Osteoarthritis 3 degrees treatment. What does the diagnosis of doa mean, symptoms and treatment. Non-drug treatments

With severe damage to cartilage and bones, only surgical intervention can restore mobility to the knee joint.

Description of the disease

Deforming osteoarthritis of the knee joint is a non-inflammatory degenerative-dystrophic disease. Initially, it affects the intra-articular cartilage, and then the tibia and femur, synovial bags, ligaments, muscles, and tendons are gradually involved in the pathological process.

Pathology is diagnosed more often in middle-aged and elderly patients, mainly in women. But young people who are actively involved in sports - running, weightlifting - are also susceptible to it.

DOA of the left knee joint on x-ray.

Types and forms of the disease

Deforming osteoarthritis is primary and secondary. The latter develops against the background of a pathology already present in the body, leading to damage to the cartilage lining of the knee. Primary disease occurs in initially healthy cartilage for unknown reasons. Usually unilateral is detected, but an increase in the load when walking on a healthy knee can cause a bilateral lesion.

1 degree

Folk ways

After the main treatment, they are used to eliminate mild pain that occurs at the stage of remission after physical exertion or hypothermia. The feasibility of their use should be discussed with the orthopedist.

Celandine oil

A dark glass container is filled 1/3 of the volume with fresh celandine grass, lightly tamped. Fill the jar to the top with any vegetable oil (olive, sunflower, corn), leave at room temperature for a month. Filter, rub into the knees for pain.

What is good about folk recipes is the lack of chemistry.

Clay compress

Pour 5 tablespoons or red cosmetic clay into a bowl, add any mineral water in small portions until a thick, elastic mass is formed. They form a cake, apply it to the knee for an hour, fixing it with a film and an elastic bandage.

Rubbing with elecampane root

A glass jar is filled a quarter with dry, crushed elecampane roots. Pour vodka or medical 90% alcohol diluted with an equal amount of water up to the neck. Infuse in a dark, warm place for 2-3 months, shake occasionally. Filter, rub into the knee up to 3 times a day.

Yolk ointment

In a mortar, grind 2 yolks with a tablespoon of mustard. Add 2 tablespoons of thick honey and linseed oil. Without ceasing to rub, add in small portions of 50 g of medical vaseline and baby cream. The ointment is stored in the refrigerator, rubbed into the knee joints with stiffness of movements.

Therapeutic gymnastics and its role

The main tasks of therapeutic exercises are the elimination of all symptoms of pathology and the prevention of its spread to healthy tissues. For this, patients are recommended to perform daily.

After 2-3 months of regular training, the blood supply to tissues improves significantly, and the range of motion increases.

Prognosis and complications

If deforming osteoarthritis is diagnosed at the initial stage of development, then with the help of conservative treatment it is possible to completely normalize the functioning of the joint. The prognosis is less favorable with already developed complications - or varus deformity, secondary reactive synovitis, spontaneous, external subluxation of the patella.

How to prevent pathology

Prevention of deforming osteoarthritis consists in eliminating increased loads on the knee joints, maintaining optimal weight, and using. Orthopedists recommend timely treatment of inflammatory and infectious diseases that provoke the development of osteoarthritis.

Osteoarthritis of the knee joint of the 3rd degree is a disease accompanied by pain, stiffness of movements and deformity of the knee joint. The disease causes many problems for the patient and is subject to treatment.

• Age. The older the person, the worse the recovery processes in the body proceed, the cartilage tissue is destroyed, the symptoms of the disease appear.
• High physical activity. All types of professional activities associated with excessive stress on the body are the cause of the disease.
• Being overweight is the most common cause of stage 3 osteoarthritis of the knee. A large mass creates an excessive load on the knee.
• Trauma, surgery. A small injury during a fall is enough - and the risk of disease increases significantly. Surgery can also cause disease.
• Hereditary tendency is one of the causes of osteoarthritis. There are cases when a congenital pathology leads to the disease, in which there is a lack of intra-articular lubrication.

Manifestation of the 3rd degree

Grade 3 osteoarthritis is the most severe form of the disease, in which the disease is practically untreatable. In such cases, a person receives a disability, the existing changes lead to restrictions on movement or their complete absence. Manifestations of the disease that characterize the 3rd degree of the disease:

• pain in the joint, which is felt at night, during rest;
• pain is aggravated by changing weather conditions;
• the joint cavity is filled with fluid;
• visually the knee increases significantly;
• any movement is accompanied by a crunch.

These manifestations can be observed with the naked eye, with a more thorough examination of the patient, changes in bone tissue can be detected.

Symptoms of knee disease

There are 3 stages of the disease. Each stage is characterized by certain signs. There are several general symptoms that will help to recognize the disease at the very beginning and prevent its development:

• pain in the knee extends to the hips, lower leg and ankle, increases after additional load on the legs;
• in the knee when moving, a crunch and clicks are heard;
• visual enlargement of the joint and its deformation;
• stiffness is felt, especially after the rest phase.

If such symptoms appear, be sure to contact a medical facility for a consultation with a specialist. This will help prevent the development of the disease.

Diagnostics

To make a correct diagnosis, it is necessary to undergo several diagnostic procedures, which will help determine the degree of the disease and prescribe treatment.

• Diagnosis of any disease begins with an examination and questioning of the patient.
• Next, you need to take blood and urine tests. Laboratory tests are less informative in diseases of this kind.
• Aspiration (withdrawal of intra-articular fluid). The resulting liquid will help determine the stage of the disease.
• Radiography. This study will help determine the size of the gap between the bones, the degree of change in bone tissue and the nature of cartilage damage.
• MRI. An image obtained with a magnetic resonance tomograph is more voluminous and allows a more thorough examination of the damaged organ. The doctor gets the opportunity to study the bone layer by layer.

Difference from stages 1 and 2

Stages 1 and 2 of osteoarthritis have less pronounced symptoms. Stage 3 of the disease, according to experts, leads the patient to disability and, in most cases, is practically untreatable. The patient receives temporary relief and can move independently only with the help of a cane, crutches or a walker.

At stage 1 of the disease, the symptoms are insignificant. The patient feels discomfort and fatigue in the knee after the load. Sharp movements in the joint cause minor pain.

Stage 2 proceeds against the background of pronounced pain sensations. The shape of the knee visually changes. Movement is difficult, pain is felt when pressing and examining the joint.

Medical treatment

It must be understood that you can take any drug only as directed by a specialist. In all other cases, there is a risk of personally causing irreparable damage to health.

• Non-steroidal drugs are used to relieve pain. Such drugs relieve pain, eliminate inflammatory reactions. It should be remembered that this group of drugs is addictive and dangerous side effects (nausea, dyspepsia, stomach and duodenal ulcers, gastrointestinal bleeding, diarrhea).
• Chondroprotectors. They help to restore damaged areas of bones and various joints: hip, knee, foot. They have a fairly strong regenerative component and are effective in treating grades 2-3 of the disease.
• The third group of medicines are preparations based on hyaluronic acid. Strengthen the joint, cartilage tissue. This drug is administered directly into the affected knee by injection.

Physiotherapy and Diet

In the treatment of stages 2 and 3 of osteoarthritis, there are effective physiotherapeutic procedures that help enhance the effectiveness of treatment. Ointments used in massage relieve pain and spasms. The diseased joint must be gently rubbed with medicinal gels and ointments, without causing unnecessary pain.

The patient may be prescribed the following procedures:

1. Electrophoresis.
2. Mud wraps.
3. ultrasound therapy.
4. Paraffin applications.
5. Magnetotherapy.
6. Carbonic and hydrogen sulfide therapeutic baths.

Proper nutrition contributes to the improvement of the condition. Healthy food with a high content of calcium has a beneficial effect on bone tissue. Fatty and salty foods should be avoided.

Exercise therapy exercises will help restore mobility in the joint, however, gymnastics is carried out only after consulting a specialist.

It should be understood that stage 3 osteoarthritis of the knee is ineffectively treated with folk remedies. To improve the condition, it is worth using medical methods.

Surgical intervention

Surgical treatment is used for stage 3 osteoarthritis of the knee joint. The simplest and most affordable method of surgery is arthroscopy. Punctures are made in the knee area, through which a type of endoscope is inserted - an arthroscope and surgical instruments, with which damaged cartilage is removed.

If the above procedure is ineffective, perform a knee replacement surgery. This is a complex operation, but such therapy always gives a positive result in the treatment of grade 3-4 DOA.

Possible complications and life prognosis

This disease can lead to disability and practically immobilize a person, here are a few possible complications:

• deformity of the knee joint;
• osteoarthritis;
• deterioration of motor functions.

This can be avoided by doing simple daily activities.

