Characteristic signs of grade 2 osteoarthrosis are pain while walking, limitation of movement, morning stiffness, swelling of the knee joint. At this stage, the disease is still amenable to conservative treatment. To restore the joint, analgesics, muscle relaxants, chondroprotectors are used. Physiotherapy, massage, exercise therapy are prescribed to patients. If conservative methods were ineffective, then a surgical operation is performed.
- Features of osteoarthrosis of the knee joint of the second degree
- Symptoms of pathology
- Causes of
- Diagnosis of the disease
- Tactics of treatment
- Exercise therapy and gymnastics
- Physiotherapeutic treatment
- Operative intervention
- diet therapy
- Therapy folk remedies
- Complications and consequences if untreated
- Preventive measures
Features of osteoarthrosis of the knee joint of the second degree
Osteoarthrosis is called a degenerative-dystrophic disease, which first affects the cartilage, and then the bone structure of the knee. Pathology develops slowly, gradually, at the initial stage not clinically manifesting itself. Therefore, usually in patients diagnosed with grade 2 osteoarthrosis, which is characterized by pronounced symptoms.
There is a pathology due to a violation of the blood supply to hyaline cartilage with nutrients. Against the background of the resulting deficit, it becomes less elastic and resilient. Instead of sliding smoothly, the cartilaginous surfaces now “cling” to each other. This leads to their wear, loss of cushioning properties and further deformation of the tibia and femur.
Symptoms of pathology
A typical symptom of osteoarthrosis of the 2nd degree is a crunch during movement, flexion and (or) extension of the knee. It occurs due to the thinning of the cartilaginous layer, impacts of bone surfaces during displacement. Crunching, crackling, clicks are accompanied by pain. At first they are weak, but gradually their intensity increases. The pain is felt not only when walking, but sometimes at rest, disrupts night sleep and daytime rest, which negatively affects the psycho-emotional state of a person. Osteoarthrosis is manifested by such symptoms:
- limitation of mobility, inability to fully bend or unbend the knee. Reduced range of motion is especially felt in the morning. It takes a patient from 30 minutes to an hour to “disperse”;
- at this stage of the development of pathology, knee deformation is noticeable, it is expanding, as it were.
In the morning, the joint looks a little swollen. If the swelling does not disappear, and the skin turns red and becomes hot to the touch, then this indicates the development of synovitis. Inflammation of the synovial membrane often accompanies the course of osteoarthrosis of the 2nd degree and requires additional treatment.
In older people, the disease often occurs due to a natural slowdown in recovery reactions. As the body ages, the regeneration of cartilage and bone tissue slows down. And as a result of a decrease in collagen production, the ligament-tendon apparatus, which stabilizes the knee joint during movement, also weakens. The number of microtrauma increases, cartilage is gradually destroyed. Secondary osteoarthritis develops against the background of such pathological conditions:
- previous injuries – intraarticular fractures, rupture of menisci, ligaments, tendons, dislocations, subluxations;
- arthritis – rheumatoid, reactive, infectious, gouty, psoriatic;
- chronic synovitis, bursitis, tendonitis, tendovaginitis;
- endocrine diseases, for example, diabetes mellitus or hypothyroidism.
Vascular pathologies (varicose veins, thrombophlebitis) lead to circulatory disorders in the joint area with further destruction of the cartilage.
Diagnosis of the disease
Radiography is the most informative for diagnosis, allowing you to squeeze out all the compensatory changes in the bone tissue. These are flattening of the bone site, compaction of the subchondral zone, the formation of multiple osteophytes (bone spikes) at the edges of the articular surfaces.
X-ray examination also helps to differentiate grade 2 osteoarthrosis from other diseases, for example, the presence of tumors in the tibia and femur. Other studies are carried out to confirm the diagnosis:
- MRI, CT for a more detailed assessment of the condition of cartilage, ligaments, tendons, blood vessels;
- arthroscopy with simultaneous sampling of material for further morphological studies.
Differentiate osteoarthritis from arthritis allows the results of general clinical, biochemical analyzes. To exclude inflammatory lesions of the knee, the levels of ESR, C-reactive protein, rheumatoid factor, sialic acids, antinuclear antibodies, uric acid are determined.
Tactics of treatment
Therapy is carried out immediately after diagnosis. A comprehensive approach to the treatment of osteoarthrosis of the 2nd degree is practiced – after the elimination of severe pain, physiotherapy, stimulants of blood supply and regeneration, massage, daily physical education classes are prescribed. To reduce the load on the knee, wearing elastic bandages or semi-rigid orthoses is indicated.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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In therapy, drugs in various dosage forms are used. Pills help to moderate pain of medium intensity, and eliminate weak discomfort – ointments, creams, gels. External agents are often prescribed simultaneously with systemic drugs to reduce the dosages of the latter, negatively affecting the internal organs. In acute pain, NSAID injections are used, and in case of their ineffectiveness, drug blockades are performed with glucocorticosteroids (Diprospan, Triamcinolone, Dexamethasone) and anesthetics (Novocain, Lidocaine).
