Osteoarthritis, gonarthrosis, osteoarthritis are synonymous terms that define the same disease: deforming changes in the cartilaginous tissue of the knee joint.
The human knee joint is made up of three bones: the femur, the tibia, and the patella. At the point of contact with each other, these bones are covered with cartilaginous tissue, which ensures a smooth gliding of the surfaces against each other.
Over time, these cartilages become thinner, losing flexibility and elasticity. Cartilage is nourished by synovial fluid; The shock absorbing properties of the joint depend on the quantity and quality of this fluid.
First symptoms and signs
- They appear most often in people ages 45 to 50. This disease is typical of both men and women, but the "weaker sex" suffer from it much more frequently.
- At the onset of the disease, the patient experiences tolerable pain in the knee joint area, and severe pain develops over time.
- The intensity of the pain changes: with movement, physical activity, it becomes stronger, at rest, the pain subsides.
If you do not pay attention to these symptoms of an approaching disease in time, the disease begins to progress, and in severe cases, it leads to disability.
When contacting a doctor, the diagnosis of osteoarthritis is clarified by X-rays. The images show the narrowing of the joint space from inside or outside the joint. But over time, the pathological process captures the entire joint. And along the edges of the articular surface, osteophytes are visible - bone growths.
The main signs of osteoarthritis of the knee joint:
- During the day, the pain intensifies; during the night's rest, the pain subsides. But if there is venous insufficiency, the dull pains persist through the night.
- Muscle tension in the joint area.
- When walking, a cracking sound is heard in the knee joint.
- In severe cases of the disease, deformation and swelling of the affected joint, an increase in its volume, is observed.
- On palpation, the joint hurts.
- When trying to move the knee brace, the pain increases.
- In the last stage of the disease, muscle shortening occurs and the patient is unable to place the leg in the correct position.
- If left untreated, joint mobility decreases or is completely lost.
What is patellofemoral osteoarthritis of the knee?
Very often, the doctor can hear the diagnosis of "patellofemoral arthrosis" - what is it? In fact, in the international classification of diseases, such osteoarthritis is absent. Few people know that osteoarthritis of the knee joint begins with the development of patellofemoral syndrome.
This syndrome occurs when a part of the body is subjected to regular overuse or repeated injury. That is, patellofemoral osteoarthritis is the same as patellofemoral syndrome.
The main causes of the disease are:
- congenital and acquired deformities of the lower extremities;
- various abnormalities in the development of the patella;
- regular overload of the knee joint (for example, in athletes).
Patellofemoral osteoarthritis of the knee joint has the following clinical manifestations: pain in the area of the front of the knee joint, which increases significantly with physical exertion (running, jumping, going up and down stairs, various squats). The pain may also increase when the patient sits with his legs bent under him. The patient may experience a feeling of tension and stiffness in the knee, both inside and front.
Patellofemoral syndrome is diagnosed clinically, as a rule, no additional studies are required.
This disease, as a rule, does not require special treatment. However, to reduce pain and develop undesirable consequences (instability of the patella, deformation of the knee joint, accumulation of inflammatory exudate), the following procedures are necessary:
- decreased physical activityThis does not mean that the patient should lead a passive lifestyle, only the level of activity should not be painful;
- wearing a special bandage that is worn on the knee joint area during exercise or stress, supporting and fixing the kneecap
- with a pronounced pain syndrome, glucocorticosteroids and anesthetics are injected into painful areas of the joint by a precise injection, which will relieve pain and help avoid the use of anti-inflammatory drugs in the future.
If patellofemoral osteoarthritis has already led to complications or is accompanied by other degenerative-dystrophic pathologies in the knee joint, therapy is carried out according to the treatment regimen for knee joint osteoarthritis.
The reasons
- Occupational disease of athletes who experience increased stress on the knee joints. Athletes suffer injuries and microtrauma to the joints, bruises and torn ligaments. After retiring from sports, the muscle structure weakens, which leads to the progression of the disease.
- Longer life expectancy and greater physical activity in middle-aged people
- Increased physical activity at the knee joint in people who spend their working day "standing up"
- Genetic predisposition
- Congenital joint and bone diseases.
- Lack of collagen
- Knee injury
- Excess weight that puts more stress on the knee joints.
- Acquired joint diseases
- Knee surgery
To achieve positive results of treatment, it is necessary to conduct a clinical and radiological examination, which reveals several stages of the disease:
- Osteoarthritis of the knee joint 1 degree. . . There is a slight narrowing of the joint space, the edges of the surface are slightly sharp, a slight restriction in movement. During the arthroscopic exam, the doctor investigates the softening of the cartilage.