Disability prevention

• morning exercises will help you stay in good physical shape and maintain the elasticity of muscles and ligaments;
• shoes should be comfortable;
• balance your diet and watch your weight;
• try to avoid lifting heavy objects.

These simple rules will help you stay fit and avoid illness.

Pain in the knee, which occurs every time you move, is initially perceived as an unfortunate misunderstanding. Over time, the discomfort may increase. Now it is not necessary to run or jump, the pain comes by itself and does not need special prerequisites. As a rule, in such cases we are talking about deforming osteoarthritis of the knee joint. This is a fairly common disease, which is very difficult to cure. It has a special section in the International Classification of Diseases (ICD). DOA of the knee joint belongs to the M17 category.

What is deforming osteoarthritis (DOA)?

Deforming osteoarthritis is a dystrophic disease of a degenerative nature, which is associated with the gradual destruction of cartilage tissue on the articular surfaces. According to WHO, at present, 5% of the world's population has such a diagnosis.

Deforming osteoarthritis is a continuously progressive disease. This means that sooner or later one stage of the pathological process will pass into the next. The rapid progress of the disease is due to the constant involvement of the tissues surrounding the joint. DOA is usually diagnosed in the elderly. However, in recent years, more and more young people have to deal with such a disease.

DOA of the knee joints

The knee joint is constantly under pressure, as it is forced to bear the entire weight of the human body and ensure the mobility of the legs. Over time, hyaline cartilage, which is responsible for the mobility of parts of the joint and their cushioning, begins to thin. If it disappears completely, the bone is exposed. It begins to grow, exostoses appear. As a result of the ongoing changes, the knee is deformed.

The impetus for the onset of destructive processes is a variety of reasons that entail a violation of metabolic processes. Cartilage gradually loses its elasticity, resistance to regular stress and strength. Its structure becomes friable, microcracks appear. If the problem is not eliminated in a timely manner, the result may be a complete destruction of the intra-articular tissue.

As a result of all these pathological changes, the disease leads to instability of the connection. The body itself reacts to this problem by the growth of osteophytes. These are special bone outgrowths that are necessary to stabilize the knee joint. Their appearance exacerbates the whole situation. Osteophytes, reaching large sizes, significantly increase discomfort. In addition, they can flake off and be free in the joint cavity. As a result, a person cannot move freely. To fix the problem, you often have to resort to surgical intervention.

In recent years, there has been a rejuvenation of the disease, now the risk group includes people over 30 years old. That is why doctors recommend that everyone who has not yet been affected by this disease adhere to certain rules of prevention.

Why do knees hurt?

DOA of the knee joints is divided into two forms: primary and secondary.

The main reasons for the occurrence of the first are still unknown. Doctors suggest that the disease develops against the background of excessive stress on the joint and some age-related changes.

The secondary form usually occurs in those people who have previously had to deal with knee injuries or other pathologies of a similar nature.

Among the main factors predisposing to the development of DOA of the knee joint (ICD code 10 - M17), experts include the following:

• Low motor activity.
• Overweight.
• Injuries of the knee joints (torn ligaments / meniscus).
• Age changes.
• Endocrine diseases (diabetes mellitus, rheumatoid arthritis).
• Intensive load on the legs during professional sports.

In addition, if close relatives were diagnosed with OA of the left knee or right, the likelihood of developing the disease increases eight times.

Clinical picture of pathology

The symptoms of the disease and the degree of their intensity depend on the neglect of the process. The longer the patient neglects treatment, the more he is disturbed by discomfort. The main signs of this pathology are listed below.

• Pain discomfort, the intensity of which may vary.
• Stiffness of movements, which is especially evident in the morning hours.
• Creaking and crunching while walking.
• The x-ray shows spikes and deformity of the cartilage.
• Swelling of the knee.
• The appearance of discomfort during sports.
• Atrophy of the leg muscles due to lack of physical activity.

Types and forms of the disease

As already noted, each pathology according to the International Classification of Diseases is assigned its own ICD code. DOA of the knee is no exception in this regard.

There are two forms of this pathology: primary and secondary. The first option develops for unknown reasons, as a rule, against the background of wear and tear of cartilage joints and natural aging of the body. Secondary occurs due to previous inflammation and joint injuries.

In addition, deforming osteoarthritis is classified according to the severity of the disease. Each of them has its own distinctive symptoms. Diagnosis necessarily implies an accurate determination of the extent of the disease, since subsequent treatment and prognosis largely depend on it.

1 degree of disease

At the initial stage of pathology development, the clinical picture is almost completely absent. Patients notice that minor discomfort occurs only after a busy day. It is manifested by heaviness or pain in the knee. Such sensations disappear immediately after rest. That is why many prefer not to pay attention to DOA 1 degree of the knee joint. At this stage of the development of the disease, no serious changes of a deforming nature are noted.

2 degree of the disease

The symptoms become more pronounced every day. Many patients become seriously worried, some seek medical help. High-quality therapy at this stage allows you to return a person to a full life and relieve discomfort.

The disease usually manifests itself as prolonged pain inside the joint. Gradually, its deformation begins, swelling of the knee appears.

3 degree of disease

Pathology is characterized by irreversible changes. Medicines are not able to cope with constant discomfort. DOA 3 degrees of the knee joint is characterized by constant pain that does not subside after rest. Sensitivity to any changes in the weather appears.

The deformity of the joint progresses rapidly, it can be seen with the naked eye. Patients with this diagnosis develop lameness, limited joint mobility.

Diagnosis of pathology

Despite the rapid development of medicine, at present, radiography remains the only effective option for diagnosing deforming osteoarthritis. The picture allows the doctor to assess the degree of neglect of the process, to consider the volume of bone changes. DOA of the knee joints has a similar clinical picture with many pathologies of the musculoskeletal system. That is why specialists often prescribe an additional examination, which includes:

Medical therapy

According to the results of the tests, the doctor can confirm the diagnosis of OA of the knee joint. Treatment of this disease should be complex. The earlier the course of therapy is started, the higher the likelihood of doing without a major operation. If the pathological process is already underway, it is not possible to completely leave it, but it is quite feasible to slow down its development. Treatment of this pathology usually pursues the following tasks:

• Improving the quality of life of the patient through the relief of pain.
• Reducing the symptoms of pathology.
• Slowing down the process of cartilage deformation.
• Restoration of the functionality of the affected joint.

Medications form the basis of conservative therapy. Patients are primarily prescribed anti-inflammatory and painkillers (Diclofenac, Ibuprofen, Ketoprofen). The main purpose of these drugs is to stop the pain syndrome.

Treatment of DOA of the knee joint of the 2nd degree necessarily involves the use of chondroprotectors ("Teraflex", "Struktum"). These medicines are necessary for the restoration of intra-articular cartilage. It is important to note that their action does not begin immediately. The positive effect of taking medications is usually observed after 3-6 months of regular use. If the cartilage layer is completely destroyed, such drugs are ineffective.

Complex therapy also includes the use of vasodilators. They significantly increase blood flow to the cartilage tissue, normalize its nutrition.

With an exacerbation of the pathology, corticosteroid hormonal preparations are used as an ambulance (Betamethasone, Triamcinolone). These medicines can reduce swelling, pain and other signs of the inflammatory process.

Physiotherapy and exercise therapy

DOA 1, 2 degrees of the knee joint is perfectly treatable with physiotherapeutic procedures, but they should be selected on an individual basis. Often, their help is resorted to as a prevention of exacerbations. Usually prescribed laser therapy, UHF, electrophoresis, paraffin applications. They significantly improve blood circulation, relieve excessive muscle spasm and swelling.

At the initial stage of deforming osteoarthritis, a course of exercise therapy is prescribed as a prevention and prevention of the progression of the pathology. Specially selected exercises allow you to strengthen the muscles without involving the diseased joint.

It is important to note that both physiotherapy and exercise therapy should not be taken as the only true treatment option for the disease. According to the doctor's recommendations, they can be used as an adjunct to drug therapy.

When is an operation required?

If the above measures do not give a positive result, the specialist decides to perform a surgical intervention. In this case, arthroplasty is usually recommended. The essence of this method is to replace worn cartilage with an artificial prosthesis. It is made from titanium alloy. Depending on the specific case, total or partial arthroplasty is possible. Surgical intervention in patients with a diagnosis of OA of the knee joints allows you to return to full working capacity, the ability to fully move around.

How to prevent pathology?

Osteoarthritis is divided into two types. The main cause of the former is disturbances at the level of metabolic processes in the body and some age-related changes, and the latter is various kinds of mechanical damage and injury. To prevent the development of deforming osteoarthritis, it is necessary to protect yourself from bruises. This is especially true for those who play sports. For such people, the disease often has an occupational character.

On the other hand, DOA can be prevented by spending more time on movement. Any moderate exercise is welcome. This is important primarily for the category of potential patients who have a sedentary job.

