2 degrees of gonarthrosis of the knee joint can not only reduce the patient's motor activity, but also worsen his overall quality of life. The reason may not be just the pain and the 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 to treatment and non-compliance with the recommendations of the doctor 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 the tissues are unable to receive nutrients and oxygen without outside help. In case of refusal of treatment or postponement "for later", there is an acceleration of destructive processes in the joint and, as a result, the transformation of the disease from their mild stage to a more severe stage.
Symptoms
Stage 2 of knee osteoarthritis is characterized by the following manifestations:
- increased pain: the attacks of pain acquire a certain regularity (after a night's sleep, prolonged rest, physical exertion);
- joint stiffness, usually in the morning, which goes away after a short walk;
- the knee joint increases in size, its relief is smoothed - all physiological swellings and depressions in the joint are no longer defined. When standing, this can manifest as the skin "hanging" above the kneecap. In a squatting position, it becomes evident that one knee (affected by knee osteoarthritis) 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 severely limited.
People with grade 2 knee osteoarthritis are rarely able to dispense with pain relievers because the knee pain begins to bother even during periods of rest. This is due to spike-like growths on the bone tissue in the joint, which irritates and traumatizes all structures in the knee.
How the doctor makes this diagnosis
In most cases, a patient complaining of deteriorating health has already been diagnosed with knee osteoarthritis, 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 knee osteoarthritis, CT, MRI and laboratory blood tests may be recommended. This is necessary to exclude infections that can enter the joint through the bloodstream and a complicated course of knee osteoarthritis, with damage to the soft tissues.
Complications of the disease
In the absence of treatment or insufficiently responsible attitude towards it, grade 2 knee osteoarthritis can quickly overcome the last 'stage' and progress to the final stage, where pain becomes a constant companion, andthe joints undergo irreversible changes and deformations.
In addition, weakened joint tissue becomes vulnerable to infection and any systemic viral or bacterial disease can lead to serious complications during knee osteoarthritis. 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.
Processing
In the treatment of grade 2 knee osteoarthritis, the emphasis is on relieving pain, slowing or stopping the degenerative process of the joint completely, preventing complications, and improvingknee mobility.
Drugs
The drugs used in the treatment of 2nd degree knee osteoarthritis are divided into the following groups:
- Anti-inflammatory drugs.These include the latest generation of nonsteroidal anti-inflammatory drugs (NSAIDs), which eliminate the inflammatory process in the joint and, therefore, reduce pain.
- Chondroprotectors.This group of drugs helps protect cartilage tissue from further destruction and improve regeneration processes in them.
- Hyaluronic acid preparations,which are analogues of the natural lubrication of the internal surface of the joint. By reducing friction in the knee joint, these drugs prevent further wear and tear on the 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).
- Help.These include vitamin preparations, immunostimulants, bioactive extracts of plants (aloe, echinacea, etc. ), which are designed to improve blood circulation in joint tissues and thereby accelerate metabolic processesin them.
Physiotherapy, massage, exercise therapy
Treatment methods such as physiotherapy, massage and exercise therapy can be considered as an adjunct in the treatment of 2nd degree knee osteoarthritis of the knee 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.
One of the most effective physiotherapeutic procedures for the treatment of osteoarthritis is MLS laser therapy with the ability to regulate the power of laser radiation. The therapy uses constant and pulsed wavelengths, due to which deep penetration into the tissues and a pronounced clinical effect is achieved. The MLS laser treats all diseases of the joints, osteochondrosis, hernias and other diseases of the musculoskeletal system.
It is recommended to perform the massage during 10 to 15 sessions, one session per day or every other day. Massage, improving the blood supply to the joint, normalizes metabolic processes and provides a more effective effect of drugs on the tissues affected by the disease.
In the diagnosis of osteoarthritis of the knee joint of the 2nd degree, massages with the use of drugs (chondroprotectors, anti-inflammatory or irritant ointments, external cooling agents and anesthetics) are often prescribed. factors.
The complex of physiotherapy exercises is assigned to attending physicians after evaluating the effectiveness of drug therapy and is selected taking into account the individual characteristics of the course of the disease and the general state of health of the patient.
Lifestyle fix
Lifestyle correction is one of the most important conditions for effective treatment. With 2nd degree knee osteoarthritis, you must adhere to the following rules:
- Reduced load on the diseased joint.For this, orthopedic canes are used, which allow you to distribute the load during the movement so that the knee joint is minimally involved. It is important to choose the correct cane for your height - it should be from the wrist to the ground when you are standing.
- Diet.For this disease, it is recommended to reduce the consumption of foods containing animal proteins (eggs, meat, fish, whole milk), carbohydrates (pastries, confectionery) and all 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
Surgical treatment can be divided into two types: arthroscopy and stent grafts.
Each operation has its own list of indications for which the intervention will be the most effective.
Arthroscopy
Arthroscopy is a minimally 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 neoplasms (osteophytes) that impede joint mobility;
- deformities of joint tissues, which can be corrected without large-scale surgery;
- the need for chondroplasty, which can significantly slow disease progression 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 allowthe surgeon to perform the necessary manipulations.
Endoprostheses
Endoprostheses - replacement of a knee joint with an artificial joint made of durable and hypoallergenic material, the structure of which is identical 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:
- lack of effect after long conservative treatment;
- rapid progression of the disease;
- changes in the joint significantly impair the patient's motor activity, causing severe and frequent pain and / or risk of disability.
Among the absolute contraindications, only systemic diseases making any surgical manipulation impossible.
The attending physician assesses the risks and benefits of surgical treatment and, based on the conclusions drawn, makes a decision about the need for surgery or the continuation of conservative treatment.