Bilateral gonarthrosis: symptoms, treatment, complications
The content of the article:
- The reasons
-
Symptoms
- Bilateral gonarthrosis of 1 degree
- Bilateral gonarthrosis of the 2nd degree
- Bilateral gonarthrosis 3 degrees
- Diagnostics
-
Treatment
- Non-steroidal anti-inflammatory drugs
- Chondroprotectors
- Corticosteroids
- Nutrition for gonarthrosis
- Physiotherapy procedures
- Complications
- Prevention
- Video
Bilateral gonarthrosis is a disease that affects both legs. It is characterized by primary degeneration of articular cartilage, followed by damage to the articular surfaces and the formation of osteophytes.
Bilateral gonarthrosis is characterized by damage to the knee joints of two legs
Deforming osteoarthritis (DOA) is one of the most common and ancient ailments. Since the knee joints are large enough, complex and carry a serious load, they are very often affected. In most cases, the disease occurs over the age of 50, mainly in women during menopause.
The reasons
DOA knee joints are taken to be classified as follows:
- primary bilateral gonarthrosis: a degenerative-dystrophic process occurs as a result of excessive load and develops on healthy articular cartilage;
- secondary bilateral gonarthrosis: the previously altered articular cartilage begins to collapse against the background of existing pathology.
The cause of the development of bilateral osteoarthritis can be a violation of the congruence of the joints. In this case, the load on the surface of the cartilage becomes uneven (the main one falls on the area where the articular surfaces converge). This leads to rapid tissue destruction.
The reasons for the gradual destruction of joints can be different.
In some cases, changes occur in the physicochemical properties of cartilage tissue. In this case, the tissues become less resistant to stress and quickly deteriorate. The reasons for the development of secondary gonarthrosis include:
- knee injuries (fractures, dislocations, subluxations, contusions);
- dysplasia;
- violation of statics;
- functional overloads leading to microtrauma;
- chronic hemarthrosis (angioma, hemophilia);
- displacement of the body axis;
- Paget's disease;
- joint hypermobility;
- osteonecrosis;
- infectious arthritis;
- autoimmune diseases (rheumatoid arthritis);
- metabolic disorders (gout, hemochromatosis);
- endocrine diseases (acromegaly, diabetes mellitus);
- genetic predisposition.
Overweight affects the development of the disease, as this leads to additional stress on the joints. Often, damage to the cartilage tissue occurs as a result of mechanical overload (if a person physically works hard or constantly overexerts himself when playing sports).
Symptoms
Depending on the severity of joint damage, there are three degrees of bilateral gonarthrosis. The severity of symptoms depends on the stage of the disease.
Bilateral gonarthrosis of 1 degree
The disease begins imperceptibly, and the first symptoms appear dim. Often the patient cannot determine when exactly he showed signs of pathology. Initially, there is a crunch in the joints and slight pain in the knees under heavy loads.
The first symptom of the disease is pain.
Pain is noted with prolonged walking, going up or down stairs, and after rest, they disappear. There may be stiffness in the knees after sleep, lasting for several minutes, after which the person walks around.
A characteristic symptom of arthrosis is the starting pain that appears during the first steps, after rising from a sitting position. Periodically, mild swelling may occur, which disappears on its own. In this case, the joint is not deformed.
Bilateral gonarthrosis of the 2nd degree
In this form of the disease, the symptoms are aggravated, and the person pays attention to them. Pain sensations are more pronounced, they arise even after short loads, intensify in the evening, and in severe cases they remain at rest. The pain is localized along the inner front surface of the joint.
Bilateral gonarthrosis 3 degrees
Osteoarthritis grade 3 is the most severe stage of the disease. In this case, joint pain is observed constantly, even at rest.
If a large cartilaginous fragment appears in the articular cavity - an articular mouse, the patient experiences sudden intense pain that makes it impossible to move the limb (joint blockade).
Painful sensations are explained by the fact that the articular mouse is pinched between the surfaces. With a certain movement, it slips out, and the painful sensations during movement disappear.
Diagnostics
The diagnosis of bilateral gonarthrosis is made by the doctor after examination and assessment of the patient's complaints. The main diagnostic method is X-ray of the knee joint. It makes it possible to identify pathological changes in the joints and determine the dynamics of the process, taking pictures after a while.
To clarify the diagnosis, radiography is prescribed
Since X-ray is quite informative and inexpensive, it is considered a classic technique to clarify the diagnosis. It also makes it possible to exclude other pathologies, such as neoplasms in the femur and tibia.
In order to study in detail the changes in bone structures, more modern research methods are used, for example, computed tomography (CT) of the knee joints. Magnetic resonance imaging (MRI) is done to assess the condition of the soft tissues.
Treatment
It is necessary to treat the disease immediately after its detection, as this will make it possible to stop the destruction of cartilage and prevent the development of serious complications that can lead to disability.
Non-steroidal anti-inflammatory drugs
To eliminate the inflammatory process and anesthesia, drugs from the group of non-steroidal anti-inflammatory drugs are used: Diclofenac, Nimid, Revmoxicam, Meloxicam, Flamidez.
Non-steroidal anti-inflammatory drugs are used to relieve pain, such as Diclofenac
Medicines should be used according to the instructions. Since they can have a negative effect on the organs of the digestive system, the period of treatment should be limited.