The fight against excess weight is another option for preventing the disease. Nutrition should be as balanced and healthy as possible. It is important to pay attention to the quantity and quality of vitamins.

DOA of the knee joints (ICD 10 - M17) is a common pathology that has recently been found even in young people. To reduce the likelihood of developing serious complications, it is important to diagnose the disease at the initial stages and undergo a course of treatment.

Deforming osteoarthritis of the knee is a disease that leads to degenerative-dystrophic changes in the knee joint.

To hold the entire body weight during movement, the knee joint is subjected to constant loads. With age and thinning of the hyaline cartilage, which provides mobility to the joint, the bone is exposed, outgrowths (thorns) are formed, and the knee is deformed. The opinion is erroneous when, with pain in the knee, people think that the joint is filled with salt deposits.

The disease deforming osteoarthritis has nothing to do with calcium salts. Rather, it can be called age-related, developing in people after 40 years (more often in women).

The disease is common, diagnosed in 1/5 of the entire population of the planet.

The primary form of the disease usually develops with age due to constant heavy loads on the joint. The secondary form of the development of the disease is preceded by joint injuries, various diseases.

The development of deforming osteoarthritis in the knee is facilitated by:

• Overweight all man
• Low physical activity, inactivity, sedentary lifestyle
• Age changes
• Rupture of the meniscus, ligaments

Diabetes mellitus, rheumatoid arthritis, gout.

Symptoms and degrees

The main symptom of this disease is pain in the knee, severity, strength, the intensity of which depends on the stage of the disease.

As the pain develops, it becomes more intense, mobility is limited, movements in the knee become constrained, painful. At the advanced stage of the disease, the joint is completely blocked, its complete immobility occurs.

At first, the symptoms are minor and often the patient simply does not pay attention to it.

Over time, the signs of deforming osteoarthritis begin to manifest themselves more actively, the knee begins to hurt even at rest.

The disease at a late stage is treated much worse, sometimes surgery is the only way to alleviate the patient's condition.

A complete cure for this disease at stage 3 is out of the question, when at stages 1 and 2, patients rarely go to the doctor.

Consider the signs of deforming osteoarthritis separately at 1, 2, 3 degrees of its development.

1 degree

The manifestation of the disease is insignificant, sometimes it tightens under the knee, it hurts when stretching the leg, or after a long stay in a sitting position.

The pain is short-lived and quickly disappears with a change in position. Often after a long walk or physical exertion in the knee occurs slight discomfort, but does not cause inconvenience to a person as a whole.

At the first stage of the development of the disease, few people go to the doctor. The mobility of the joint is normal, there is no deformity yet.

2 degree

replaces the first with more pronounced symptoms. The pain becomes more severe, prolonged, often worse in the evening, torments at night, hurts in the calves.

The joint begins to deform, during flexion and extension it causes discomfort, becomes limited in free movement, swells and crunches abnormally when walking.

At stage 2, the treatment is quite successful, effective. It is still possible to return the patient to full-fledged movement, and to return the joint to full value, but not everyone turns to the doctor.

3 degree

running, pain is constant and prolonged do not subside even at rest.

Aggravated at night, in a sitting position, standing or walking. The knee begins to ache when the weather changes, becomes sensitive and vulnerable.

The joint is deformed, and over time it becomes noticeable visually, the person begins to limp. The mobility of the joint is limited, sometimes it is simply impossible to bend it, a strong, burning pain begins.

All methods of treatment of deforming osteoarthritis of the knee

Treatment is administered by an orthopedic traumatologist.

Methods of treatment - conservative or surgical.

It all depends on the degree of the disease, the clinically pronounced symptoms, the general condition of the patient, individual indications. Treatment is purely individual.

Medical therapy

To relieve inflammation, pain in the joint, the doctor prescribes non-steroidal anti-inflammatory drugs: Diclofenac, Meloxicam, Nimesulide.

Drugs or ointments will ease the situation during an exacerbation of the disease.

For vasodilatation, Nikoshpan, Trental, Theonicol, Betamethasone, Hydrocortisol injections, hyaluronic acid are prescribed.

With synovitis, cartilage depletion, corticosteroids are prescribed by injection into the diseased joint.

To enhance blood circulation are prescribed vasodilators: Hyaluronic acid, Injectable corticosteroids to relieve inflammation and swelling.

To maintain joint function chondroprotectors will help. They are necessarily included in the course of treatment, regardless of the choice of method and degree of joint damage.

The knee is treated by intramuscular or intraarticular administration of Glucosamine, Chondrotin sulfate. Chondroitin contains some biopressures, which are also recommended in the treatment of the disease.

With severe pain, the doctor will prescribe analgesics, but each patient must understand that taking medication is not able to cure the disease. This is just a symptomatic relief, a short-term effect to alleviate the patient's condition.

Diet

Spicy, salty, fatty, carbohydrate-rich foods are contraindicated.

Cartilage tissues do not absorb amino acids well, a person quickly gains extra pounds. A lot of the necessary chondroitin is found in crabs, shrimp, and collagen in lean meat.

Surgical method of treatment

Surgical intervention is necessary at the 3rd, advanced stage of the disease.

Arthroscopy is prescribed - an endoscopic operation to remove the destroyed elements of the meniscus, cartilage, nearby damaged structures.

It is also possible to carry out joint arthroplasty, replacing it with an artificial implant - an endoprosthesis, the material for which is steel, titanium, or polyethylene. These materials are strong, durable, will last up to 25 years.

other methods

Orthokine administration obtained from the patient's cells. Blood taken from a vein is processed to produce a protein that can stop the cartilage from breaking down. But, treatment with this method is effective at stages 1-2 of the disease, as soon as the first symptoms appear, with complete destruction of the cartilage, more radical methods of treatment are needed.

Bubnovsky's method is able to improve the nutrition of cartilage, eliminate dysfunction in the muscles of the knee. According to the Bubnovsky method, the patient undergoes treatment on a special simulator to improve the nutrition of joint tissues, work out each muscle group separately, and restore blood microcirculation.

Use of table cells. Cells are taken from the patient by inserting a thin needle into the pelvic bone. After their activation, they are reintroduced into the joint cavity. The method is effective in deforming osteoarthritis of the 2nd degree, stem cells are able to restore the destroyed cartilage in full.

Normal life for the patient, unhindered movement is guaranteed.

Folk ways

They are harmless in the early stages of the disease, quite effective in the treatment of complex.

a) Celandine oil, vegetable oil infusion (2-3 tablespoons) of crushed leaves is rubbed into sore spots.

b) Put burdock (several leaves) in a saucepan, put on fire, steam, then lubricate the knee with vegetable oil and apply burdock to the knee, fix with a warm bandage.

c) Shilajit is ground into powder, diluted with water. The mixture is applied to anesthetize and warm the joint.

d) Blue clay. Grind into powder, dilute with water to the consistency of thick sour cream, apply as a compress, wrap with woolen cloth, leave for 2-3 hours.

e) Dandelions, prepare a tincture. Put the yellow flowers in a dark glass container, pour the usual triple cologne, keep for 2 weeks in a dark place, periodically shaking the container, rub the composition into the diseased joint 2-3 times a day.

f) Mix apple cider vinegar (3 tbsp. L) with honey (1 tbsp. L), rub into sore spots, cover with a cabbage leaf and a bag on top, fix with an elastic bandage. Carry out the procedures daily for 1 month.

Paraffin compresses reduce pain.

It is useful to drink tomato juice, apple cider vinegar 1-2 tsp, 2-3 times a day.

Therapeutic gymnastics and its role

Gymnastics is an excellent addition to medical treatment in combination with compresses and proper nutrition. Exercises should be performed regularly, while the load on the joint is completely eliminated.

The purpose of gymnastics is to reduce pain, strengthen the muscle ligaments around the diseased joint. You can not perform exercises without the appointment and supervision of a doctor, or a trainer.

If done incorrectly, you can cause irreparable damage to the joint. First you need to consult with a physiotherapist, perhaps there are contraindications to the behavior of gymnastics, or you need to take into account certain features during its implementation.

a) Lie on the floor on your back, straighten your sore leg, slowly raise it from the floor to a height of up to 20 cm, keep it up as much as possible.

b) Lie on the floor on your back, tear off the sore leg from the floor up to 20 cm in height, lower it right down, repeat the movements 10-15 times.

It is useful to sit on the edge of the table and dangle your legs, or lying on your back to do the “bike” exercise.

This will strengthen the muscles of the legs, increase the range of motion, nourish the cartilage tissue.

Prevention

1) Watch your weight, obesity leads to increased stress on the joint, then to its destruction.

2) Give up bad habits.

Smoking and alcohol are detrimental to the joints.

3) Wear special knee pads.

