The osteoarthritis of the knee joint is a slowly progressive-deigenerative inflammatory joint disease. Most of the time, this ailment is observed in medium and older people and is the most common cause of skeletal-mechanical pain in the area of knee joint and disability. From this publication, you will learn how to treat the osteoarthritis of the knee joint.
General description
In the knee joint, femur and tibia are covered with joint cartilage. There is also a second type of cartilage fabric, forming the meniscio called So, which acts as layers or shock absorbers. The joint fluid adds additional protection and softness. Osteoarthrosis begins to develop if the cartilage that protects the bones is disturbed and damaged, as a result of which the surface of the bones is exposed, and the joint lubricant ceases to occur in the required amount. In this case, the complete and partial loss of the cartilage can be observed. This process is often isolated by a certain area in the joint, in such cases it can be caused by injuries and wear of the chronic joint.
The deforming arthrohrosis of the knee joint is characterized by the process of destroying its cartilage shells. In the future, the closest fabrics, such as ligaments and bones, can also include in the process. Gonarrosis, or osteoarthritis of the knee joint, due to the loss of cartilage, is accompanied by an increase in stiffness and joint deformation. Bone spurs (osteophyte), which are a pathological growth of bones, can even be felt from the outside. The surfaces of the bones deform and no longer close and do not adjust to each other, as in the healthy joints. As a result, the restriction of movements increases.
At the same time, pain occurs, which is especially strong when it moves after prolonged immobility, for example, in the morning, as well as at night, which finally leads to a decrease in the quality of life. Stress can also cause affected joint pain. An indirect sign of the pathological change of cartilage is the visible narrowing of the articular cavity between the femoral and the warm in the image X -Ray.
Reasons
There are several reasons for osteoarthritis: this is the process of aging and wear of the cartilage, overweight, lesions, autoimmune diseases in which immunity attacks its own articular tissue, causing inflammation and its subsequent destruction. An example is rheumatoid arthritis, in which both joints are affected at the same time and disability develops. Some experts combine concepts such as arthrita and osteoarthritis of the knee joint, the symptoms of these ailments are similar and are often caused by the same reason.
A decrease in the blood supply to the femoral head can also cause tension deformation, in this case they speak of aseptic necrosis. Inadequate formation of the knee joint in early childhood can lead to the displacement of the mechanical axis and the degeneration of the knee joint. Postraumatic osteoarthritis is secondary and develop as a result of the damage to the mesucos, frontal or posterior cross ligaments.
Symptoms
There are three degrees of osteoarthritis of the knee joint, each of which has its own signs. In the first stage, there is a slight pain, discomfort in a painful place and periodically emerging swelling. The second degree is accompanied by an increase in symptoms, the appearance of crunch and a limitation of mobility. When painful sensations practically do not leave a person, and cartilage is thoroughly destroyed, the disease enters osteoarthritis of the third grade knee.
Pain for osteoarthritis may appear suddenly, but most of the time it develops slowly. A person can notice pain in the morning, after lifting the bed. The knees can hurt when the stairs climb, or when you have to roll, and often the pain occurs only during a walk. For climate sensitive people, climatic changes can also cause joint pain.
Swelling is a consequence of inflammation, which periodically increases with osteoarthritis. Edema can also be associated with the formation of bone spurs or the accumulation of excess fluid in the knee. They can be more pronounced after a long period of inaction, for example, in the morning or after a long stay on the desk. The skin can become reddish and hot when touching. If the chronic inflammation of the articulation occurs, the elimination of pain and edema is generally achieved by taking anti -inflammatory medications.
The loss of stability develops over time due to the weakening of the muscles and the instability of the entire system. Occasionally, situations arise when a person simply cannot be fold or completely straightened in the knee. Such symptom is generally accompanied by osteoarthritis of the second grade knee joint. It feels a crunch when it moves because the cartilage has lost its original softness and the required amount of synovial lubrication. In the posterior stages, a crispy sound can be caused by the fact that the spurs of the bones rub each other when moving.
The limited range of movements can be seen when climbing the stairs or during exercise. Many are forced to resort to the help of walkers or canes to move. The deformation of the knee joint is perhaps the most terrible symptom of osteoarthritis, since it indicates irreversible changes in the joint, making a person a disabled person. The knees can be turned inside, as well as out. Knee deformation is barely noticeable.
Diagnosis
The definition of osteoarthritis of the knee joint begins with the physical examination of the doctor, the study of medical history and conversation with the patient. Be sure to pay attention to the doctor who most frequently causes pain and tell us about the cases of the disease in the family, if there is.
The additional diagnosis is carried out using:
- radiography, which can show the presence of bone spurs and changes in cartilage;
- Magnetic resonance images;
- Blood analyzes allow you to identify autoimmune disorders.
How to treat the osteoarthritis of the knee joint, what medications are needed for this? Look for more answers to these questions.
The principles of treatment
The standard treatment of a ailment such as the osteoarthritis of the knee joint is mainly aimed at eliminating pain and eliminating functional restrictions. It is worth knowing that analgesics only weaken symptoms, but they cannot affect the course of the disease and restore damaged cartilage. For treatment, narcotic analgesics, non -steroidal anti -inflammatory drugs, gold preparations of slow action, corticosteroids, methotrexate, etc.