- Osteoarthritis of the knee joint of the second degree.characterized by a significant limitation in the movement of the knee joint, a loud crunch. The images clearly show osteophytes and a 2-3 fold narrowing of the joint space. Small cracks are seen on the surface of the joint.
- Grade 3 knee osteoarthritis- this is already a complete restriction in movement, when a deformation of the joint has occurred, deformation and compaction, osteophytes and cysts are observed on the surface of the joint. There have been changes in the cartilage tissue throughout its thickness.
- Knee osteoarthritis grade 4- Arthroscopy shows the total absence of cartilaginous tissue.
Drug treatment
In the complex treatment of osteoarthritis of the knee joint, drug therapy occupies an important place. Combining it with physiotherapeutic procedures, therapeutic exercises and manual therapy, very good results can be achieved, up to the restoration of limb function.
When diagnosed with osteoarthritis of the knee joint, drug treatment helps eliminate pain, normalizes blood circulation in the problem area, improves metabolism and nutrition of cartilage, activates recovery processes and increases joint mobility. .
Since it is impossible to apply other therapeutic methods against the background of acute pain sensations, first of all, the patient is prescribed painkillers and anti-inflammatory drugs. However, it is not recommended to use such funds for a long time, since, in addition to side effects (most often it is a negative effect on the digestive system), they can contribute to dehydration and further destruction of cartilage tissue. .
Chondroprotectors are used to restore cartilage nutrition, regenerate the cartilage plate, and improve the quality of synovial fluid.. . . Drugs in this group are injected directly into the sore joint and are the safest for the patient. By immediately falling on the affected area, chondroprotectors save the joint from destruction and help restore its functions. One of the disadvantages of this method is the long wait for the result: the patient may notice an improvement only after a few months. Also, it is not advisable to take chondroprotectors if the disease is in the third stage and the joint is almost completely destroyed.
Various ointments and creams are used to reduce pain, relieve swelling, and somewhat improve joint mobility.Various warming agents are good for relaxing ligaments and muscles, improving blood circulation, and speeding up metabolism in the joint. But they cannot be used in the presence of inflammation, in which case it is shown that non-steroidal anti-inflammatory gels and ointments are used.
Compresses should not be neglected: they have penetrating ability, improve blood circulation, have anesthetic and anti-inflammatory effects, and accelerate metabolic processes in cartilage.
Therefore, you should not delay a visit to the doctor for people who suspect the presence of a disease or osteoarthritis of the knee joint is found - drug treatment, started in a timely manner and correctly selected, can save thejoint and help avoid surgical intervention.
Medicines for the treatment of osteoarthritis of the knee joint.
Treatment of knee osteoarthritis is never complete without the use of medications.
Drug therapy is primarily aimed at eliminating inflammation and pain, improving local blood circulation and nutrition of articular cartilage, activating metabolic processes, and restoring joint mobility.
What medications are prescribed for osteoarthritis of the knee joint?
- For the successful treatment of the disease, you must initially relieve pain and eliminate the inflammatory process. For this, non-steroidal anti-inflammatory drugs are used. However, you should not get carried away by these funds: with prolonged use, they tend to mask the true clinical picture of the disease.
- To restore the cartilaginous surface of the joints, restore their structure, nourish the cartilage and improve the production of intra-articular fluid, chondroprotectors are used. The action of these drugs is very slow, therefore, before the patient notices a real improvement, he will have to undergo 2-3 cycles of treatment with chondroprotectors, which will take about a year.
- To improve the general condition of the patient and relieve pain, in combination with other drugs, gels and ointments can be used. If the course of arthrosis is accompanied by synovitis, preference is given to ointments based on non-steroidal anti-inflammatory substances.
- Intra-articular injections are used to provide emergency care for osteoarthritis. Corticosteroids or hyaluronic acid that are injected most often.
- For local treatment, compresses with drugs are prescribed: dimethyl sulfoxide, bischophyte and medical bile. Dimethyl sulfoxide has the ability to cross skin barriers, that is, its action is directed directly to the site of inflammation. This substance has analgesic, anti-inflammatory, absorbent properties and improves metabolism in the area of its application. Bischofite, a derivative of the oil, also has an anti-inflammatory effect on the affected joint, gives a warming effect. Medical bile has the same properties as bischophyte dimethyl sulfoxide, but its use is limited by some contraindications. Patients with pustular skin diseases, elevated body temperature, and swollen lymph nodes should not take medical bile.
