Gonarthrosis is one of the most common osteoarticular conditions and one of the leading causes of disability in the elderly. It most often affects women and people who are overweight or obese.
Gonarthrosis, also known as knee osteoarthritis, is a degenerative joint disease that mainly affects the knee. It is characterized by progressive deterioration of the articular cartilage, which leads to pain, inflammation, stiffness, and limited mobility of the joint.
Gonarthrosis can be caused by a variety of factors, including aging, previous knee injuries, obesity, being overweight, and genetic factors. Increased body mass index (BMI) has been closely associated with this pathology, and it is estimated that approximately 80% of people over 65 years of age have obvious radiographic changes of knee osteoarthritis. In addition, sports and professional activity, as well as insufficient muscle strength in the quadriceps, can also contribute to the development of gonarthrosis.
The most common symptoms of gonarthrosis include pain (which in the initial stages decreases with rest, but over time may become continuous), joint effusion, limited mobility, crepitus, muscle atrophy (usually of the quadriceps due to disuse), and instability.
In cases of severe gonarthrosis, cartilage destruction and knee deformity can cause ongoing pain and incapacitate the patient.
The diagnosis of gonarthrosis is based on the patient’s signs and symptoms, associated risk factors, and alterations during the physical examination. A combination of clinical diagnostic criteria, anteroposterior and lateral X-rays of both knees, as well as complementary tests such as magnetic resonance imaging or CT scans are used in some cases to confirm the diagnosis.
Doubtful narrowing of the joint space and possible formation of osteophytes or bone spurs.
Possible narrowing of the joint space and formation of osteophytes.
Narrowing of the joint space, moderate osteophyte formation, mild sclerosis, and possible deformity of the ends of the bones.
Marked narrowing of the joint space, abundant osteophyte formation, severe sclerosis and deformity of the ends of the bones.
Lifestyle changes are critical in the treatment of gonarthrosis. Maintaining a healthy weight through a balanced diet and regular exercise can reduce the load on the joints and decrease pain.
In addition, avoiding activities that involve impact and excessive load on the knees is essential to preserve joint integrity.
Physiotherapy and therapeutic exercise are pillars in the management of gonarthrosis. Physical therapy programs seek to strengthen the muscles surrounding the knee, improve joint stability, correct muscle imbalances, and increase flexibility.
Regular exercise, especially strengthening the quadriceps, hamstrings, and gluteal muscles, helps to improve the biomechanics of the knee and reduce the load on the affected joint.
In the pharmacological treatment of gonarthrosis, analgesic and anti-inflammatory medications can be used to relieve pain and reduce inflammation. In addition, in some cases, nutritional supplements such as glucosamine sulfate and chondroitin sulfate may be prescribed, both of which have been associated with symptom improvement in patients with gonarthrosis.
Intra-articular infiltrations of hyaluronic acid and ozone are therapeutic options that seek to improve joint lubrication, reduce inflammation and relieve pain in patients with gonarthrosis. These infiltrations provide long-term symptomatic relief and improve patients’ quality of life.
In cases of severe gonarthrosis in which conservative treatments and infiltrations have not provided sufficient relief, the surgical option may be considered.
Total knee arthroplasty is an intervention that consists of replacing damaged joint surfaces with prosthetic components. This surgery seeks to restore joint function and relieve pain in patients with advanced gonarthrosis.
Other less invasive surgical options include arthroscopy for the treatment of associated injuries and osteotomy to correct knee alignment.
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