Treatment of knee joint osteoarthritis

Knee joint osteoarthritis-This is a degenerative-dystophical disease of the cartilage, which leads to the exposure of bone heads and deteriorated mobility in the joint.The disease has non -inflammatory nature and progresses slowly: the transition from the initial stage to disability takes several decades for several years.The osteoarthrosis of the knee joint is included in the 5 most common causes of disability and disability worldwide.

More than 20% of people over 55 are subject to knee osteoarthritis (gonarrosis), but the disease is quickly young, more and more their symptoms manifest at the age of 25.

Over time, the treatment of the osteoarthritis of the knee joint will help avoid complications and destruction of the cartilage.

Signs of osteoarthritis of the knee joint

The wear of the joint cartilage is accompanied by characteristic features, whose intensity depends on the stage of the disease.Very often, patients complain about:

• Morning stiffness and reduction in articulation mobility (it is required to explode);
• pain and discomfort in the knees, which are improved after physical effort (walking, running, running or standing) and are in decline when they rest;
• In the second stage, the starting pains called after a long stay in a position;
• greater fatigue, which are often discarded to age -related changes;
• Dry thick crunch, which is repeated regularly when kneeling and bending;
• edema and other symptoms of inflammation that appear in the second stage of the disease due to the trauma of perioster tissues;
• Make -sensibility, increased symptoms in the cold season.

When trying to bend the knee beaten by gonarrosis, acute pain and a feeling of physical obstacle occurs.In the posterior stages, even in the presence of treatment of the osteoarthritis of the knee joint, patients are altered in patients (they become enjoying, patients walk on rigid legs), the deformation of the lower extremities in the form of letters "or" or "x" appears.

The insidiosity of the disease lies in the fact that it can occur in a hidden way for years, and the first significant symptoms often appear only in the second stage, when the complete restoration of the synovial cartilage is already impossible.
Therefore, it is important to consult a doctor with the first signs of discomfort in the knees, for example, weak, as if pains occur with insufficient production of synovial fluid.Remember: knee pain is not the norm regardless of age.The timely exam and the treatment of the osteoarthritis of the first grade knee can completely protect it from painful pain in old age joints.

What will happen if knee osteoarthritis is not treating?

In case of self-medication, breach of the doctor's recommendations or the absence of treatment, the osteoarthrosis of the knee joint progresses on average 3-8 times faster than with complex therapy.If gonarrosis occurs aggressively, the patient may lose the ability to move normally before the retirement age.

Especially important is the effective treatment of knee osteoarthritis in a exacerbation stage.Crude oil, physical or emotional stress, allergies, poisoning, transferred to the region with another climate: in a word, any shake for the body can cause it.The exacerbation of osteoarthritis proceeds with the destruction of a large number of chondrocytes.In response to this, the body produces enzymes designed to process and remove dead cells.However, if their concentration is too high, healthy cartilage areas suffer: cell membranes become thinner, erosion spotlights appear in the synovial seizure of the joint.This process, if you do not stop treating knee osteoarthritis with medications, can flow in a few weeks and with chronic stress, lack of sleep or insufficient diet, constantly.

Ultimately, without treatment, knee osteoarthrosis leads to a complete reduction in the light gap light due to the growth of osteophytes.The necessary gap for the normal movement closes, and the patient cannot bend the leg even at 30-45 °.The difficulty represents not only to climb the stairs, but also an attempt to get up from the sofa or the ordinary movement.This condition is accompanied by pain of which common analgesics do not help.In such cases, an option for the treatment of the osteoarthritis of the knee joint remains: surgical, with a complete replacement of articular architecture with prostheses and rehabilitation later long -term.But in this case, most patients cannot return to a completely normal life.

Treatment of the knee joint osteoarthrosis

Depending on the stage of the disease and the condition of the joint, the conservative or surgical treatment of the osteoarthritis of the knee joint is used.

The treatment of the arthrosis of the first grade knee joint is always carried out by conservative methods, in case of a successful combination of circumstances and good auto -Discipline, the patient can be obtained or persistent remission.

The treatment of osteoarthritis of the second degree knee joint, as a rule, is based on the use of all conservative effects methods, but the doctor can decide on minor surgical interventions in the joint if the disease develops aggressively or with complications.

The treatment of osteoarthritis of the 3 -degree knee joint almost always implies surgery.