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|Group of drugs for the treatment of osteoarthrosis of the 2nd degree||Names of medicines||Therapeutic action|
|Nonsteroidal anti-inflammatory drugs||Diclofenac, Meloxicam, Ketoprofen, Lornoxicam, Indomethacin, Nimesulide, Ibuprofen, Etoricoxib||Analgesic, anti-inflammatory, decongestant|
|Muscle relaxants||Baclosan, Baclofen, Midokalm, Sirdalud, Tizanidin, Tolperizon||Elimination of muscle cramps, soreness, stiffness|
|Warming ointment||Viprosal, Finalgon, Kapsikam, Apizartron, Efkamon, Nayatoks||Painkiller, decongestant, distracting, locally irritating|
|Chondroprotectors||Arthra, Alflutop, Rumalon, Teraflex, Structum, Dona, Chondrogard, Chondroxide||Prevention of the spread of the degenerative process to healthy articular structures|
|Means with vitamins of group B||Milgamma, Kombilipen, Neuromultivit, Neurobion, Pentovit||Improving trophism and innervation|
|Blood circulation medications||Xanthinol Nicotinate, Pentoxifylline, Eufillin||Restoring blood supply to tissues with nutrients and oxygen|
Exercise therapy and gymnastics
Regular physical therapy and gymnastics classes are the most effective method for the treatment of osteoarthrosis of the 2nd degree. Daily training helps to strengthen the muscles of the knee and the entire leg, improve blood circulation, reduce the severity of pain. Exercise doctor makes an individual set of exercises taking into account the general health of the patient. He is present at the first lessons, shows how to dose physical activity. The complex usually includes such exercises:
- simulated cycling while lying down;
- walking with the knees raised high;
- in a sitting position, with emphasis on the arms raised back, alternating bending and extension of the knees;
- in the supine position, flexion and extension of the legs in the knee joints.
The movements should be smooth, without jerking. The appearance of even slight discomfort becomes a signal for a long rest.
Ultraphonophoresis or electrophoresis is used both during relapses and in remission. In case of exacerbations, the procedures are carried out with analgesics, anesthetics, hormonal agents for pain relief. In the rehabilitation period, chondroprotectors, B vitamins, calcium salt solutions are used. The following physiotherapeutic measures are also shown to patients:
Applications with ozokerite or paraffin, balneotherapy, hirudotherapy, acupuncture help to get rid of mild symptoms.
With osteoarthrosis of the 2nd degree, surgical intervention is rarely practiced. Indications for it are fatal pain medication, the rapid progression of pathology. Arthroplasty is performed – an operation to restore articular surfaces, excision of bone growths. After separation of the fibrous and bone fusion, the doctor creates a soft tissue pad. Surgical intervention is performed as planned under general anesthesia.
Patients are advised to give up alcohol and coffee, contributing to the removal of beneficial trace elements from the bone structures of the knee. It is necessary to exclude foods with a high fat content (semi-finished products, smoked meats, fast food), the use of which worsens the condition of blood vessels supplying cartilaginous tissues. The basis of the diet should be lean meat, clear soups, cereals, fresh vegetables and fruits, cottage cheese, low-fat cheeses. Every day you should drink about 2 liters of liquid – pure still water, sweet and sour stewed fruit, jelly, juices, slightly salted mineral waters (Essentuki No. 2, Smirnovskaya, Slavyanovskaya), chamomile tea, and rosehip infusion.
Therapy folk remedies
With osteoarthrosis of 2 severity, all folk remedies are ineffective. Orthopedists recommend using them only at the end of the main treatment, after achieving a stable remission. With concomitant synovitis, folk remedies with a warming effect are forbidden – alcohol rubbing, tinctures with red pepper, horseradish, garlic, golden mustache.
Complications and consequences if untreated
The immediate cause of the development of osteoarthrosis of the 2nd degree is the neglect of the first signs of cartilage damage – pain and limitation of range of motion. If there is no medical intervention at this stage of degenerative-dystrophic pathology, then the joint space fuses with the appearance of ankylosis – complete or partial immobilization of the leg.
The triggering factors are smoking, alcohol abuse, obesity, low physical activity, increased stress on the knee. It is necessary to exclude them from the usual way of life, otherwise the likelihood of developing osteoarthritis significantly increases over several years. Orthopedists remind us of the need for annual medical examinations for the timely detection of the disease.
Complete restoration of cartilage tissue in osteoarthritis of the 2nd degree is impossible to achieve. But after conducting therapy, rehabilitation measures, all the symptoms of the disease are completely eliminated, and the functioning of the knee joint improves.