metabolic processes in it and provides a more effective effect of medications on the tissues affected by the disease.
In the diagnosis of arthrosis of the knee joint of the 2nd degree, massages with the use of drugs (chondroprotectors, anti-inflammatory or irritating ointments, cooling and anesthetic external agents) are often prescribed. factors.
The complex of physiotherapy exercises is assigned to the attending physicians after evaluating the effectiveness of drug treatment, and is selected taking into account the individual characteristics of the course of the disease and the general health of the patient.
Lifestyle correction is one of the most important conditions for effective treatment. With gonarthrosis of the 2nd degree, you must adhere to 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 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 protein (eggs, meat, fish, whole milk), carbohydrates (baked goods, sweets) and any foods and drinks 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 the tissues of the joints. In addition, being overweight is an unnecessary strain on the joints.
Surgical treatment can be divided into two types: arthroscopy and endoprosthetics.
Each operation has its own list of indications for which the intervention will be most effective.
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.
- the presence of bone neoplasms (osteophytes) that impede joint mobility;
- deformities of the joint tissues, which can be corrected without large-scale surgical intervention;
- the need for chondroplasty, which can significantly slow down the progress of the disease and restore the movement ability of the joint.
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 - replacement of a knee joint with an artificial one made of durable and hypoallergenic 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.
- lack of 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 any systemic diseases that make any 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.