The complex conservative treatment of the osteoarthritis of the knee joint implies the elimination of pain and inflammation, the restoration of the cartilage and an increase in the volume of movements in the joint.For this, the patient is prescribed an orthopedic regime of loads, system and local medications (hormonal and non -hormonal anti -inflammatory, analgesics, condoprotectors and others).Innovative biological methods are also propagated: drug injections for the treatment of osteoarthritis of the knee joint directly in the joint bag.At the same time, PRP infections (blood plasma, plotted with platelets) are used, as well as stem cell injections obtained from the patient's fatty tissue.Parallel, auxiliary and rehabilitation methods are connected: physiotherapy, massage, manual therapy, therapeutic gymnastics.

The surgical treatment of the osteoarthrosis of the knee joint is carried out in cases where medications are helpless.With this pathology, the doctor can prescribe the following interventions:

• Outroscopy of the knee joint.The collective name for a minimally invasive group of operations aimed at eliminating the broken area of articular fabric or osteophite, or partial split of the articular roof.It allows you to delay or exclude prostheses, as well as eliminate discomfort in the early stages of the disease.It is mainly used for the treatment of knee osteoarthritis in patients under 60 years.
• OsteotomyThe operation to cut part of the bone and the correction of the cargo axis in the painful knee, which allows it to slow down the degenerative changes.In general, it is carried out in the treatment of the osteoarthritis of the second degree knee joint.
• Endoprothetics.Partial or complete replacement for the knee joint with a titanium implant, which serves 15-20 years.This technique is an extreme measure, since it entails certain risks.Recommended for patients over 55 years.

All these operations require the recovery period and have a series of contraindications, so the best option remains prevention (exercise therapy, condoprotectors) and the treatment of the osteoarthritis of the knee joint in the early stages.

In addition to the main therapeutic techniques, diet therapy and other methods to reduce body weight are used.To download the sore joint, bandages and other orthosis are used (walking canes, orthopedic templates, etc.).

The treatment of knee osteoarthritis is prescribed by a rumatologist or orthopedist.At the first reception, feel the joint, perform motor tests and then direct the patient to tomography or radiography.

Therapeutic gymnastics for knee osteoarthritis

Medical Physical Education for the lower belt limbs is considered the most effective method to reduce the pain and treatment of osteoarthritis of the first grade knee joint.The first results of therapeutic gymnastics occur after 2-4 weeks of continuous classes.The continuity in the treatment of the osteoarthritis of the knee joint is one of the main factors that affect the effectiveness of exercise therapy.A complete lesson is carried out once a day a day, it is also recommended to make at least 3-4 heating during the day.

Therapeutic gymnastics for knee osteoarthritis during remission periods will help relieve pain syndrome.

The main task of physical exercises in the treatment of the osteoarthros of the knee joint is to strengthen the muscles of the thigh and the lower part of the leg, maintaining the elasticity of the ligaments and tendons, as well as the fight against muscular atrophy, which is characteristic of osteoarthritis.This allows you to transfer the load of the joint to the periarticular structures and, therefore, reduce the speed of the mechanical abrasion of the cartilage, reduce inflammation.

Exercises are performed for the treatment of osteoarthritis knee for both legs!When acute pain appears, the lesson must stop or continue at a softer pace.

1. Initial position: lying on my back.One leg extends on the floor, the other rises folded by 90 ° (the bottom of the leg is parallel to the floor).We perform movements with the lower leg up and down, in regards to the amplitude of the movements in the Board.
2. Initial position: lying on my back.We perform the "bicycle" exercise.
3. Initial position: lying on the stomach.In turn, we hang our feet, trying to bring the heels as close as possible to the buttocks.
4. The initial position is on the side, the hand bends under the head or stretches over the head along a line with the body.The other hand rests on the side.We make swings backwards.We change the side.
5. Initial position: lying on my back.We throw our legs forward on the floor in front of the heel (of ourselves), the socks look at us. "
6. Initial position: lying on the stomach.We do the "ship" exercise.If the physical preparation does not allow it, we put our palms on both sides of the chest and turn to take our legs back, experiencing stress on the posterior surface of the thigh and the lower part of the leg.
7. Initial position: lying on my back.We turn on the feet in turn, trying to describe the most complete circle with the socks.
8. Initial position: standing against the wall.Slowly and gently presented, without looking up with the back of the wall to distribute the load.When the legs bend on the knees at 90 °, we begin the soft movement up.
9. The initial position is standing.Alternatively, we are balancing our feet forward, back and forth.

