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- Basic information about gonarthrosis
- Causes and risk factors for gonarthrosis
- How gonarthrosis manifests itself
- How to diagnose gonarthrosis
- Treatment of gonarthrosis
- Drug treatment for gonarthrosis
- Surgical treatment for gonarthrosis
- Natural treatment for gonarthrosis
- Regenerative cell treatment for gonarthrosis
- Hyaluronic acid infiltrations for gonarthrosis
- Physical therapy in gonarthrosis
- Prevention of gonarthrosis
- Beneficial exercise in gonarthrosis
- Diet and nutritional supplements to prevent gonarthrosis
- Recommended spas for treating gonarthrosis
Article by dr. Georgiana Tache, primary care physician, with over 30 years of experience, vice president of the Romanian Society of Rehabilitation Medicine.
The onset of the pathology is usually associated with structural changes in cartilage tissue at the molecular level. Then, the process involves hyaline cartilage, which becomes cloudy, has a reduced thickness, and is covered with layered and mixed microscopic cracks. The pathological process results in the final destruction of the small and large cartilage and, at the same time, the exposure of the bone joint. The body reacts instinctively to the disappearance of cartilage through bone growth in peripheral areas, which leads to the growth of osteophytes.
Playing top sports is another known risk factor. Contact sports (especially football and rugby) expose the knees to serious injuries.
Meniscus removal (partial or total) and knee deformity are two other risk factors for the development of osteoarthritis.
Other causes that can lead to gonarthrosis:
- metabolic disorders
- especially hormonal imbalances
- knee injuries (fracture, cracked bones, torn ligaments, or meniscus)
- inflammatory diseases (rheumatism, arthritis)
- prolonged frequency and physical overload (especially in athletes - gymnasts, football players)
- endocrine disorders
- genetic abnormalities of tissue structure
- age factors
While walking, the patient rotates the lower limb outward, bends, and tilts the torso forward and sideways. The length of the step is then reduced, and the use of diseased lower limbs is limited. In the early stages of the development of degenerative changes, the patient does not feel symptoms and does not show any dysfunction. However, over time, mild and often unnoticed symptoms may occur, such as:
- difficulty performing knee flexion and extension in the full range
- slight swelling caused by effusion and thickening of the synovial
- redness and elevated temperature in the knee joint area, especially after exercise or other activities
- sensitive compression - characteristic cracking during movement, caused by the joint surfaces rubbing against each other
- quadriceps femoris muscle atrophy (especially the medial head)
- stiffness in the morning
When the degenerative process has already reached the advanced stage, the symptom of pain appears. In fact, the appearance of pain is the main reason why the patient goes to the doctor. The pain increases, especially when the affected person walks, stands for a long time, bends down, gets up from the chair, goes down the stairs, carries heavy objects.
The pain is located especially in the front or middle part of the knee joint. The pain that occurs during the movement makes the patient avoid the movement of the affected limb by limiting his physical and professional activity, which leads to restricted mobility.
Through radiological images of the knee joint affected by the degenerative process, the stenosis of the articular surfaces can be observed, as well as the presence of free intra-articular bodies and the deformation of the articular axis. The primary diagnosis is made by inspection, palpation of the joint, change of direction of the bones, mobility of the plumb joints.
Laboratory research is performed on common blood and urine tests: determining the sedimentation rate of erythrocytes, fibrinogen, urea, and other biochemical parameters, and ultrasound scanning of the knee joint. The most informative are X-ray examinations and magnetic resonance imaging. Only then does the doctor treat the disease.
MRI or CT imaging to diagnose gonarthrosis
Magnetic resonance imaging (MRI) provides a sensitive tool for examining all structures involved in the gonarthrosis process. While much of the MRI literature has previously focused on cartilage, there is advanced research on whole organ evaluation and includes features such as synovitis, bone marrow edema, and meniscal and ligament pathology.