If deforming osteoarthritis could not be avoided, the joint must be fixed, so there will be less pain.

4) Wear shoes with insoles, arch supports.

They will support the foot in the desired position.

Deforming osteoarthritis is incurable, but it is still possible to reduce joint pain and stop the progress of the disease.

Prognosis and complications

Deforming osteoarthritis in the knee is a common disease, but it is sometimes difficult to establish the causes of its occurrence. Nevertheless, the destruction of the joint inevitably leads to a limitation of its mobility, up to immobilization, and hence to disability, the inability to move independently.

The appearance of pain is a symptom, a bell that not everything is in order with the joint.

Complications in dystrophic lesions of the knee joint are inevitable:

• Injury to nearby tissues
• Muscle contracture develops
• A patient with immobility develops hypostatic pneumonia.

Do not hesitate to go to the doctor, it is easier to treat the disease at an early stage. With connivance, sometimes there can be no talk of cure. It is possible to replace a destroyed joint with an artificial one, but it is troublesome, expensive and, of course, painful.

Diseases / Osteoarthritis

Osteoarthritis of the knee joint is a very common disease, represented by destructive processes in the joint. The mentioned systemic disease brings a lot of inconvenience in the form of pain, stiffness in movements, swelling of the knee joint.

Like other diseases, gonarthrosis (a similar name is often used) is considered a common disease among similar diseases, 15-30% of the population suffers from osteoarthritis of the knee joint. Despite advances in medicine, the number of people suffering from gonarthrosis is not decreasing, on the contrary, it is increasing. Protracted treatment complicates the situation.

Osteoarthritis of the knee

The stubborn fact is considered an unfavorable trend: treatment is often complicated by late seeking medical help. Not surprisingly, in the initial stages, when a small lesion occurs directly in the joint, people are more likely to write off minor pain and stiffness in movements in the morning as simple fatigue. When the pain becomes obvious, movements bring tangible inconvenience, treatment without surgery is impossible, the joint is destroyed.

Symptoms

Signs in the development of gonarthrosis differ from the degree of development of the disease. In the initial stages, the symptoms are mild, seeking help is rare.

More often the disease is diagnosed already at the third stage of deforming gonarthrosis. In this condition, the patient is observed:

• Constant and excruciating pains, especially worse when going up and down stairs, in the morning.
• The patient and others hear a constant loud crunch in the patient's knee joint.
• The deformation of parts of the joints is visually visible, the amplitude of movement becomes minimal.
• Joint enlargement occurs due to the constant accumulation of fluid in the interarticular bag.

  Curvature of the legs

• The varus curvature of the legs becomes noticeable, the limbs take on an O or X-shape.
• When diagnosing with an x-ray, destruction of the ligaments and menisci is noticed, and the erasure of cartilage is noticeable. Cartilage regrowth is already observed. Treatment becomes more difficult.

The development of grade 3 osteoarthritis in the majority means an early disability. Only implantation can save in advanced cases. If surgery is not performed on time, it is possible:

• Complete fusion - ankylosis;
• The appearance of an incorrect false joint is neoarthrosis.

With the formation of the described consequences, movements already become impossible, a person does not have long to go to a wheelchair.

Osteoarthritis of the knee joint is complicated by sanovitis. The phenomenon is characterized by smoothing of the knee joint and protrusion of tissues from the side. The phenomenon does not affect body temperature, blood tests during diagnosis. Signs are purely external.

General provisions for treatment

Knee gonarthrosis is quite easy to treat at the onset of the disease, with stage 3 or 4 deforming gonarthrosis the situation is much more complicated. It is difficult to completely restore the joint, there are degrees of deformation.

Knee gonarthrosis

When drawing up a scheme according to which third-degree gonarthrosis is treated, the necessary measures are first taken to relieve the pain syndrome. Then doctors are engaged in stopping the inflammatory process and restoring mobility. If the medical measures taken do not give a result, in the third degree, in the fourth, surgical intervention will be required.

At the first stage, the patient is prescribed anti-inflammatory drugs that relieve pain and make movements possible. After stopping inflammation and relieving pain, the doctor prescribes procedures to restore joint mobility. Eg:

• Physiotherapy procedures;
• Massotherapy;
• Gymnastics.

To restore cartilage tissue, doctors will prescribe chondroprotectors that act on the affected joint and restore it. Thanks to the reception, the production of joint fluid is stimulated, which helps the regenerative processes of cartilage tissue. With advanced forms of the disease, the third and fourth stages, taking protective drugs is completely useless, there is simply nothing to restore after the destruction that has occurred. Any treatment should be carried out for a duration of three months. Drugs, especially anti-inflammatory drugs, cause sensitive damage to the stomach, causing the development of gastritis or ulcers.

In the treatment of deforming knee osteoarthritis, the use of injections of hyaluronic acid is effective, which at the third stage no longer gives a therapeutic effect, it is used only to reduce symptoms and alleviate the condition.

The maximum result can be achieved in the treatment of the third degree of osteoarthritis using the traction method, which is combined with physiotherapy. The method involves the physical separation of the joints, which allows to increase the size of the joint space and reduce the load on the joint. Thanks to the parallel physiotherapy procedures, an improvement in blood circulation and tissue condition is achieved. Pain is relieved when a spasm occurs.

To relieve the load on the joints, in the treatment of the disease, the patient is recommended to regularly use a cane, which reduces it by up to 40%. It is important to choose the right cane according to your height, it is better if the model comes with a rubber non-slip tip.

Surgery

If the treatment of gonarthrosis of the knee joint is not obtained by conservative methods, the doctor directs the patient for surgery. The choice of the type of surgical intervention depends on the type of lesion and the goals to be achieved. Signs of damage are important.

Performed:

1. Puncture. The type of operation involves the removal of excess fluid in the interarticular gap with further administration of hormonal preparations.

   Knee puncture

2. Osteotomy of the tibia transcondylar. With this option, the axis of joint deformity is restored.
3. Arthrodesis. The operation is rarely performed when fused bone surfaces are observed.
4. Arthrolysis. During the operation, the fused synovial membranes and walls are removed. Thanks to this surgical intervention, a large amplitude of movement of the affected knee joint is achieved.
5. Arthroplasty. Decreased cartilage in the joint. Thanks to the procedure, a flattened surface of the knee joint is formed. Manipulation is used extremely rarely, the joint becomes unstable.
6. Endoprosthetics. As a result of the procedure, the damaged joint of the implant is replaced. With an advanced stage of the development of the disease - the only way to partially restore the mobility of the joint.

During the last operation, it is important to follow the recommendations of the rehabilitation period. To obtain the maximum effect in the first days, it is required to make gradual movements under the strict supervision of medical personnel. If the patient's condition after the operation is satisfactory, it is shown to get up on the second day.

To develop the joint, special exercises are gradually introduced to the patient, which will help to recover faster. If there are no complications, the rehabilitation period reaches six months. You will need to constantly be in touch with your doctor and report on changes that occur with the knee joint. Sometimes non-standard knee joint pain or sensations are caused by circulatory disorders, damage to nerves or blood vessels.

Treatment is most effective if done on time and in the early stages.

Consequences of the disease

If you start the process of the course of the disease up to stage 3, and then stage 4, the cartilage tissue will be completely erased. The bone becomes exposed, becomes severely deformed. Arthrosis, which flows into the 4th stage of development, leads to complete immobilization of the knee joint.

Launched treatment in the third stage provokes the flow of the disease to the fourth degree and makes a person disabled, who is no longer able to fully move the knee joint. If arthrosis of the 3rd degree is diagnosed when contacting the hospital, doctors talk about a negligent and inattentive attitude to health. Treatment at an early stage is easy and fast.

In the early stages of arthrosis, the elimination of the disease often does not present problems, prevention is enough. However, in the event that you have developed arthrosis of the 3rd degree of the knee joint, treatment becomes very problematic.

Basically, the treatment of grade 3 arthrosis is aimed at eliminating pain, returning the mobility of the knee joint and preventing inflammation. Anti-inflammatory drugs are used for no more than 3 months, and after the pain syndrome is relieved, massage, gymnastics and physiotherapy are used.

In this article, you will learn how arthrosis of the 3rd degree of the knee joint is treated with traditional and folk remedies, methods for relieving pain and inflammation, as well as the prevention of this disease.

What is arthrosis?

arthrosis 3 degrees of the knee joint treatment

It should be noted that arthrosis is a whole group of joint diseases that have different origins and similar mechanisms of development.

The most common arthrosis of large joints:

• deforming arthrosis of the knee joint (gonarthrosis)
• deforming arthrosis of the hip joint (coxarthrosis)
• shoulder arthrosis

These are the most severe types of arthritis.

