Arthrosis of the knee joint-Thies is a degenerative-dystrophic cartilage disease that leads to exposure to bone heads and impairing mobility in the joint.The disease does not have anti -inflammatory and is slowly going - the transition from the initial phase to disability takes several years to several decades.The osteoarthrosis of the knee joint is contained in the 5 most common causes of disability and disability around the world.
Over 20% of people over 55 years are subject to knee arthrosis (gonar rose), but the disease is quickly young - their symptoms are increasingly being manifested at the age of 25.
Over time, the treatment of osteoarthritis of the knee joint will help avoid complications and the destruction of cartilage.
Signs of osteoarthritis of the knee joint
The wear of the articular cartilage is accompanied by characteristic features, the intensity of which depends on the stage of the disease.Most of the time the patients complain about:
- Morning stiffness and reduction in mobility in the joint (Wake -up is required);
- Pain and symptoms in the knees that are reinforced after physical exertion (long walking, running or standing) and remove them in rejection;
- In the 2nd stage - the so -called starting pain that occur in a position after a long stay;
- Increased fatigue, which is often written off to age -related changes;
- Dry gross crunch, which is repeated regularly when kneeling and bending;
- Edema and other inflammatory symptoms that occur in the 2nd stage of the disease due to the trauma of Perioster tissue;
- Mete sensitivity, increased symptoms in the cold period.
When trying to bend the knee hit by gonar rose, there is a sharp pain and a feeling of physical obstacles.In the later stages, patients themselves are disturbed in the presence of osteoarthritis of the knee joint in patients (it will enjoy that patients go on stiff legs) and the deformation of the lower extremities appears in the form of the letters "O" or "X".
The insidence of the disease lies in the fact that it can occur in hidden form for years, and the first significant symptoms often only occur in the 2nd stage - if the complete restoration of the synovial cartilage is already impossible.
Therefore, it is important to consult a doctor at the first signs of symptoms in the knees - for example, weak as if they were pulling pain that occurs with inadequate production of synovial fluid.Remember: Knee pain is not the norm regardless of age.A timely examination and treatment of the osteoarthritis of the knee of the 1st degree can fully protect it in the age of painful pain in the joints.
What will happen if the osteoarthritis of the knee is not treated?
In the event of self-medication, the doctor's recommendations or the absence of treatment are on average 3-8 times faster than with complex therapy.If gonarthrosis occurs aggressively, the patient can lose the ability to move normally before retirement age.
The effective treatment of knee osteoarthritis at a deterioration stage is particularly important.Raw weather, physical or emotional stress, allergies, poisoning, move to the region with a different climate - with a word, everyone shaking the body.The deterioration in arthrosis is with the destruction of a large amount of chondrocytes.In response, the body produces enzymes that are supposed to process and remove dead cells.However, if your concentration is too high, healthy cartilage areas will suffer - cell membranes become thinner, erosion forms appear on the synovial attack of the joint.If it is not stopped by the treatment of knee arthrosis with medication, this process can flow within a few weeks and with chronic stress, lack of sleep or inadequate nutrition.
Ultimately, the osteoarthrosis of the knee without treatment leads to a complete reduction in the lumen of the common gap due to the growth of osteophytes.The gap required for the normal movement is closed and the patient cannot bend the leg even at 30-45 °.Difficulties are not only climbing the stairs, but also an attempt to get up from the sofa or ordinary movement.This condition is accompanied by pain, of which ordinary analgesics do not help.In such cases, an option to treat the arthrosis of the knee joint remains surgically with a complete replacement of the joint architecture by prosthesis and subsequent long -term rehabilitation.In this case, however, most patients cannot return to a completely normal life.
Treatment of osteoarthrosis of the knee joint
Depending on the stage of the disease and the condition of the joint, conservative or surgical treatment of the arthrosis of the knee joint is used.
The treatment of the osteoarthritis of the knee joint of the 1st degree is always carried out by conservative methods - in the successful combination of circumstances and good self -discipline, the patient can be obtained or a persistent remission.
The treatment of the osteoarthritis of the knee joint of the 2nd degree is usually based on the use of all methods of conservative effects, but the doctor can choose minor surgical interventions in the joint if the disease develops aggressively or with complications.
The treatment of osteoarthritis of the knee joint of 3 degrees almost always implies surgery.
The complex conservative treatment of the arthrosis of the knee joint includes the removal of pain and inflammation, the restoration of the cartilage and an increase in the movement volume in the joint.For this purpose, the patient is prescribed an orthopedic regime of loads and calm, systems and local drugs (hormonal and non -hormonal inflammatory anti -inflammatory analgesics, chondroprotectors and others).Innovative biological methods are also widespread - injections of medication for the treatment of osteoarthritis of the knee joint directly into the joint bag.At the same time, PRP infections (blood plasma with platelets) and injections of stem cells are used from the patient's own adipose tissue.At the same time, auxiliary and rehabilitation methods are connected - physiotherapy, massage, manual therapy, therapeutic gymnastics.