Ultrasound imaging for the diagnosis of gonarthrosis
Ultrasound is an effective technique that can be performed in the examination room minimizing patient discomfort. This method facilitates the repeated examination of all peripheral joints. The real-time imaging capability of ultrasound not only allows dynamic evaluation of joints but also provides a dimensional aspect that is not achieved by static radiology techniques.
Knee arthroscopy is a surgical technique that can diagnose and treat problems in the knee joint. During the procedure, the surgeon makes a tiny incision and inserts a camera (called an arthroscope) into the knee. This allows you to view the inside of the joint on a screen. The surgeon will start by making a few small incisions or cuts in the knee. He will use saline to extend the knee. This will allow him to see more easily inside the joint.
Arthroscopy can repair many knee problems, including gonarthrosis. There are limited risks to the procedure, and the outlook is good for most patients. The timing and prognosis of recovery will depend on the severity of the knee problem, and the complexity of the procedure required.
The surgery is preceded by a complete examination of the patient, and by precise planning. The patient will perform medical tests, including EKG and blood tests. Depending on the individual arrangement, the surgery is performed under general anesthesia or by spinal anesthesia. Access to the affected joint is through an incision of about 15 cm in the front of the knee. After the surgery, it is necessary to perform an x-ray to check if everything is fine.
Gelatin is used as a supplement to desserts, as well as salty foods and salads. It is known as the best natural remedy for cartilage regeneration. Gelatin contains amino acids, proline and hydroxyproline, collagen, and does not contain fat and cholesterol, so there are no unwanted side effects when eating. You should include 10 g of gelatin daily if you want to use it to restore the cartilage of the knee. The gelatin treatment lasts 30 days, and then a 6-month break. You can buy gelatin from health food stores, but it is best to take beef gelatin.
The clay and lemon compress is very effective. Grind the seeds of two lemons, add 4 tablespoons of clay, and 1 egg white. Mix everything until you get a thick paste. Put the mixture on the gauze and put it on your knees. Tie tightly and let the compress act overnight.
- All movements are performed slowly and their amplitude gradually increases.
- The exercises take place daily. The total duration of physical exercises during the day should not exceed 35-45 minutes divided into 3-4 periods of 10-15 minutes each.
- Rest after each session should be at least 4 hours.
- Start the session by relaxing the leg muscles to improve blood flow.
- Wear comfortable shoes.
- Adequate nutrition.
- Regular exercises (especially cycling).
- Avoid putting heavy weights on the knee joint.
- Take vitamins.
- Start slowly. It takes time to strengthen the muscles and make them more flexible, and a too fast increase in pregnancy almost always leads to injuries. Start with simple exercises and when the muscles become stronger, you will be able to gain weight.
- Don't ignore the pain. Gymnastics in gonarthrosis of the knee joint should not cause pain. You may feel discomfort when stretching your muscles, but if there is pain, you should stop exercising and let your muscles rest for a few days.
Supplements containing glucosamine are among the most commonly used products for gonarthrosis. Although the evidence is not entirely consistent, most research suggests that glucosamine sulfate may improve gonarthrosis-related pain symptoms as well as slow disease progression.
- Sulfurous waters: Herculane, Pucioasa
- Waters with oligominerals: Gioagiu, Felix
- Iodized waters: Govora, Bazna
- Chlorinated salt waters: Ocna Sibiului, Amara, Salt Lake
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- Orthopedics , a department composed of an extremely experienced team of orthopedic doctors, led by Dr. Andrei Ioan Bogdan, primary care physician in orthopedics-traumatology, with surgical activity at Medlife Orthopedic Hospital, specialized in sports traumatology and ankle and foot surgery.
- Pediatric orthopedics , where children's sports conditions are treated (ligament and meniscus injuries), spinal deformities (scoliosis, kyphosis, hyperlordosis) and those of the feet (hallux valgus, hallux rigidus, equine larynx, flat valgus, hollow foot).
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- Medical imaging , the clinic being equipped with ultrasound and MRI, high-performance devices dedicated to musculoskeletal disorders, and complemented by an experienced team of radiologists: Dr. Sorin Ghiea and Dr. Cosmin Pantu, specialized in musculoskeletal imaging.
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