Arthrosis of small joints is less common. More common are deforming arthrosis of the interphalangeal joints of the hands, as well as the metacarpophalangeal joints of the thumbs. Patients note pain in the interphalangeal joints, a decrease in their mobility, the appearance of seals near the joints (Heberden's and Bouchard's nodes).

This type of arthritis is more common in the elderly. Often there is arthrosis of the joints of the foot. Polyarthrosis, or generalized arthrosis, is characterized by damage to several joints at once. Arthrosis of the joints of the spine - spondylarthrosis - belongs to the group of diseases of the spine, although it has a mechanism of development similar to other arthrosis.

The main clinical symptom of arthrosis is joint pain, decreased mobility. Specific symptoms are determined by the stage of arthrosis and depend on the degree of destructive changes in the joint.

What is the danger of arthrosis of the 3rd degree?

The methods of treating gonarthrosis of the 3rd degree have similarities and differences with the methods of treating other degrees of the disease. As in the early stages, apply:

• load reduction
• taking painkillers and anti-inflammatory drugs
• physiotherapy
• diet

Intra-articular injections of hyaluronic acid, effective at degrees 1 and 2 of arthrosis, chondroprotectors designed to restore cartilage tissue, at degree 3 of the disease bring only temporary relief.

At the 3rd stage of gonarthrosis, when the articular cartilage is almost destroyed, and the bones have undergone significant changes, conservative treatment is not enough - in this case, they resort to surgical intervention.

Surgical treatment of gonarthrosis includes several technologies, of which two are most often practiced:

1. Surgery to remove osteophytes and deformed bone elements. Such operations are less traumatic and are carried out using an arthroscope - an instrument that can be manipulated through several holes.
2. Endoprosthetics - replacement of a destroyed knee joint with an implant.

Arthrodesis (fixing the joint with fused bone surfaces) and arthrolysis (removal of bone adhesions and thickened synovial membranes in order to increase the range of motion in the joint) are performed much less frequently.

Causes of the disease

The causes of arthrosis are not only diverse, but can also arise from opposite extremes. They can also be congenital or acquired.

The main causes of arthritis are:

• genetic changes that lead to the rapid destruction of cartilage tissue;
• birth defects such as joint dysplasia or flat feet;
• traumatization: joint injuries; bone fractures; hypodynamia; excessive physical activity, including due to excess weight; incorrect posture, flat feet, as well as O- and X-shaped deformations; transferred operations)
• inflammatory diseases of the joints resulting from infections or hypothermia;
• various endocrine disorders and nutritional deficiencies;
• violation of the production of synovial fluid, which is a lubricant in the mechanism of movement of the joints;
• hormonal and autoimmune diseases, including the menopausal period in women;
• vascular disease and, as a result, malnutrition of the tissues of the joint.

The disease can be primary and secondary, that is, it can occur as a result of another disease.

Symptoms of arthrosis of the 3rd degree

With grade 3 gonarthrosis, all the symptoms of the early stages (stiffness and pain in the knee area, crunching when moving) increase, and new ones are added to them. The pain becomes very strong, sometimes unbearable, and persists at rest. Patients are often forced to remain in bed, but even then they are not always able to find a position that is relatively painless for the leg.

The next most important symptom of the 3rd degree of arthrosis is a significant limitation of joint mobility caused by its deformation. The patient has difficulty flexing the leg even to an angle of 90 degrees and cannot completely straighten it. This limits the ability to walk normally.

The characteristic signs of the 3rd degree of gonarthrosis also include:

1. accumulation in the joint bag of effusion - synovial fluid (synovitis),
2. reduction of the interarticular gap,
3. replacement of cartilage cells with connective tissue (sclerosis of the subchondral zone),
4. deposition of salts on the surface of the joint.

Sometimes a blockade of the knee joint develops when the affected leg cannot be flexed or extended. Due to the deformity of the joint in arthrosis, the legs often acquire an X- or O-shape, which causes gait disturbances.

Stages and degrees of arthrosis

In Russia, the classification of arthrosis based on clinical and radiological signs, proposed by N. Kosinskaya (1961), is considered “classical”. In accordance with it, three stages of the development of the disease are distinguished.

It corresponds to the classification according to the degree of ability to work (according to A.I. Nesterov), which distinguishes 3 degrees of arthrosis:

• I degree of arthrosis - the disease does not interfere with the performance of work, although it makes it difficult,
• II degree of arthrosis - the disease prevents the performance of work,
• III degree of arthrosis - disability.

Arthrosis of the 1st degree (the initial stage of arthrosis). In the initial stage of the disease in the morning, after rest, there is stiffness, difficulty in movement in the joints, which gradually disappears some time after the start of movement. There may be some limitation of mobility in the joint.

Periodically there are "starting" pains (pain at the beginning of movement after a long stay at rest). With sudden movements, the joint crunches, but there is no pain during movement.

Pain at this stage of arthrosis appears only with a significant and prolonged load, and subsides after rest. There is no pain at rest or with light exertion. At this stage of the disease, patients rarely see a doctor.

On an x-ray with arthrosis of the 1st degree, no special changes in the joint are visible, sometimes small osteophytes can be seen along the edges of the joint, the joint space is slightly narrowed.

Arthrosis of the 2nd degree (second stage of arthrosis). With the further development of arthrosis, the pain becomes more significant, acquires an acute character. A distinct crunch in the joint appears with any movement, there is a noticeable limitation of mobility in the joint (contracture), functional shortening of the limb, violations of the biomechanics of movements, but the mobility of the joint is still preserved.

At this stage, a noticeable increase in starting pains is characteristic, they become sharp and more prolonged. Under the influence of daily physical activity, constant fatigue appears, a feeling of pressure in the affected joints, so-called "mechanical pain" occurs, caused by a decrease in the depreciation abilities of the cartilaginous tissues of the joint.

The destruction in the joint is already quite significant, the joints are already beginning to partially deform. On radiographs, noticeable osteophytes are visible, narrowing of the joint space by 2-3 times compared to the norm, sclerosis of the subchondral bone and the formation of cystic cavities in the epiphyseal zone are observed.

Arthrosis of the 2nd degree is characterized by a decrease in working capacity, the inability to perform certain types of work.

Arthrosis of the 3rd degree is a severe, advanced stage of the disease. At this stage, there are:

• significant deformation of the joint (due to the growth of bones and the accumulation of fluid in the joint cavity);
• a sharp restriction of movements, up to the preservation of only rocking movements;
• sharp pain not only when moving, but also in a state of complete rest - constant pain associated with reflex spasm of nearby muscles, as well as the development of reactive synovitis
• inflammation of the joints
• joint sensitivity to weather changes
• muscles around the knee are spasmodic and atrophied

The axis of the limb is deformed, varus or valgus curvature of the legs is noticeable (that is, in the shape of the letter "O" or "X"). On radiographs with arthrosis of the 3rd degree, there is an almost complete disappearance of the joint space, a pronounced deformation of the articular surfaces, extensive multiple marginal osteophytes.

Articular mice and calcification of paraarticular tissues can be determined. In the 3rd degree, the disease has gone very far, often it is already the cause of permanent disability.

It appears as follows:

1. the pain becomes constant and excruciating: walking, and especially descending and climbing stairs, is a difficult test for the patient;
2. a loud crunch with any movement, well audible to others;
3. the deformation of the joints is strongly pronounced, the movements are limited to only a small amplitude or even impossible;

The images show the destruction of intra-articular structures (ligaments and menisci), as well as complete abrasion of cartilage and signs of sclerosis (replacement of functioning organs and structures by connective tissue).

The state of complete destruction of the joint in arthrosis, when the joint completely ceases to function, is often distinguished into a separate - 4th degree of arthrosis. There is a so-called "blockade of the joint" - an acute pain syndrome, in which even limited movement in the diseased joint is impossible.

The fourth degree of arthrosis is accompanied by unbearable pain in the joints, which are not relieved even by potent painkillers and intensive physiotherapy.

Complete ankylosis (joint fusion) or neoarthrosis (formation of a false joint between the displaced ends of the bones) is possible.

Independent movement in both cases is almost impossible. The pictures show a rough sclerosis of the articulated surfaces with pronounced cystic enlightenments, the fusion of the connecting bones in the area of ​​the joint space. The development of the disease to this stage almost always means disability, which can only be prevented by the implantation of an artificial joint prosthesis.

Arthrosis of the 3rd degree of the knee joint - treatment

Knee osteoarthritis is easily treatable in the early stages, when even simple prevention may be sufficient. But at grade 3 (not to mention 4), treatment becomes problematic, since arthrosis of the knee severely deforms the joint, and it is extremely difficult to restore it.

In the treatment of gonoarthrosis of the 3rd degree of strength, first of all, the removal of pain, inflammation and the return of mobility of the knee joint are directed. However, if all the means used prove to be useless, then, as with the 4th degree, the only way out will be an operation.