Keep in mind: therapeutic gymnastics after the operations in the joint has its own details and changes depending on how many days have passed since the moment of surgery.It is prescribed by a surgeon or rehabilitist.

Knee osteoarthritis massage

The therapeutic massage for knee osteoarthritis is carried out on both legs.At first, at least 10-12 sessions are required for a rehabilitologist or equipment for hydromassage equipment, but a simple massage of general strengthening at home can be made.Includes the following types of movements:

• superficial caressing and rubbing (up and down, software and in anti -Horary sense);
• probing and stretching with the fingertips of deeper fabrics;
• Tighten and hit the skin.

The knee osteoarthritis massage must be performed by a specialist who does not damage the sick joint.

The car -massage can be combined with the treatment of osteoarthritis of the knee joint with drugs: it will not be superfluous to apply an ointment or a heating balm before or during the session.You can also take a warm bath before the procedure.

Important: massage is contraindicated to patients with symptoms of inflammation (osteoarthritis or exacerbation of osteoarthritis).In this case, acute phase therapy is required.

Diet therapy for osteoarthritis

The standard energy protocol in the treatment of the osteoarthritis of the knee joint requires:

• Limit products and dishes rich in simple carbohydrates (white bread, confectionery, snacks, sweets, potatoes, sugar);
• to exclude processed dishes (ready for use) and rich: fast food, semi -ends, sausages;
• Rejection alcohol, decoded coffee and fat meat.

Instead, you must include in the menu:

• Grooved and whole grains;
• Fat fish of the north seas and dietary meat of poultry;
• cartilage (ears, nyushki, legs and other parts rich in collagen), cold men and jelly;
• Vegetables and fruits rich in vitamins and antioxidants (in particular, vitamins A, B12, C, E);
• The nuts and other sources of omega fat and valuable minerals.

The diet with osteoarthritis of the knee joint provides a balanced diet, which helps restore cartilage tissue.

The treatment of osteoarthritis of the knee joint - Vitamin mineral complexes (2 courses annually) is also recommended.

Physiotherapy for the treatment of knee osteoarthrosis

The following physiotherapeutic procedures are used for the effective treatment of knee osteoarthritis and to improve the action of medicines:

• Magnetotherapy;
• laser therapy;
• UHF;
• ultrasound therapy;
• ampulse;
• electrophoresis (including medicinal);
• Ozkerita and Paraffin applications;
• Thermotherapy (cryotherapy, inductothermia);
• phonoforesis;
• Balneological therapy (sulfuric, hydrogen sulphide baths).

Acupuncture in the treatment of the osteoarthritis of the knee joint 2 degrees, as a rule, is not used.

Before visiting the procedures, it is necessary to consult a doctor: many types of physiotherapy are contraindicated in the exacerbation of the disease.

Medications for the treatment of osteoarthritis of the knee joint

The treatment of the osteoarthritis of the knee joint with medications is carried out symptoms and takes into account the individual reaction of the patient to the selected medications.Pharmacological therapy (injections, ointments or tablets for the treatment of the osteoarthritis of the knee joint) is usually prescribed courses or as necessary.

To choose the appropriate medication for the treatment of the osteoarthritis of the knee joint, consult a doctor who, after the study, will select the necessary medications.

In the treatment of the osteoarthritis of the knee joint, there are several directions: relief of the patient's life, improving the nutrition of the cartilage, the regeneration of the cartilage and the maintenance of the norm of the muscle line apparatus.

Non -steroid anti -inflammatory drugs

To relieve NSAIDs in tablets or capsules, they take courses (approximately 12 days) or if necessary, depending on the intensity of pain syndrome.The uncontrolled NSAID reception with impaired instructions or recommendations of the doctor is loaded with stomach ulcer or intestines.They must be very careful when taking them in combination with glucocorticosteroids and medications that affect blood coagulation.Additional risk factors: age of more than 65, smoking, alcohol intake during the course.In these cases, doctors generally recommend the administration of injection drugs overlooking the gastrointestinal tract.Together with the NSAIDs, it is advisable to take gastroprotectors.

The maximum effect can be achieved with a combination of systemic NSAIDs (for internal administration) and external, in the form of ointments, creams or gels.The second option provides a specific effect on the affected joint and at the same time minimally affects digestion.

Corticosteroids (steroid drugs for the treatment of the osteoarthritis of the knee joint)

Hormonal drugs (civil code) are generally used for knee steroid blockade in cases where NSAIDs is not enough to calm pain and inflammation.

