Osteoarthritis of the knee joint 2nd degree: causes, symptoms, treatment
The content of the article:
- The reasons
-
Symptoms
- Joint pain
- Joint stiffness after sleep
- Clicking and crunching joints
- Decreased range of motion
- Increased joint volume
- Diagnostics
-
Treatment
-
Drug therapy
- Non-steroidal anti-inflammatory drugs
- Glucocorticoids
- Chondroprotectors
- External means
- Non-drug therapy
-
- Complications
- Prevention
- Video
Osteoarthritis of the knee joint of the 2nd degree (gonarthrosis) is a degenerative-dystrophic disease in which the articular cartilage is destroyed. This is a fairly common pathology: almost 20% of the population are faced with such a problem. The disease can affect one or both joints. ICD-10 code: M17 - arthrosis of the knee joint.
With gonarthrosis, joint destruction occurs gradually
The knee joint connects the tibia to the femur and is supported by several groups of ligaments. It is enclosed in a fluid-filled synovial capsule that allows the joint bones to slide smoothly during movement. The articular surfaces are covered with cartilage (connective tissue, consisting of dense intercellular substance), which perform a supporting function.
Why does the disease occur? Under the influence of unfavorable factors, the destruction of cartilage occurs. In the small vessels feeding it, blood circulation is disturbed, as a result of which the surface becomes dry and microcracks appear.
Cartilage loses its elasticity, and the surfaces of the bones are exposed, resulting in friction. Inflammation of the synovial membrane leads to a change in the composition and viscosity of the synovial fluid. There is a thickening of the joint capsule. The surface of the bones is covered with bone spines (osteophytes), which grow and interfere with free movement.
The reasons
Conditionally deforming osteoarthritis (DOA) is divided into primary and secondary forms. If the exact cause of the disease cannot be identified, idiopathic osteoarthritis is diagnosed.
The primary form of DOA is most often detected in elderly patients, in most cases it is bilateral, while in the secondary, one limb is affected.
The reasons for the development of grade 2 gonarthrosis include:
- injuries of the lower extremities (fractures of the legs, damage to the menisci, rupture of the ligaments);
- hallux valgus;
- overweight;
- knee hypermobility syndrome;
- acromegaly;
- arthritis of various etiologies (rheumatoid, reactive, psoriatic);
- gout;
- congenital shortening of the legs;
- innervation disorders in neurological diseases (spinal trauma or traumatic brain injury);
- knee dysplasia;
- osteomyelitis;
- weakness of the ligamentous apparatus (genetically determined);
- chondrocalcinosis;
- diabetes.
The development of grade 2 deforming osteoarthritis of the knee joint may be influenced by the following factors:
- old age of the patient;
- high bone mineral density;
- female;
- frequent physical activity;
- doing some sports;
- improper diet, as a result of which an insufficient amount of vitamin C, D 3 or calcium enters the body;
- frequent injuries;
- smoking;
- hereditary predisposition;
- hormone replacement therapy.
Often, patients over 40 years old do not take into account age-related changes and begin to overload the joints, for example, jogging or actively squatting. As a result, degenerative-dystrophic changes quickly appear.
Symptoms
There are three stages of the disease. Initially, DOA practically does not manifest itself, the patient has a slight crunch in the joints and mild pain after prolonged exertion. The bones are almost not deformed, keeping their original shape.
Over time, the disease progresses, and the patient is diagnosed with grade 2 gonarthrosis.
Joint pain
It can even be observed at rest. The longest attacks occur after long walks or physical exertion.
The most common symptom of the disease is pain in the knee joint.
In order to get rid of pain, a long rest is required, but once you resume movement, the pain returns. The reason for this is the erasure of the upper layer of cartilage and the exposure of nerve endings. If a person rests for several hours, the articular membranes are restored.
Joint stiffness after sleep
This symptom occurs after waking up in the morning. In most cases, the stiffness disappears within half an hour. If it lasts longer, this may indicate the development of an inflammatory process.
The cause of stiffness is a violation of the production of glucosamine and chondroitin - components of natural intra-articular lubrication.
Clicking and crunching joints
This symptom is observed already at the first degree of DOA, but with the development of the disease it gets worse.
Crunching occurs not only during flexion of the limbs, but also when walking. The reason for this is damage to the articular surfaces, the formation of grooves and osteophytes.
Decreased range of motion
Trying to make the pain less intense, the patient seeks to bend and straighten the limb as rarely as possible. After a while, the ligamentous apparatus adjusts to the range of motion and the ligaments are shortened.
As a result, there is a reduction in the range of motion, a person cannot fully straighten or bend his leg, in some cases he begins to limp. It is possible to develop a joint, but for this you need to perform special exercises for a long time.