Treatment of gonoarthrosis in the 3rd degree begins with the removal of puffiness with the help of anti-inflammatory drugs. With the removal of edema, the intensity of pain decreases and the general condition of the patient improves. When the pain subsides, you can begin treatment with physiotherapy, gymnastics and therapeutic massage.

It is important to remember that the course of taking anti-inflammatory drugs should not exceed 3 months, because otherwise you can severely damage the gastric mucosa, which is fraught with problems such as gastritis and even an ulcer.

To help the body restore damaged cartilage tissue, chondroprotectors are used that affect the very cause of gonoarthrosis. When they are taken, the joint fluid necessary for the normal functioning of the knee joint is produced better.

However, at 3 degrees (and even more so at 4), they may be useless, since there is nothing to restore. Effective at the first two stages of the disease, injections with hyaluronic acid into the joint by 3 only alleviate the patient's condition for a while.

Much better results with advanced knee arthrosis up to stage 3 are shown by the traction method, which is combined with physiotherapy. With traction, the bones are bred and, accordingly, the interarticular gap becomes wider, and the load on the joint becomes less.

Physiotherapy significantly improves the condition of the tissues and blood circulation of the knee joint, even with severe grade 3 disease.

For more effective treatment of gonoarthrosis, you need to use a cane, since walking with it removes about 40% of the load from the diseased knee joint.

It is important to choose a cane according to height (from the wrist to the floor with arms extended down). It is advisable to give preference to a cane with a rubber nozzle, as it does not slip and absorbs well.

Medical treatment

For therapy use:

1. non-steroidal anti-inflammatory drugs (NSAIDs)
2. chondroprotectors
3. hormonal preparations for intraarticular administration
4. glucocorticoid hormones

NSAID preparations are suitable for relieving pain during an exacerbation of the disease. Drug treatment is aimed more at improving the patient's quality of life than at curing osteoarthritis. Medicines for the treatment of DOA (ibuprofen, diclofenac, and others) are taken only after meals.

The popularity of drugs based on glucosamine and chondroitin sulfate is growing. These are chondroprotectors. They are available in tablet form and as intramuscular injections. The drugs contribute to the restoration of cartilage tissue, but in advanced cases they will not help much: new cartilage tissue will not grow.

In the early stages, a course of intra-articular injections of chondroprotectors with hyaluronic acid shows good results. For treatment, intra-articular injections of corticosteroid hormonal drugs are also used to relieve general pain. This group includes hydrocortisone, diprospan, kenalog.

It must be understood that these drugs will not help patients with a clearly visible deformation of the bones and curvature of the legs.

The most popular drugs:

1. Hydrocortisone is a corticosteroid drug. Available in the form of ointment and suspension for injection. Effective in the first and second degree of osteoarthritis. The drug is identical to cortisone, but has a more pronounced effect.
2. Diclofenac is an anti-inflammatory drug in the form of tablets, suppositories, injection solutions, and topical agents. It is well tolerated by patients and gives a positive effect in complex therapy.
3. Diprospan is a glucocorticoid drug with anti-inflammatory action. The method of administration is chosen based on the severity of the disease.

Choosing what to treat, you need to be guided by the principle - do no harm. In the complex treatment of DOA of the knee joint, ointments, creams, gels are used to improve blood circulation in the tissues. They also reduce pain and swelling.

Complementary Therapies

There is a misconception that with diseased joints, you need to lie down and move less. “Movement is life”, this statement perfectly reflects the need for movement for people with diseases of the musculoskeletal system.

In the treatment of arthrosis of the knee joint, after the removal of the pain syndrome, the patient is prescribed physiotherapy exercises. Physical exercises strengthen muscles, reduce tension in diseased joints, and activate blood circulation in them.

To strengthen the muscles, you need to do such an exercise - lie on your back, lift your leg up and hold it like that for about 2 minutes. A feeling of fatigue in the muscles will appear, but the joint will not experience any physical stress. In addition to strengthening the muscular apparatus, exercises should be performed to stretch the joint capsules and ligaments.

It should be taken into account that the exercises should not be dynamic, but gentle, not exerting excessive physical stress on the diseased joint. For example, squats are not recommended.

We do such exercises measuredly, smoothly, slightly stretching the legs in turn and pressing on the joint. If an exercise causes pain or discomfort, stop doing it. Therapeutic exercise is contraindicated during an exacerbation of the disease.

In addition to physiotherapy exercises, additional methods of treating gonarthrosis include:

• massage
• manual therapy
• laser therapy
• acupuncture
• cryotherapy - cold treatment
• magnetotherapy
• hydrocortisone phonophoresis
• hirudotherapy - treatment with leeches
• electrophoresis with novocaine
• thermal procedures using paraffin, ozocerite, therapeutic mud
• cauterization with wormwood cigarettes

For each patient, a rheumatologist or orthopedist develops his own special course of procedures, depending on the degree of the disease and his physical condition.

Surgical treatment

At grade 4 (and sometimes at 3), when osteoarthritis of the knee can no longer be cured by conservative methods, the doctor suggests that the patient undergo surgery.

Depending on the characteristics of the disease, various operations are performed:

1. A puncture, when excess fluid is removed from the cavity of the knee joint, and then hormonal preparations are injected into it.
2. Osteotomy of the tibia is transcondylar, when the deviation of the axis of the deformed knee joint is corrected.
3. Arthrodesis, when a knee joint is resected with fused bone surfaces. This operation is carried out (even at 3 and 4 degrees) very rarely.
4. Arthrolysis is the removal of altered and / or thickened synovial membranes and adhesions so that the joint can move in a larger volume.
5. Arthroplasty is the reduction of the remnants of the cartilage of the joints and the formation of a simplified surface of the affected knee joint. Due to the possible development of joint instability, such an operation is performed very rarely.
6. Endoprosthetics - replacement of a diseased destroyed knee joint with an implant. This is the only way to restore joint mobility if osteoarthritis has reached grade 4.

During endoprosthetics, special attention is paid to rehabilitation. Already in the first days after the operation, the patient begins to make the first movements of the restored joint. With a general satisfactory condition, the patient can get up for the first time already on the second day.

During rehabilitation, the patient, under the supervision of a doctor, performs various exercises that develop the joint and strengthen the muscles. On average, rehabilitation lasts about 6 months. All changes, even the smallest ones, must be reported to the doctor, because they may be the result of damage to the nerve or blood vessel.

In order not to bring the disease to surgery, be sure to listen to your body. Whatever the disease is, it is easier to treat a baker's cyst of the knee joint, gonoarthrosis or any other disease in the initial stages.

Treatment of arthrosis with folk remedies

Official medicine claims that no one has yet been able to restore a joint destroyed by arthrosis, you can only slow down the disease.

Basically, the treatment of arthrosis with folk remedies is based on increasing the general tone of the body, improving blood circulation, increasing immunity and relieving pain.

At the same time, there are many cases when people used folk remedies in the treatment of arthrosis and achieved excellent results without drugs.

Folk remedies are used for the treatment of arthrosis in the form of tinctures (decoctions, mixtures) of hot and cold medical compresses, rubbing (ointments) and wraps.

Let us consider in more detail the main recipes for the treatment of arthrosis with folk remedies:

• Tincture on rye grains. For one course, you will need 1 kg of rye grain, which should be poured with 7 liters of water, put on fire and bring to a boil. Allow to cool, then strain and then add a kilogram of natural honey, three teaspoons of barberry root and half a liter of vodka. Mix everything until the honey dissolves and put in a dark, cool place for three weeks. Take the remedy should be half an hour before meals, three tablespoons.
• Bay leaf tincture. Pour 10 g of dry bay leaf with a glass of boiling water, put on fire and continue to boil for another five minutes. Let the broth brew for five hours. The decoction should be taken throughout the day, drinking in small sips. The decoction should be prepared and taken within three days. It is recommended to repeat the procedure after a week.
• Garlic tincture. Mix olive oil with garlic juice or grated garlic paste in a ratio of 1:10. In the absence of olive oil, you can use corn oil, but the proportion will be already 1:12. Take half a teaspoon of this mixture before breakfast daily. It prevents the occurrence of pain and brings a general improvement in well-being in arthrosis.