The surgical treatment of osteoarthrosis of the knee joint is carried out in cases where medication is powerless.With this pathology, the doctor can prescribe the following interventions:
- Arthroscopy of the knee joint.The collective name for a group of minimal invasive operations that aim to remove the broken area of joint material or osteophytes or a partial excision of the joint shell.They can delay or exclude prosthetics and eliminate symptoms in the early stages of the disease.It is mainly used to treat the knee osteoarthritis in patients under 60 years.
- Osteotomy.The operation to cut part of the bone and the correction of the load axis on the painful knee so that you can slow down degenerative changes.It is usually carried out in the treatment of the osteoarthritis of the knee joint of the 2nd degree.
- Endoprosthetics.Partial or complete exchange of the knee joint with a titanium implant that serves 15 to 20 years.This technology is an extreme measure because it forms certain risks.Recommended for patients over 55 years.
All of these operations require the recovery phase and have a number of contraindications.The best option remains prevention (exercise therapy, chondroprotectors) and the treatment of osteoarthritis of the knee joint in the early stages.
In addition to the most important therapeutic techniques, nutritional therapy and other methods to reduce body weight are used.To unload the painful joints, associations and other orthoses are used (hiking sticks, orthopedic insoles, etc.).
The treatment of the arthrosis of the knee is prescribed by the A-Rhumatologist or orthopedic surgeon.At the first reception, he gropes the joint, makes motor tests and then leads the patient to tomography or radiography.
Therapeutic gymnastics for the arthrosis of the knee
Medical physical education for the limbs of the lower belt is considered the most effective method to reduce pain and to treat the osteoarthritis of the knee joint of the 1st degree.The first results of therapeutic gymnastics occur after 2-4 weeks of continuous classes.The continuity in the treatment of osteoarthritis of the knee joint is one of the main factors that influence the effectiveness of training therapy.A complete lesson is carried out once a day.It is also recommended to make at least 3-4 warming during the day.
Therapeutic gymnastics for the arthrosis of the knee in remissions of remissions helps to alleviate pain syndrome.
The main task of physical exercises in the treatment of osteoarthritis of the knee joint is to strengthen the muscles of the thigh and lower leg and to maintain the elasticity of ribbons and tendons as well as the fight against muscle atrophy, which is characteristic of arthrosis.In this way you can transfer the load from the joint into the periartic structures - and thus slow the mechanical abrasion of cartilage, reduce inflammation.
Exercises for the treatment of arthrosis knees are carried out for both legs!If a sharp pain appears, the lesson should be stopped or stopped at a gentler pace.
- Starting position - lie on the back.One leg is extended on the floor, the other is increased by 90 ° (the lower leg is parallel to the floor).We carry out movements with the lower leg up and down until the amplitude of the movements allows in the connection.
- Starting position - lie on the back.We carry out the "bike" exercise.
- Starting position - lying on the stomach.In return, we wander our feet and try to bring the heels as close as possible on the buttocks.
- The starting position lies on the side, the hand is bent under the head or stretched over the head over the head over the head.The other hand rests on the side.We swallow around upside down.We change the site.
- Starting position - lie on the back.We pull our legs on the floor in front of our heel (from ourselves), socks look "on ourselves".
- Starting position - lying on the stomach.We do the "boat" exercise.If the physical preparation does not allow, we cover our palms on both sides of the chest and take the legs back, experiencing excitement in the rear surface of the thigh and lower leg.
- Starting position - lie on the back.We again turn in our feet and try to describe the most complete circle with socks.
- Starting position - stand against the wall.Slowly and gently crouch, without looking at your back from the wall to distribute the load.If the legs are bent on the knees by 90 °, we start a smooth movement.
- The starting position is available.Alternatively, we swing our feet forward, back and on the side.
Please note: The therapeutic gymnastics after the operations in the joint has its own details and changes, depending on how many days have passed since the operation.It is prescribed by a surgeon or rehabilitologist.
Massage with osteoarthritis of the knee
In both legs, the therapeutic massage for the osteoarthritis of the knee is carried out.For the first time, at least 10-12 sessions are required for a rehabilitologist or devices for hydromassage devices, but a simple general strengthening of the massage can be carried out at home.It contains the following types of movements:
- superficial stroking and rubbing (up and down, software and against clockwise);
- Examination and stretching with the fingertips of lower fabrics;
- Pull and knock on the skin.
A massage with osteoarthritis of the knee should be carried out by a specialist who will not damage the pathological joint.
Self -massage can be combined with the treatment of the osteoarthritis of the knee joint with medication: it is not superfluous to apply a heat ointment or balm in front of or during the session.You can also take a warm bath before the procedure.