Glucocorticoid injections are considered an extreme measure in the treatment of the osteoarthritis of the knee joint with medications.They provide relief 20 minutes after administration, but hormonal disorders and damage to cartilage tissue in violation of the administration rules can cause.Due to side effects, many orthopedists prefer an operation in the knee of prolonged CC therapy.

Condroprotectors in the treatment of osteoarthritis of the knee joint

Condroprotector agents based on nuclei extracts and cattle of cattle, marine and mollusc fish contribute to the restoration of synovial cartilage and, therefore, are irreplaceable for the effective treatment of knee osteoarthritis.Condroprotectors contain a lot of glycosaminoglycans: natural polymers, from which the cartilage is built.Therefore, they make chondrocytes (cartilaginous cells) more stable, contribute to their growth, enrich the synovial fluid.

Unlike anti -inflammatory medications, chondroprotectors practically have no contraindications.They provide a cumulative and prolonged effect: the first improvements occur after 1-3 months of admission, and the duration of the course is 3 to 6 months.

Skin playback agents

External preparations for the treatment of knee osteoarthritis with a local growth effect improve blood circulation and joint nutrition, and also distract the patient from pain.For this purpose, ointments, gels, creams and balms based on natural ingredients are used: a snake bees or poison, burning pepper extract.

In the presence of an allergic reaction (persistent redness and skin pain, eruption), during pregnancy and breastfeeding, as well as in the presence of other contraindications, it is better to avoid the heating of ointments for the treatment of osteoarthritis of the knee joint and limit to warm baths, applications and external anti -inflammatories.

Synovial fluid prosthesis

If the synovial fluid in the joint is too small, the sliding of the articular surfaces is altered.And most importantly, cartilage hunger begins, because joint fluid, which only drinks it as a sponge, usually provides nutrients for the growth and maintenance of cartilage tissue.To prevent cell destruction and mechanical abrasion of the knee cartilage, the doctor can prescribe injections of high molecular derivatives of Hialuron.The drug injections in the treatment of the osteoarthritis of the knee joint (viscator) become directly into the joint bag, which leads to rapid relief, which lasts from 3 to 12 months at the end of the course.However, with the introduction of prostheses, there is a risk of necrotic changes or infections in the joint.

Antispasmodics, analgesics, muscle relaxants

In cases where spasms and muscle tension prevent the patient from falling asleep, create pain during movement, the doctor prescribes antispasmodics and muscle relaxants.

Simple analgesics are not used in the treatment of the osteoarthritis of the knee joint, since they mask pain, but do not relieve inflammation.You can use them or Aine affordable without a medical recipe for up to 10 days, after which an exam is required.

The form of release of medications for the treatment of osteoarthritis of the knee joint

For the convenience of patients, medicines for the treatment of osteoarthritis of the knee joint are released in several ways.Is there any difference between them and which one to choose?

Preparations for the treatment of knee osteoarthritis have several forms of release: Sasha, injections, ointments, tablets.Choose what is most suitable for you.

Capsules, Sasha and tablets for the treatment of osteoarthritis of the knee joint

Non -steroidal anti -inflammatory medications, corticosteroids, condoprotectors and muscle relaxants occur in forms for oral administration.In this case, they are easy to dose, the reception is possible without the participation of a medical worker, it is easy to control which part of the course has already been approved.When taking condoprotectors and NSAIDs inside, they have a fairly high bioavailability (especially in Sasha's form).When taking a condoprotective in the periarticular region, more than 95% of the beneficial substances of the drug are obtained.

Injection solutions

In the form of injections, you can take the NSAIDs already mentioned, the Civil Code, the condoprotectors and the muscle relaxants, as well as the prostheses of synovial fluids.This method to treat the osteoarthritis of the knee joint demonstrates maximum bioavailability.

This method to treat knee osteoarthritis is safe for digestion, but it is desirable that injections (intravenously, intramuscular in the joint or intra -articular) place a qualified medical staff.Intramuscular injections in the buttock or thigh can be done independently.

External use

Local growth, anti -inflammatories and chondroprotective ointments are used externally to treat the osteoarthritis of the knee joint.The advantage of such a drug is to direct the effects on the affected tissue.But on the path of active substances, it increases a skin barrier, unfortunately, often only 5% of the active ingredients reach the desired layers of tissues.

We hope we have been able to help.Grits confident for you!