Compresses and rubbing are also used for treatment:

1. Cabbage juice compress. To obtain cabbage juice, grind the head of cabbage and then rinse the cabbage well with your hands or with a mortar in a non-oxidizing bowl. Pour everything into a juicer and squeeze out the juice. Take a thick, soft weave made of natural wool without synthetic impurities, moisten it well with the resulting cabbage juice and apply such a compress to the sore spot.
2. Chalk compress with fermented milk products. Grind ordinary white chalk very finely. For this, it is best to use the one used for writing on the blackboard at school. Pour the crushed chalk with curdled milk, kefir or sour cream and mix well. Apply the resulting paste to the diseased joint, cover with a film and apply a bandage. Such a compress is done at night.
3. Oatmeal compress. The use of boiled oatmeal also gives good results. Take three to four tablespoons of oatmeal, pour boiling water over it and cook over low heat for five to seven minutes. The amount of water used should provide a thick porridge that should be cooled and used as a compress overnight.
4. Rubbing from propolis. Melt the amount of propolis you need in a water bath and mix it with sunflower or corn oil. Cool the mixture and rub into the skin around the joint for pain and at night.
5. Rubbing from hellebore. To prepare the ointment, you will need a plant such as hellebore Caucasian, 20 grams of which should be carefully chopped. After that, add 10 g of vegetable oil, 20 g of honey and 5 g of mustard powder to it. Heat the mixture in a water bath and let cool. Store in a dark place at room temperature.
6. Rubbing from chicken eggs. Mix two tablespoons of ammonia with the same amount of turpentine. Crack two raw chicken eggs into the resulting mixture and mix everything thoroughly. This composition should be used to rub the joints before going to bed.

Unfortunately, traditional medicine, like traditional medicine, does not know the methods for the complete cure of arthrosis. However, it is quite capable of improving the metabolism and supply of nutrients to the joints, prolonging their life.

Remedies for pain, swelling and cramps

To relieve pain during treatment, various non-steroidal drugs are used, mainly in the form of tablets and injections (diclofenac, piroxicam, nimulide, etc.).

Of the topical preparations - Nanoplast patch, Dimexide solution, medical bile in the form of lotions, but before using Dimexide, it is necessary to test for an allergic reaction. The doctor should choose the optimal treatment.

The drugs will help to anesthetize the joint, make movements more free. Without this, it is impossible to undertake further treatment of the diseased joint. But on this, in no case, you can not calm down, since the main problem has not been solved, the disease can return at any moment.

It is imperative to undergo a course of treatment with chondroprotectors - drugs that restore articular cartilage. The chondroitin sulfate contained in them - a natural component of cartilage (single products Artiflex, Dona) and glucosamine (drugs Artron chondrex, Structum) start the processes of regeneration of the cartilaginous tissue of the diseased joint.

There are many chondroprotectors of various cost, they should be selected individually at a doctor's consultation. Chondroprotectors in injections are diluted with solvents. In addition to drugs, there are many dietary supplements containing chondroitin and glucosamine (Sustanorm, Stopartrit, etc.).

These dietary supplements are not drugs and have not been clinically tested, so it is not recommended to use them as a treatment. Widely used in the treatment of arthrosis of the knee joint intraarticular injection of drugs. Injections directly into the diseased joint help to quickly relieve pain, inflammation, swelling.

Their advantage is that the medicine goes directly to the diseased cartilage and treats the problem, and not just removes the pain. In this way, glucocorticoids (flosterone, hydrocortisone, kenalog and other corticosteroid hormones) are introduced, which are used in the acute period of the disease to relieve pain and swelling.

Hormonal drugs have a lot of side effects.

Hyaluronic acid preparations (sodium hyaluronate, ostenil, viscoplus, etc.), when injected into the joint cavity, replace healthy synovial fluid, lubricate the articular surfaces and nourish the cartilage.

Consequences of the disease

If you start arthrosis and allow its development to degree 3, then the disease can go to the final, degree 4, when the bone is exposed, the cartilage has completely disappeared, and the joint is severely deformed. All these factors lead to the fact that at grade 4 arthrosis causes complete immobilization of the knee joint, which can only be corrected by prosthetics.

In the absolute majority of cases, with grade 4 osteoarthritis of the knee, the patient becomes disabled with completely lost functions of the knee joint.

If the patient allowed the development of gonoarthrosis to 3 or even 4 degrees, this only speaks of inattention and neglect of one's own health, since modern medicine makes it possible to diagnose and treat knee arthrosis, starting from the earliest stages.

If you neglect the morning stiffness, swelling and slight aching pain, then you can one day find twisted legs, lameness and a changed gait.

Therefore, it is very important to treat osteoarthritis on time, and not to use ointments available in any pharmacy for the treatment of joints, but by contacting a competent doctor. Moreover, today medicine has a wide range of methods and means for the treatment of gonoarthrosis.

If you do not start arthrosis of the knee to 3 or 4 degrees, there are many chances to cure the disease completely.

Prevention of arthrosis

It is not difficult to prevent the occurrence of osteoarthritis of the knee joint if you think about it from a young age. How are prevention rules formed? Very simple.

Read the causes of the disease and do everything to avoid them, namely:

• Do not overeat, stick to a sparing diet and the principles of proper nutrition
• Distribute physical activity wisely
• Do not get cold
• Treat any disease promptly
• Avoid injury
• Do gymnastics
• Contact a specialist promptly

During the treatment of arthrosis, patients must follow a strict diet.

The food should be rich in a large amount of protein, which means that the following foods should be included in it:

1. poultry and rabbit meat;
2. dairy products and cheeses;
3. legumes;
4. nuts.

Products containing gelatin, such as jelly, jelly, have a good effect on sore joints. Aspic also contains a large amount of collagen. However, a contraindication to the use of large quantities of jelly is a predisposition to excess weight, because this dish is high in calories.

It is equally important to observe the drinking regimen. If no kidney problems have been previously identified, it is recommended to drink approximately 2 liters of water per day.

There are also foods that should not be consumed when suffering from arthrosis. These include:

• sweet carbonated drinks;
• spicy dishes, especially with flavor enhancers;
• fatty;
• semi-finished products;
• cabbage;
• tomatoes;
• Bell pepper;
• grape;
• bananas.

These are foods that contribute to increased salt formation in the body. And so they can only make the situation worse.
If a patient has grade 3 arthrosis in the ankle joint, then the patient may be referred for a surgical procedure, up to replacing the affected joint with a prosthesis.

Prosthetics are carried out on plastic or metal prostheses. The operation takes place under endotrachial or epidural anesthesia. In rare cases, operations are performed in which partial joint replacements are made. This is an effective way to restore the former mobility of the joint and restore the patient's freedom of movement.

Arthrosis is a disease that is easy enough to diagnose on your own. There is no need to wait until sharp pains arise in the joints, and it becomes problematic to move. At the first sign of difficulty in movement, you can start doing physical education. And by balancing the diet, patients can easily stop the pathological process.

In the early stages of arthrosis, the elimination of the disease often does not present problems, prevention is enough. However, in the event that you have developed arthrosis of the 3rd degree of the knee joint, treatment becomes very problematic.

Basically, the treatment of grade 3 arthrosis is aimed at eliminating pain, returning the mobility of the knee joint and preventing inflammation. Anti-inflammatory drugs are used for no more than 3 months, and after the pain syndrome is relieved, massage, gymnastics and physiotherapy are used.

In this article, you will learn how arthrosis of the 3rd degree of the knee joint is treated with traditional and folk remedies, methods for relieving pain and inflammation, as well as the prevention of this disease.

What is arthrosis?

Arthrosis (deforming arthrosis, popular name - salt deposition) is a chronic joint disease of a degenerative-dystrophic nature, in which the destruction of the articular cartilage, the joint capsule, and the deformation of the bone itself occur.

It should be noted that arthrosis is a whole group of joint diseases that have different origins and similar mechanisms of development.

The most common arthrosis of large joints:

• deforming arthrosis of the knee joint (gonarthrosis)
• deforming arthrosis of the hip joint (coxarthrosis)
• shoulder arthrosis

These are the most severe types of arthritis.

Arthrosis of small joints is less common. More common are deforming arthrosis of the interphalangeal joints of the hands, as well as the metacarpophalangeal joints of the thumbs. Patients note pain in the interphalangeal joints, a decrease in their mobility, the appearance of seals near the joints (Heberden's and Bouchard's nodes).

This type of arthritis is more common in the elderly. Often there is arthrosis of the joints of the foot. Polyarthrosis, or generalized arthrosis, is characterized by damage to several joints at once. Arthrosis of the joints of the spine - spondylarthrosis - belongs to the group of diseases of the spine, although it has a mechanism of development similar to other arthrosis.

The main clinical symptom of arthrosis is joint pain, decreased mobility. Specific symptoms are determined by the stage of arthrosis and depend on the degree of destructive changes in the joint.

What is the danger of arthrosis of the 3rd degree?

The methods of treating gonarthrosis of the 3rd degree have similarities and differences with the methods of treating other degrees of the disease. As in the early stages, apply:

• load reduction
• taking painkillers and anti-inflammatory drugs
• physiotherapy
• diet

Intra-articular injections of hyaluronic acid, effective at degrees 1 and 2 of arthrosis, chondroprotectors designed to restore cartilage tissue, at degree 3 of the disease bring only temporary relief.

