Osteoarthritis of the knee joint of the 2nd degree (gonarthrosis) is a degenerative-dystrophic disease in which the destruction of articular cartilage occurs.. This is a fairly common pathology: almost 20% of the population faced such a problem.. The disease may affect one or both joints.. ICD-10 code: M17 - arthrosis of the knee joint.

With gonarthrosis, the destruction of the joint occurs gradually. The knee joint connects the tibia to the femur and is supported by several groups of ligaments.. It is enclosed in a synovial capsule filled with fluid, which allows the articular bones to glide smoothly during movement.. The articular surfaces are covered with cartilage (connective tissue consisting of a dense intercellular substance), which perform a supporting function.

Why does the disease occur? Under the influence of adverse factors, cartilage is destroyed. In the small vessels that feed it, blood circulation is disturbed, as a result of which the surface becomes dry and microcracks appear..

Cartilage loses its elasticity, and the surfaces of the bones are exposed, resulting in friction. Inflammation of the synovial membrane leads to a change in the composition and viscosity of the synovial fluid. Thickening of the joint capsule. The surface of the bones is covered with bone spikes (osteophytes), which grow and interfere with free movement.

Causes Conditionally deforming osteoarthritis (DOA) is divided into primary and secondary forms. If the exact cause of the disease cannot be identified, then idiopathic osteoarthritis is diagnosed..

The primary form of DOA is most often detected in elderly patients, in most cases it is bilateral, while in the secondary form one limb is affected..

The reasons for the development of gonarthrosis of the 2nd degree include:.

lower extremity injuries (fractures of the legs, meniscal injuries, torn ligaments);

valgus deformity of the legs;

overweight;

hypermobility syndrome of the knee;

acromegaly;

arthritis of various etiologies (rheumatoid, reactive, psoriatic);

gout;

congenital shortening of the leg;

disorders of innervation in neurological diseases (spinal injuries or craniocerebral injuries);

knee dysplasia;

osteomyelitis;

weakness of the ligamentous apparatus (genetically determined);

chondrocalcinosis;

diabetes.

The following factors can influence the development of deforming osteoarthritis of the knee joint of the 2nd degree:.

advanced age of the patient;

high bone mineral density;

female;

frequent physical activity;

doing some sports;

malnutrition, as a result of which insufficient amounts of vitamin C, D3 or calcium are supplied to the body;

frequent injuries;

smoking;

hereditary predisposition;

hormone replacement therapy.

Often, patients over 40 do not take into account age-related changes and begin to overload the joints, for example, running or actively squatting.. As a result, degenerative-dystrophic changes quickly appear..

Symptoms There are three stages of the disease. Initially, DOA practically does not manifest itself, the patient has a slight crunch in the joints and mild pain after prolonged exercise. The bones are almost not deformed, retaining their original shape.

Over time, the disease progresses, and the patient is diagnosed with grade 2 gonarthrosis.

Joint pain May occur even at rest. The most prolonged attacks are observed after long walks or physical exertion..

The most characteristic symptom of the disease is pain in the knee joint. In order to get rid of pain, a long rest is required, but it is worth resuming movement, and the pain returns.. The reason for this is the erasure of the upper layer of cartilage and the exposure of nerve endings.. If a person rests for several hours, the articular membranes are restored.

Joint stiffness after sleep This symptom occurs after waking up in the morning. In most cases, stiffness disappears within half an hour.. If it is observed longer, this may indicate the development of an inflammatory process..

The cause of stiffness is a violation of the production of glucosamine and chondroitin - components of natural intra-articular lubrication.

Clicking and cracking joints This symptom is observed already at the first degree of DOA, but with the development of the disease it is aggravated.

The crunch occurs not only during flexion of the limbs, but also when walking. The reason for this is damage to the articular surfaces, the formation of grooves and osteophytes..

Decreased range of motion Trying to make the pain less intense, the patient tends to bend and straighten the limb as little as possible. After some time, the ligamentous apparatus adjusts to the range of motion and the ligaments shorten..

As a result, there is a reduction in the amplitude of movements, a person cannot fully straighten or bend his leg, in some cases he begins to limp. It is possible to develop a joint, but for this you need to perform special exercises for a long time.

An increase in the volume of the jointThe most common cause of this is synovitis - an inflammatory process that occurs in the synovial membrane. It may be accompanied by the accumulation of fluid in the joint cavity..

Also, swelling of the soft tissues, which occurs in the chronic form of the disease, can lead to an increase in the joint.. The cause of the pathology can also be the formation of osteophytes (thorns) along the edges of the articular surfaces..

DiagnosisIn order to diagnose the disease, an orthopedic traumatologist conducts a survey of the patient, identifying complaints. The classic method that allows you to determine the disease is radiography..

To make a diagnosis, radiography is most often performed. At grade 2 osteoarthritis, joint deformity, narrowing of the joint space by 2 or 3 times, and compaction of the subchondral zone may be observed.. The ends of the tibia and femur are expanded, and the edges of the condyles are sharpened.

Also, this research method allows you to exclude the presence of tumors or other pathological processes.. In some cases, magnetic resonance imaging is prescribed to confirm the diagnosis..

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