Osteoarthritis of the knee joint is a disease of the musculoskeletal system, which consists of deformation and destruction of the cartilage tissue of the joint, as a result of which the structure and functions of the cartilage are disturbed.The disease has several names - gonarthrosis, deformed osteoarthritis.The treatment of osteoarthritis of the knee joint does not have an unequivocal scheme or a single drug that will equally help everyone who suffers from this problem.Since arthrosis is a progressive disease, it is more often observed in overweight women, venous diseases and the elderly.Treatment is carried out and prescribed individually for each patient.
Osteoarthritis of the knee joint can be unilateral or bilateral (depending on whether the disease develops on one or both legs).At the first symptoms, it is necessary to use adequate treatment, because neglecting this problem can lead to the final destruction of the cartilage and bone exposure and, as a result, the disability of the person.
There are three stages of the disease:
- The initial stage of knee arthrosis is characterized by the loss of shock-absorbing properties and, as a result, the cartilages rub together during movement, which causes severe discomfort to the patient.Cartilage becomes rough, deformed, dries up and even cracks in the advanced stage of the disease.
- Due to reduced cushioning, bone deformation begins, which leads to the formation of osteophytes (growths on the surface of bones) - this is the second stage of the disease.The new joint membrane and capsule are also subject to deformation, the knee joint gradually atrophies due to stiffness of movement.There is also a change in the density of the joint fluid (it becomes thick, viscous), poor circulation and the supply of nutrients to the knee joint deteriorates.Thinning of the membrane between cartilaginous joints reduces the distance between the articular bones.
- The disease progresses rapidly and quickly moves into the third stage, when the patient is practically unable to move due to constant pain in the knee.Global and irreversible changes occur in the cartilage tissue, which causes a person to be disabled.
Most often, arthrosis or gonarthrosis develops after an injury or a bruise, and a person experiences constant severe pain in the knee, which significantly hinders his movement.
Reasons for the development of arthrosis
Arthrosis of the knee joint, the treatment of which takes a long time, can be detected due to the following factors:
- genetic predisposition.
- Injuries: dislocations, bruises, fractures.When treating an injured knee, the joint is immobilized and the person cannot bend or straighten the leg for a certain period of time.This leads to the deterioration of blood circulation, which most often leads to the development of post-traumatic gonarthrosis.
- Meniscus removal.
- Excessive physical activity that is not suitable for a person's age, which causes injuries or microtraumas, as well as hypothermia of the joints.For example, jogging or squatting on asphalt is not recommended for elderly people, because during these exercises, significant pressure is placed on the knee joint, which wears out with age and cannot withstand such a load.
- Overweight and obesity.This factor causes damage to the menisci, the damage of which provokes the development of arthrosis of the knees.
- Loose ligaments or weak ligaments.
- Arthritis or other acquired joint diseases.The inflammatory process can cause accumulation of synovial fluid in the joint cavity or swelling.This leads to the destruction of the cartilage tissue of the knee, which leads to osteoarthritis of the knee joints.
- Metabolic disorders in the human body.An insufficient amount of calcium significantly worsens the condition of bone and cartilage tissue in the human body.
- flat feet.The incorrect structure of the foot changes the center of gravity and the load on the joint becomes greater.
- Stress and nervous tension.
Symptoms of knee arthrosis
The clinical picture of the disease has the following symptoms:
- painful sensations.The pain appears suddenly, depending on the physical load on the knee joint.Painful sensations can be of different nature.At the initial stage, it is a weak lumbago, which a person usually does not pay much attention to.Intermittent mild pain can be experienced for months, and sometimes years, before the disease progresses to a more aggressive stage.
- Visible knee deformity.This symptom appears in later stages.Initially, the knee appears swollen or swollen.
- Accumulation of joint fluid in the joint cavity or Baker's cyst.It is a dense growth on the back wall of the knee joint.
- Cramping of the joints.In patients in the second and third stages of the disease, sharp crackling sounds accompanied by pain are observed.
- Inflammatory reactions in the articular synovium, resulting in cartilage swelling and volume increase.
- Joint mobility decreases.fixed at later stages.Bending the knee becomes almost impossible and is accompanied by severe pain.At the final stage, the knee can be completely immobilized.Human movement becomes difficult or completely impossible (some patients move on bent legs).
Treatment of arthrosis of the knee joint
Treatment of arthrosis of the knee joint should be comprehensive.To date, there is no medical drug that relieves this disease.One of the important conditions for successful treatment is timely diagnosis.The earlier the treatment of knee arthrosis begins, the greater the chance of prolonging the remission period and preventing the destruction and deformation of cartilage and bone tissue.
During the treatment, the doctor and the patient face several tasks:
- elimination or reduction of pain;
- supplying nutrients to the knee joint and thus increasing its regenerative function;
- activation of blood circulation in the knee joint;
- strengthening the muscles around the joint;
- increasing joint mobility;
- Try to increase the distance between the articulated bones.
Treatment of the disease, depending on the stage of its development, can be conservative and surgical.
Conservative treatment of knee joint arthrosis
Painkillers, anti-inflammatory drugs
To relieve or reduce the pain, the patient is usually prescribed a course of non-steroidal anti-inflammatory drugs (NSAIDs).It can be tablets, ointments and injections.Among the most common pain relievers are the following.These drugs can be used in two ways - orally or topically.