At the 3rd stage of gonarthrosis, when the articular cartilage is almost destroyed, and the bones have undergone significant changes, conservative treatment is not enough - in this case, they resort to surgical intervention.

Surgical treatment of gonarthrosis includes several technologies, of which two are most often practiced:

1. Surgery to remove osteophytes and deformed bone elements. Such operations are less traumatic and are carried out using an arthroscope - an instrument that can be manipulated through several holes.
2. Endoprosthetics - replacement of a destroyed knee joint with an implant.

Arthrodesis (fixing the joint with fused bone surfaces) and arthrolysis (removal of bone adhesions and thickened synovial membranes in order to increase the range of motion in the joint) are performed much less frequently.

Causes of the disease

The causes of arthrosis are not only diverse, but can also arise from opposite extremes. They can also be congenital or acquired.

The main causes of arthritis are:

• genetic changes that lead to the rapid destruction of cartilage tissue;
• birth defects such as joint dysplasia or flat feet;
• traumatization: joint injuries; bone fractures; hypodynamia; excessive physical activity, including due to excess weight; incorrect posture, flat feet, as well as O- and X-shaped deformations; transferred operations)
• inflammatory diseases of the joints resulting from infections or hypothermia;
• various endocrine disorders and nutritional deficiencies;
• violation of the production of synovial fluid, which is a lubricant in the mechanism of movement of the joints;
• hormonal and autoimmune diseases, including the menopausal period in women;
• vascular disease and, as a result, malnutrition of the tissues of the joint.

The disease can be primary and secondary, that is, it can occur as a result of another disease.

Symptoms of arthrosis of the 3rd degree

With grade 3 gonarthrosis, all the symptoms of the early stages (stiffness and pain in the knee area, crunching when moving) increase, and new ones are added to them. The pain becomes very strong, sometimes unbearable, and persists at rest. Patients are often forced to remain in bed, but even then they are not always able to find a position that is relatively painless for the leg.

The next most important symptom of the 3rd degree of arthrosis is a significant limitation of joint mobility caused by its deformation. The patient has difficulty flexing the leg even to an angle of 90 degrees and cannot completely straighten it. This limits the ability to walk normally.

The characteristic signs of the 3rd degree of gonarthrosis also include:

1. accumulation in the joint bag of effusion - synovial fluid (synovitis),
2. reduction of the interarticular gap,
3. replacement of cartilage cells with connective tissue (sclerosis of the subchondral zone),
4. deposition of salts on the surface of the joint.

Sometimes a blockade of the knee joint develops when the affected leg cannot be flexed or extended. Due to the deformity of the joint in arthrosis, the legs often acquire an X- or O-shape, which causes gait disturbances.

Stages and degrees of arthrosis

In Russia, the classification of arthrosis based on clinical and radiological signs, proposed by N. Kosinskaya (1961), is considered “classical”. In accordance with it, three stages of the development of the disease are distinguished.

It corresponds to the classification according to the degree of ability to work (according to A.I. Nesterov), which distinguishes 3 degrees of arthrosis:

• I degree of arthrosis - the disease does not interfere with the performance of work, although it makes it difficult,
• II degree of arthrosis - the disease prevents the performance of work,
• III degree of arthrosis - disability.

Arthrosis of the 1st degree (the initial stage of arthrosis). In the initial stage of the disease in the morning, after rest, there is stiffness, difficulty in movement in the joints, which gradually disappears some time after the start of movement. There may be some limitation of mobility in the joint.

Periodically there are "starting" pains (pain at the beginning of movement after a long stay at rest). With sudden movements, the joint crunches, but there is no pain during movement.

Pain at this stage of arthrosis appears only with a significant and prolonged load, and subsides after rest. There is no pain at rest or with light exertion. At this stage of the disease, patients rarely see a doctor.

On an x-ray with arthrosis of the 1st degree, no special changes in the joint are visible, sometimes small osteophytes can be seen along the edges of the joint, the joint space is slightly narrowed.

Arthrosis of the 2nd degree (second stage of arthrosis). With the further development of arthrosis, the pain becomes more significant, acquires an acute character. A distinct crunch in the joint appears with any movement, there is a noticeable limitation of mobility in the joint (contracture), functional shortening of the limb, violations of the biomechanics of movements, but the mobility of the joint is still preserved.

At this stage, a noticeable increase in starting pains is characteristic, they become sharp and more prolonged. Under the influence of daily physical activity, constant fatigue appears, a feeling of pressure in the affected joints, so-called "mechanical pain" occurs, caused by a decrease in the depreciation abilities of the cartilaginous tissues of the joint.

The destruction in the joint is already quite significant, the joints are already beginning to partially deform. On radiographs, noticeable osteophytes are visible, narrowing of the joint space by 2-3 times compared to the norm, sclerosis of the subchondral bone and the formation of cystic cavities in the epiphyseal zone are observed.

Arthrosis of the 2nd degree is characterized by a decrease in working capacity, the inability to perform certain types of work.

Arthrosis of the 3rd degree is a severe, advanced stage of the disease. At this stage, there are:

• significant deformation of the joint (due to the growth of bones and the accumulation of fluid in the joint cavity);
• a sharp restriction of movements, up to the preservation of only rocking movements;
• sharp pain not only when moving, but also in a state of complete rest - constant pain associated with reflex spasm of nearby muscles, as well as the development of reactive synovitis
• inflammation of the joints
• joint sensitivity to weather changes
• muscles around the knee are spasmodic and atrophied

The axis of the limb is deformed, varus or valgus curvature of the legs is noticeable (that is, in the shape of the letter "O" or "X"). On radiographs with arthrosis of the 3rd degree, there is an almost complete disappearance of the joint space, a pronounced deformation of the articular surfaces, extensive multiple marginal osteophytes.

Articular mice and calcification of paraarticular tissues can be determined. In the 3rd degree, the disease has gone very far, often it is already the cause of permanent disability.

It appears as follows:

1. the pain becomes constant and excruciating: walking, and especially descending and climbing stairs, is a difficult test for the patient;
2. a loud crunch with any movement, well audible to others;
3. the deformation of the joints is strongly pronounced, the movements are limited to only a small amplitude or even impossible;

The images show the destruction of intra-articular structures (ligaments and menisci), as well as complete abrasion of cartilage and signs of sclerosis (replacement of functioning organs and structures by connective tissue).

The state of complete destruction of the joint in arthrosis, when the joint completely ceases to function, is often distinguished into a separate - 4th degree of arthrosis. There is a so-called "blockade of the joint" - an acute pain syndrome, in which even limited movement in the diseased joint is impossible.

The fourth degree of arthrosis is accompanied by unbearable pain in the joints, which are not relieved even by potent painkillers and intensive physiotherapy.

Complete ankylosis (joint fusion) or neoarthrosis (formation of a false joint between the displaced ends of the bones) is possible.

Independent movement in both cases is almost impossible. The pictures show a rough sclerosis of the articulated surfaces with pronounced cystic enlightenments, the fusion of the connecting bones in the area of ​​the joint space. The development of the disease to this stage almost always means disability, which can only be prevented by the implantation of an artificial joint prosthesis.

Arthrosis of the 3rd degree of the knee joint - treatment

Knee osteoarthritis is easily treatable in the early stages, when even simple prevention may be sufficient. But at grade 3 (not to mention 4), treatment becomes problematic, since arthrosis of the knee severely deforms the joint, and it is extremely difficult to restore it.

In the treatment of gonoarthrosis of the 3rd degree of strength, first of all, the removal of pain, inflammation and the return of mobility of the knee joint are directed. However, if all the means used prove to be useless, then, as with the 4th degree, the only way out will be an operation.

Treatment of gonoarthrosis in the 3rd degree begins with the removal of puffiness with the help of anti-inflammatory drugs. With the removal of edema, the intensity of pain decreases and the general condition of the patient improves. When the pain subsides, you can begin treatment with physiotherapy, gymnastics and therapeutic massage.

It is important to remember that the course of taking anti-inflammatory drugs should not exceed 3 months, because otherwise you can severely damage the gastric mucosa, which is fraught with problems such as gastritis and even an ulcer.

To help the body restore damaged cartilage tissue, chondroprotectors are used that affect the very cause of gonoarthrosis. When they are taken, the joint fluid necessary for the normal functioning of the knee joint is produced better.

However, at 3 degrees (and even more so at 4), they may be useless, since there is nothing to restore. Effective at the first two stages of the disease, injections with hyaluronic acid into the joint by 3 only alleviate the patient's condition for a while.

Much better results with advanced knee arthrosis up to stage 3 are shown by the traction method, which is combined with physiotherapy. With traction, the bones are bred and, accordingly, the interarticular gap becomes wider, and the load on the joint becomes less.