Increased joint volume
The most common cause of this is synovitis - an inflammatory process that occurs in the synovial membrane. It can be accompanied by the accumulation of fluid in the joint cavity.
Diagnostics
In order to diagnose the disease, the orthopedic traumatologist interviews the patient, identifying complaints. The classic method that allows you to determine the disease is X-ray.
X-rays are most often done to make a diagnosis.
With 2 degrees of osteoarthritis, joint deformity, narrowing of the joint space by 2 or 3 times and compaction of the subchondral zone can be observed. The ends of the tibia and femur are widened, and the edges of the condyles are sharpened.
Also, this research method allows you to exclude the presence of tumors or other pathological processes. In some cases, magnetic resonance imaging is prescribed to confirm the diagnosis.
Treatment
Therapy for grade 2 knee arthrosis should be comprehensive.
Drug therapy
Non-steroidal anti-inflammatory drugs
The drugs of this group - Diclofenac, Meloxicam, Ibuprofen, Nimesulide - reduce pain and eliminate inflammation. Since such drugs have a negative effect on the condition of the gastrointestinal tract, they should be taken after meals.
As part of complex treatment, non-steroidal anti-inflammatory drugs are used, for example Diclofenac
The treatment period should be limited. Do not exceed the permissible dosage, as this can cause the development of a large number of side effects.
Glucocorticoids
These are hormonal drugs with anti-inflammatory effects. They are used for intense inflammation.
The most commonly used are Mometasone (Diprospan, Kenalog) or Dexamethasone, which are administered intramuscularly or intraarticularly. Before injection into the knee, the fluid is removed and the joint cavity is washed.
In some cases, glucocorticoids are given orally, such as methylprednisolone.
Chondroprotectors
The drugs of this group improve metabolic processes in tissues and promote their regeneration. Most often, Teraflex, Don or Artiflex are prescribed for the treatment of the disease. Also used are injectable drugs Mucosat or Alflutop.
Medicines affect the production and viscosity of the synovial fluid. In addition, drugs in this group have a mild analgesic and anti-inflammatory effect. Chondroprotective treatment should be long-term.
External means
In the complex treatment of the disease, drugs are used for external use in the form of ointments, gels or creams based on NSAIDs, bee and snake venom or extracts of medicinal plants. They are applied to the affected area 2-3 times a day, according to the instructions.
External agents are used to relieve pain and inflammation.
Such funds improve blood circulation, reduce pain and restore joint mobility.
Non-drug therapy
During an exacerbation of the disease, the patient needs to unload the affected limb as much as possible. You can use a cane or special insoles for walking.
Therapeutic gymnastics is an important part of the treatment of DOA
Physiotherapy is effective:
| Method | Description |
| Electrophoresis | With the help of an electric current, drugs are injected into the body - novocaine, Dimexide and other drugs that relieve pain and inflammation. Local application of drugs avoids many side effects |
| Magnetotherapy | Eddy magnetic currents promote tissue heating at a depth of 10–12 cm, thereby increasing the tone of blood vessels, accelerating recovery reactions, and improving metabolic processes in the affected area |
| Ozokerite therapy | One of the types of thermotherapy. Ozokerite is a petroleum-based substance containing mineral oils, resins and paraffins. It is used in the form of applications or compresses, as a result of which microcirculation improves, pain decreases |
| Cryotherapy | Under the influence of cooled gas, tissue edema decreases, pain receptors are blocked, increased muscle tone decreases |
| Phonophoresis | A combined method of physiotherapy, combining drug and ultrasound exposure. For gonarthrosis, it is most often used with hydrocortisone |
It is also necessary to engage in medical gymnastics. Massage helps to improve blood circulation in the affected area.
Quite often, folk remedies are used in the form of tinctures, lotions and compresses based on black radish, larkspur, golden mustache, which are applied to damaged areas.
Complications
The gradual destruction of cartilaginous tissue leads to the fact that over time, deformation of the knees occurs. Due to the weakness of the ligamentous apparatus, the patient often has dislocations and fractures.
Pathogenic microorganisms can penetrate through cracks in the cartilage tissue, which can cause aseptic necrosis. In severe cases, osteoarthritis leads to disability.
Prevention
In order to slow down the destruction of cartilage tissue, it is necessary:
- avoid heavy loads on the affected limb;
- choose comfortable shoes and use special orthopedic insoles;
- exercise and swimming;
- monitor body weight.
It is impossible to cure grade 2 gonarthrosis, but timely started therapy helps to stop the disease at this stage. Also, treatment allows you to get rid of some of the symptoms of the disease (pain, edema), therefore, if signs of pathology are detected, you should consult a doctor.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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