As a rule, patients prefer local treatment in the form of gels, ointments and heating patches.The effect of these painkillers does not occur immediately, but after several days (about 3-4 days).The maximum effect is achieved after a week of regular use of the drug.Such medicines do not treat the disease as such, but only relieve the pain, because it is impossible to start treating the pain.
Painkillers should be taken strictly according to the doctor's prescription;They should be used only in severe pain, as long-term and frequent use can cause side effects and even accelerate the destruction of joint cartilage.In addition, long-term use of these drugs increases the risk of adverse reactions, including stomach ulcers, duodenal ulcers, liver and kidney dysfunction, and allergic manifestations in the form of dermatitis.
hormones
Sometimes in the treatment of arthrosis of the knee joint, a course of hormonal drugs is prescribed.They are prescribed if non-steroidal anti-inflammatory drugs are no longer effective and the disease itself begins to progress.Most often, hormonal drugs are used in the form of injections to treat this disease.
The course of treatment with hormonal drugs is usually short and is prescribed during severe exacerbations, when inflammatory fluid accumulates in the joint.The hormone is injected into the joint about once every ten days.
Chondroprotectors
At the initial stage of the disease, glucosamine and chondroitin sulfate, the so-calledCourse of chondroprotectors.This is the most effective treatment for arthrosis.They have almost no contraindications and side effects occur in rare cases.
Vasodilators
Vasodilators are prescribed to relieve spasm of small blood vessels, improve blood circulation and deliver nutrients to the knee joint, as well as eliminate vascular pain.They are delayed with chondroprotectors.If knee arthrosis is not accompanied by fluid accumulation, it is also recommended to use heating ointments, gels and fluids.
therapeutic exercise
A course of exercise therapy can be very useful and bring good results only under the prescription and supervision of a doctor, with the recommendation of a specialist or trainer.Self-medication is dangerous for health.Exercise therapy is used to prevent further cartilage destruction, slow the development of stiffness, and relax muscle spasms that cause pain.Exercise therapy is contraindicated in the period of exacerbation.A course of special individual exercises, which takes into account not only the stage of the disease and the condition in which the cartilage is located, but also the age of the patient, should be developed by a competent specialist in this field.
Physiotherapy
Physiotherapy is used as one of the methods of conservative therapy - electrophoresis, laser therapy, acupuncture, diadynamic currents, UHF.A local massage course also gives positive results.Physiotherapy methods act in several directions - relieve pain, reduce inflammation, normalize metabolism inside the joint and restore its normal functions.The method and duration of physiotherapy treatment is determined by the patient's medical history and is prescribed only after a thorough diagnosis and study of the joint condition.
Pain-relieving physiotherapy includes:
- Medium wave ultraviolet radiation (SUV radiation).The contact of ultraviolet radiation with the skin of the knee lasts until a slight redness.Substances are produced in the tissues that reduce the sensitivity of nerve fibers, due to which the pain-relieving effect is achieved.The duration of the treatment course is determined by the doctor depending on the symptoms, frequency and severity of the pain.On average, the course of treatment is about 7-8 sessions.
- Local magnetic therapy aims at the total recovery of the patient's body.This procedure relieves inflammation, relieves pain and neutralizes muscle spasm.It is effectively used in the initial stages of arthrosis of the knee joint.The course of treatment is usually limited to 20-25 procedures, each of which lasts about half an hour.
- Infrared laser therapy, low intensity UHF therapy, centimeter therapy (SMV therapy).
- Ultrasound, darsonvalization, therapeutic baths, interference therapy prescribed to improve blood circulation in the joint.
Treatment at a health resort is of no small importance.This treatment is prescribed for deforming and dystrophic osteoarthritis.This treatment, like the one listed above, has its contraindications, so the attending physician carefully examines the patient's medical history before recommending the sanitary-spa method.
Surgical treatment of arthrosis of the knee joint
This is a radical method of treating arthrosis of the knee joint, which partially or completely restores the function of the joint.Methods and forms of surgical intervention depend on the degree of joint damage, as well as the patient's medical history.
Late arthrosis of the knee joint can only be treated surgically - the knee joint is completely or partially replaced with an endoprosthesis.Surgical treatment allows not only to improve well-being, but also to restore the patient's ability to work in the final stages of knee arthrosis.Many consider the long recovery period to be a significant disadvantage of surgery using exercise therapy, mechanotherapy, and other means.
There are several types of surgical intervention for knee arthrosis:
Prevention of knee arthritis
To prevent this disease, people at risk (athletes, elderly, overweight, factory workers) should follow certain guidelines:
- Proper nutrition and fight against excess weight.It is necessary to exclude unhealthy foods from the diet - fatty foods, fried foods, alcohol, and it is better to consult a nutritionist who will individually help you choose a suitable diet.
- When playing sports, monitor the load on the joints and reduce it if necessary.
- Monitor your health and treat infectious diseases in time to prevent them from becoming chronic.
- Timely and adequate treatment of spine diseases, if any, development of correct posture.
- Sports activities (cycling, swimming, walking, special joint exercises).
- No self-medication!At the first symptoms of knee arthritis, contact the clinic.
- Avoid stress, sleep well.
- Systematically increase immunity (get stronger or take a course of vitamins at least 2-3 times a year).
- Avoid hypothermia of the body, especially the lower extremities.
A healthy lifestyle and timely treatment are the best ways to prevent knee arthritis.