Before starting any medication for osteoarthritis of the knee joint, it is necessary to consult with a doctor, discuss the dosage, characteristics of administration and duration of treatment.
Injections in the knee joint for osteoarthritis.
Intra-articular injections are one of the most effective methods of treating osteoarthritis of the knee joint. This rather expensive procedure significantly reduces pain and inflammation, and new modern drugs not only improve the general condition of the patient, but also treat the affected cartilage tissue.
Injections in the knee joint for osteoarthritis is quite a difficult procedure, therefore you need to consult a doctor, even if the patient knows which drugs to inject and in what quantity.
For intra-articular injections, the following medications are most often prescribed:
- Corticosteroid hormones. These are the most common remedies, since the effect after its introduction is achieved in a matter of minutes. However, by relieving inflammation and pain, corticosteroids adversely affect the joint itself: the cartilage tissue remains degenerative, in addition, drugs of this group cause narrowing of blood vessels, which further destroys joint tissues. Therefore, the use of corticosteroid hormones is justified only in case of excruciating pain in the later stages of osteoarthritis. The injection cannot be repeated more than once every two weeks.
- Chondroprotectors and enzymes. Unlike hormones, they do not reduce inflammation, so administration is meaningless in the presence of joint inflammation. But they have a regenerative effect, partially restore cartilage tissue. The use of such drugs is especially effective in the initial stages of osteoarthritis. The course of treatment is 5 to 10 injections.
- Hyaluronic acid. A very effective drug, but at the same time expensive. Its effectiveness lies in the fact that the acid itself is similar in composition to the natural lubrication of the joint. After the introduction of drugs with hyaluronic acid in the knee, the friction of the affected joint surfaces decreases and the mobility of the knee improves. Such injections are very effective in the initial stage of osteoarthritis, a slightly less effect is observed in the second stage, and with osteoarthritis of the third knee joint, such drugs only briefly relieve the patient's condition. The course of treatment generally includes three to four injections once a year.
Injections in the knee joint for osteoarthritis are strictly contraindicated in the following cases:
- infection of the skin or subcutaneous tissue in the area intended for injection;
- septicemia;
- infectious arthritis;
- hemophilia;
- the presence of a viral infection;
- lack of result of previous injections;
- individual intolerance to the drug.
It is also unacceptable to perform intra-articular injections for prophylactic purposes.
Orthopedic knee braces for osteoarthritis of the knee joint.
During the treatment of osteoarthritis of the knee joint, to prevent various injuries, as well as to support damaged tissues and relieve stress on the joint, knee braces are used.
An orthopedic knee brace is essentially the same as an elastic bandage. However, compared to the latter, the knee brace has its advantages: it does not need to be bandaged several times a day, it does not slip or hang, a well-fitting knee brace does not squeeze the leg and causes swelling and other unpleasant consequences. prolonged tightening.
Orthopedic knee braces for osteoarthritis of the knee joint perform the following functions:
- reduce inflammation and pain;
- relieve swelling;
- relieve stiffness and tension;
- normalize blood circulation;
- Facilitate free movement of the joint.
When choosing an orthopedic knee brace, you should pay attention to the following features:
- Knee brace type: selected based on the severity of pain. There are these types of knee braces:
- closed - used when it is impossible to determine the location of pain;
- open with adjustable tension: used during rehabilitation and for minor pain;
- open with spiral reinforcement ribs - for pain during ascending and descending stairs, etc. ;
- articulated - for different types of pain;
- to support tendons: used if pain is located below the kneecap.
- The material from which the knee brace is made is of great importance, since not only the degree of fixation depends on it, but also the intensity of the heating effect. Modern knee pads are made of cotton, lycra, nylon, neoprene, spandex, camel, and dog hair.
- The size of the knee brace, which is calculated individually for each patient.
The doctor will help determine the parameters of the future purchase: he will not only select the size and type of knee brace that is optimal for the patient, but will also recommend which material will be the most effective.
Orthopedic knee braces for osteoarthritis can be purchased at a pharmacy or a store specializing in medical equipment, their price is quite acceptable. You need to be careful about such purchases from unspecialized outlets or from dubious companies, as you can easily buy a fake, which, if it does not harm, certainly will not help.
Proper nutrition
Nutritionists have been studying the nutritional characteristics of various peoples for many years. By comparing national cuisines, scientists are trying to understand the influence of people's culinary preferences on the occurrence of certain diseases. This type of research has been carried out many times in relation to such a common disease as osteoarthritis of the knee joint.