Chondroprotectors
In order to stop the destruction of cartilage tissue, drugs from the group of chondroprotectors based on chondroitin, glucosamine or hyaluronic acid are used. These substances protect cartilage from adverse factors and promote the production of intra-articular fluid. They also have anti-inflammatory effects.
Chondroprotectors are prescribed to restore cartilage tissue
The most effective chondroprotectors - Teraflex, Artiflex - include several components that enhance each other's influence, providing a complex effect. It must be remembered that the effect of taking such drugs is observed 1-2 months after the start of use. Treatment with chondroprotectors should be prolonged and repeated periodically.
Corticosteroids
Drugs from the group of corticosteroids have a pronounced anti-inflammatory effect. Hormonal agents are prescribed if the effect of the use of NSAIDs is insufficient.
Corticosteroids are given by intra-articular injection
It is important to note that oral corticosteroids are not prescribed for deforming arthrosis of the knee joints. They are mainly used in the form of intra-articular injections.
Betamethasone or dexamethasone is more commonly used for intra-articular administration. They are combined with vitamins of group B. Up to 5 ml of the medicine can be injected into the cavity of the knee joint.
Nutrition for gonarthrosis
In order to stop the destruction of joints, it is necessary to normalize nutrition.
With osteoarthritis, proper nutrition is important
The patient's diet should contain:
- fish (pollock, trout, cod, herring);
- seafood (mussels, squid, shrimp);
- dairy products (curdled milk, fat cottage cheese, sour cream, cream, hard cheese);
- meat (beef, rabbit, turkey, duck);
- vegetables (cucumber, zucchini, cabbage, salad);
- fruits and berries (apples, pears, cherries, currants);
- cereals (oatmeal, buckwheat, millet).
Food should be taken in small portions 4-5 times throughout the day. Preference should be given to steamed, boiled or oven baked dishes. They are easily absorbed and do not adversely affect the digestive tract.
It is necessary to consume up to 2 liters of liquid per day. It is recommended to include jelly, compote, dried fruit or rosehip decoction and still mineral water in the diet.
Physiotherapy procedures
With bilateral gonarthrosis, the following physiotherapeutic procedures are used:
- electrophoresis. Under the influence of a constant electric field, charged particles deliver drugs (chlorine preparations, anesthetics) to deep tissues, directly to the area of inflammation. The course of treatment is 10-14 days. The duration of one procedure is 30 minutes;
- ultraphonophoresis. Under the influence of ultrasound, drugs enter deep tissues. Combinations of pain relievers and hormonal drugs are commonly used. The duration of the procedure is 10 minutes. The course of treatment can last from 10 days to two weeks;
- infrared radiation. Under its influence, deep tissues are warmed up (the temperature rises by 1–2 ° C), which enables the body to start restorative reactions. Each joint is affected for about 10 minutes, the duration of treatment is 7 days;
- laser irradiation. The rays activate cells responsible for tissue repair processes. The duration of the procedure is from 7 to 10 minutes. The treatment should last for two weeks;
- magnetotherapy. The effect of a pulsed magnetic field makes it possible to stabilize the permeability of the cell membrane and normalize metabolic processes in tissues. The course of treatment is 7 days, the duration of the session is 7–8 minutes;
- cryotherapy. Under the influence of low temperature, the protective properties of the body are enhanced, which leads to the stimulation of recovery and metabolic processes. The duration of the procedure is 10 minutes, the course of treatment is 10 days.
Complications
The following factors influence the course of the disease and its prognosis:
- the patient's age. The later the signs of the disease appear, the more favorable the prognosis, since in older people, the metabolism in tissues slows down and destruction occurs more slowly. If the disease is detected at an early age, then it progresses rapidly;
- compliance with the doctor's recommendations. If the patient takes chondroprotectors, eats properly and is engaged in therapeutic exercises, then the disease will progress more slowly;
- normalization of weight. In the event that the patient loses weight, the load on the knee joints decreases, so the destruction of cartilage tissue slows down.
If the treatment of bilateral gonarthrosis is not started on time, this can lead to the development of the following complications:
| Complications | Description |
| Joint deformities | When cartilage is destroyed, bone tissue hypertrophy occurs, as a result of which the patella is displaced, and dense formations appear in the joint area. The limb begins to bend at an unnatural angle, as a result, the person cannot lean on it |
| Ankylosis | With this pathology, in the place where cartilage used to exist, the bones grow together, and the lower leg is fixed in one position. This is a serious complication that leads to the fact that a person becomes disabled and cannot move independently |
| Fractures and dislocations | Dysfunction of the knee joint leads to the fact that the load is unevenly distributed, and the ligaments that support the joint are weakened. This results in dislocations and fractures, which can appear even with normal walking. To avoid this, people with 2-3 degrees of gonarthrosis need to move with a walker or crutches |
Prevention
In order to prevent the development of bilateral gonarthrosis, it is necessary:
- avoid heavy stress on the knee joints;
- exercise to strengthen the periarticular muscles;
- maintain normal body weight;
- avoid heavy lifting;
- eat right so that the body receives a sufficient amount of vitamins and minerals;
- to refuse from bad habits.
Early treatment can slow down the process, eliminate some symptoms and reduce the risk of complications. Therefore, if signs of a disease are detected, it is necessary to seek advice from a traumatologist, orthopedist or rheumatologist.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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