In addition, surgical intervention, as well as physiotherapy and physiotherapeutic procedures, may be necessary. Gymnastics with osteoarthritis of the knee joint helps significantly in the treatment, the exercises are selected by the treating doctor. Despite the fact that in modern pharmacology, active research and the development of the most effective medications and at the same time safe for the treatment of osteoarthritis are underway, most medications still have their side effects and with prolonged use interrupt the normal functioning of systems and organs.
Drug treatment
The pharmacological therapy of the osteoarthritis of the knee joint provides three main directions:
- the use of non -steroid anti -inflammatory drugs that are needed to relieve pain and reduce the intensity of the inflammatory process in tissues;
- Take medications for cartilage restoration, which include condoproprotectors: glucosamine and chondroitin;
- The use of creams and ointments in the complex osteoarthritis deformation therapy.
In combination with physiotherapy and manual therapy, taking medications allows you to reduce the speed of the process of destruction of the joint cartilage, accelerate the regeneration of the cartilage tissue and restore the normal functioning of the limb.
The main objective of pharmacological treatment is pain elimination, improving cartilage nutrition, activating recovery processes, increasing joint mobility and normalization of blood circulation in the knee.
Nesteroid drugs
The most common for the treatment of osteoarthritis are non -steroidal anti -inflammatory drugs such as diclofenac, indomethacin, pyroxykam, ketoprofen and others. They are used to relieve pain and reduce inflammation, but long -term treatment with these medications is not recommended, since the medications of this group have undesirable side effects, including the negative effect on the gastric mucosa and the intestines, the effect of the kidneys, the liver and cardiovascular system. However, each drug has its own characteristics. And recently, funds with a minimum patient health risk have begun to develop.
In addition, despite the need for the use of these tools, some studies found that NSAs can lead to a decrease in proteoglycan production, thus dehydrating cartilage tissue, so such medications must be taken strictly in accordance with the prescription of the doctor and under their control. The frequency of NSAIDs side effects increases with prolonged use, which acts as a need for many patients with osteoarthritis. Experts recommend choosing selective anti -inflammatory medications for long -term use, having less side effects and do not have a negative effect on metabolism in cartilage.
Most non -steroidal anti -inflammatory drugs occur in different ways: in the form of capsules or tablets, in the form of a solution for injections and ointments or gels for local external use.
Cartilage restoration
For the nutrition and regeneration of the cartilage to its tissues, the constant intake of compounds is necessary as condoprotectors: glucosamine and chondroitin. These are useful substances for people who suffer from osteoarthritis in front of the knee. Your reception must be carried out for a long time, from six months or more, only in this case you can have a positive therapeutic effect. Condroprotectors improve the quality and quantity of synovial fluid, unlike NSAIDs, increase the synthesis of proteoglycans and contribute to the regeneration of the cartilage plate. However, due to such useful properties of these compounds, they should not be considered as the main treatment of osteoarthritis. Deforming osteoarthritis of the knee joint requires the use of chondroitin and glucosamine preparations for at least 1, 5 years. It is also taken into account that they cannot restore a completely destroyed cartilage.
Ointments and creams
The treatment of a disease such as the osteoarthritis of the knee joint should include the local use of gels and ointments. These forms of dosing should not depend on the only option for therapy, their use should be considered as the necessary addition to the NSAID receipt and condoprotectors. Such medications significantly reduce discomfort, pain, swelling, joint mobility.
This effect is explained by the fact that blood penetration through the skin, ointments and creams improve blood circulation in the joint, accelerate metabolism in cartilage and, consequently, its regeneration.
Compresses
Osteoarthritis applications have a greater effect than applying ointments. For therapeutic compresses, the tellxide tool is often prescribed, which has a good anti -inflammatory and analgesic effect, penetrates the tissue well. Bishophyte is also effective, accelerating metabolic processes in the cartilage.
Injections
Within the knee joint, the synovial fluid is very viscous, this ensures the absence of tissue friction. An important part of this lubricant is hyaluronic acid, which binds to proteoglycans to stabilize the structure of cartilage tissue. In patients with osteoarthritis, the level of this compound in synovial fluid is significantly reduced, as a result from which the latter becomes less viscous, friction increases.
Injections in the knee of medications based on hyaluronic acid can slow down the progression of osteoarthrosis, but only half of people with such a diagnosis receive symptomatic relief. The course of injections is usually three weeks, while an injection takes place every seven days. After six months, it is recommended to repeat the procedures.
Popular remedies
The osteoarthritis of the knee joint provides an integrated approach for treatment, and recipes for traditional medicine act as additional therapy. Media such as a decoction of onion peel, an infusion of lion tooth leaves, a mixture of aloe, vodka and honey in equal volumes, night compressions of salt with honey and many others deserve attention. It is also recommended to eat more jelly and jelly.
Joint replacement
If all the previous treatment methods did not bring the result, the operation is shown to replace the joint with an endoprosthesis. The main objective of the operation is to restore the natural mechanical axis of the leg and complete the release of pain and discomfort. In this case, part of the Board or the entire Board can be replaced. The constant improvement of surgical equipment and the quality of implants have made this procedure quite successful and generalized.