Many theories have been proposed, many different assumptions have been made. For example, at one time it was thought that the use of tomatoes contributes to the development of the disease, then it was suggested that table salt was "the culprit" of the development of osteoarthritis.
In the 20th century, the situation with the development of the disease has drastically deteriorated.
Proper nutrition is the key to joint health.
To prevent the development of the disease, it is necessary to understand that nutrition plays a key role in osteoarthritis of the knee joint. From the diet, the consumption of meat products belonging to the fast food segment should be minimized. These products are:
- semi-finished products made from meat waste: sausages, sausages, sausages of all kinds, etc.
- smoked meats that are sold in stores (most of the time, these types of products are prepared with chemicals and not in smokehouses).
- ready-to-eat meat: ham, bacon (manufacturers in this case do not hesitate to use flavor enhancers and colorings).
- Fast food.
Of course, not all people can give up the food products mentioned above. Many over the years have developed a habit of indulging in smoked sausage sandwiches or boiled hot dogs in the morning. In this case, we advise you to buy a piece of meat in the market, bake it in the oven with spices, cut it and then use it as a base for sandwiches. This type of "fast food" does not harm the body.
So we found that semi-finished products, smoked meats, and fast food are better off. But what happens to the meat if it is injected with a syringe?
The ideal option, of course, is to buy meat from trusted suppliers, but in urban conditions this advice is impractical.
In this regard, it is necessary to use such cooking methods so that as many harmful chemical compounds as possible are destroyed. Sometimes the use of only this factor made it possible to achieve an excellent effect in the fight against arthrosis.
How to properly cook food for osteoarthritis of the knee joint
It should be remembered that nutrition for arthrosis of the knee joint should not be saturated with fat.
Therefore, when preparing food, it is necessary to trim the visible fat from the meat and remove the skin from the poultry. It is in fat where the greatest amount of harmful substances is concentrated.
Boiling, stewing, baking in foil, and steaming are the healthiest ways to prepare food.
With osteoarthritis of the knee joint, you should not eat jelly and jelly meat. There is an opinion from the series "the grandmother in the yard said" that these dishes are good for joints, but this is not so. A person with osteoarthritis will only get worse with high cholesterol levels.
Meat broths and soups should be consumed as little as possible. Even if you drain the first broth, there will still be a lot of unhealthy fats in the second. It is better to get used to vegetable soups, so popular in western countries. Mushroom soups are also helpful.
An attempt to replace meat with soup with dry broths and cubes will not lead to anything good: these products contain an incredible amount of chemical components.
Unfortunately, the fish sold in our markets is also diligently injected with dyes and preservatives and is therefore detrimental to osteoarthritis of the knee joint. Therefore, you should buy live fish whenever possible. It is clear that not everyone has enough money for it. The above methods will help to properly cook frozen fish.
Prevention of osteoarthritis of the knee joint.
It is impossible to allow the living condition to worsen due to the disease, therefore the causes leading to osteoarthritis should be ruled out. It is much easier to prevent the disease than to deal with expensive and long-term treatment.
- You need to lose weight.
- The joints need constant physical activity: jumping rope, squats, small runs. But everything should be in moderation. Excessive exercise also leads to illness. Alternate joint loads with adequate rest.
- Due to knee injuries, osteoarthritis develops. When skiing, skating, biking, or rollerblading, padded knee pads should be worn. On sale there is a sufficient selection of fixing and warming knee pads from sheep's wool.
- Don't ignore someone else's help if the weight is beyond your strength.
- Eat more vegetables and fruits. It is observed that vegetarians practically do not suffer from osteoarthritis. Replace mayonnaise with olive or mustard oil. Especially useful are plums, dried apricots, apricots, apples, raspberries, blueberries with honey.
- Strong tea and coffee remove calcium in large amounts.
- Homemade cottage cheese and cheese will help strengthen your bones.
- Walking with a cane will prevent you from overstressing your knee joints.
- Shoes must be comfortable, with small heels.
- Swimming and water aerobics will relieve whole body stress and knee joint fatigue.
- Of the vitamins, vitamin E is especially useful, which prevents the destruction of cartilage tissue.
- Vitamin C participates in the synthesis of cartilage tissue.
- The disease progresses faster due to a lack of vitamin D.
- Calcium helps keep bones strong. High calcium content in sesame and celery seeds.
By observing these simple rules of a healthy lifestyle, you can avoid serious illness. And in the case of a manifestation of the disease, they will slow down the development of pathological processes.