Important: Massage is contraindicated against patients with inflammatory symptoms (osteoarthritis or deterioration in arthrosis).In this case, therapy is required for the acute phase.
Dietotherapy for osteoarthritis
The standard performance protocol requires the treatment of osteoarthritis of the knee joint:
- Limit products and dishes that are rich in simple carbohydrates (white bread, confectionery, snacks, sweets, potatoes, sugar);
- Processed (ready for use) and exclude rich dishes - fast food, semi -financed products, sausages;
- Turn alcohol, decoded coffee and fat meat.
Instead, you should include in the menu:
- Dishes made of sprouts and whole grains;
- Fat fish the northern lake and dietic poultry meat;
- Cartilage (ears, nyushki, legs and other parts that are rich in collagen), cold men and jelly;
- Rich vegetables and fruits are rich in vitamins and antioxidants (especially vitamins A, B12, C, E);
- Nuts and other sources for fatty acids and valuable minerals.
The diet with osteoarthritis of the knee joint ensures a balanced diet that helps to restore cartilage tissue.
The treatment of osteoarthritis of the knee joint with medication - vitamin mineral complexes (2 courses per year) is also recommended.
Physiotherapy to treat osteoarthrosis of the knee
The following physiotherapeutic methods are used for the effective treatment of knee arthrosis and to improve the effect of medicinal products:
- Magnetotherapy;
- Laser therapy;
- UHF;
- Ultrasonic therapy;
- Amplipulse;
- Electrophoresis (including medical);
- Ozokerite and paraffin applications;
- Thermotherapy (cryotherapy, inductothermia);
- Phonophoresis;
- Balneological therapy (sulfur, hydrogen sulfide).
Acupuncture in the treatment of osteoarthritis of the knee joint 2 degrees is usually not used.
Before visiting the procedures, it is necessary to consult a doctor - many types of physiotherapy are contraindicated when tightening the disease.
Medicines for the treatment of osteoarthritis of the knee joint
The treatment of the arthrosis of the knee joint with medication is carried out symptoms and taking into account the patient's individual response to the selected medication.Pharmaceutical therapy - injections, ointments or tablets to treat the arthrosis of the knee joint - are usually prescribed courses or as required.
In order to choose the right medication to treat the osteoarthritis of the knee joint, according to the study, a doctor chooses the necessary medication.
There are several directions when treating the arthrosis of the knee joint: relief of the patient's life, improvement in the food of the cartilage, the regeneration of cartilage and maintaining the norm of the muscle rocking apparatus.
Non -steroidal anti -inflammatory medication
In order to alleviate exacerbations of NSAIDs in tablets or capsules, you need courses (approx. 12 days) or, if necessary, depending on the intensity of pain syndrome.The uncontrolled reception of NSAIDS with impaired instructions or recommendations from the doctor is affected with stomach ulcers or intestines.You should make sure to take them in combination with glucocorticosteroids and medicines that influence blood clotting.Additional risk factors - age over 65 years, smoking, alcohol consumption during the course.In these cases, doctors usually recommend the administration of medicinal products in the injection by bypassing the gastrointestinal tract.Together with NSAIDS, it is advisable to take guest protectors.
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 point effect on the affected joint and at the same time influences digestion.
Corticosteroids (steroid medication for the treatment of osteoarthritis of the knee joint)
Hormonal drugs (civil code) are usually used for those to do the steroid blockade of the knee in cases in which the NSAID is not sufficient to calm pain and inflammation.
Injections of glucocorticoids are seen as an extreme measure in the treatment of osteoarthritis of the knee joint with medicinal products.They make relief 20 minutes after administration, but hormonal disorders and damage to the cartilage tissue that violates the administrative rules can lead to this.Due to side effects, many orthopedists prefer surgery on the knee of longer CC therapy.
Chondroprotectors in the treatment of the osteoarthritis of the knee joint
Chondroprotective active ingredients based on extracts made of seeds and cartilage of cattle, sea fishing and mollusks contribute to the restoration of the synovial cartilage and are therefore irreplaceable for the effective treatment of the knee arthrosis.Chondroprotectors contain a large number of glycosaminoglycans - natural polymers from which the cartilage is built.Therefore, they make chondrocytes (cartilaginous cells) more stable and contribute to their growth and enrich the synovial fluid.
In contrast to anti -inflammatory medication, chondroprotectors have practically no contraindications.They provide a cumulative, longer effect-like-the first improvements after 1-3 months of approval, and the duration of the course is 3-6 months.
Skin memory
External preparations for the treatment of osteoarthritis of the knee with a locally growing effect improve the blood circulation and the diet of the joint and also distract the patient from pain.For this purpose, ointments, gels, creams and balms based on natural ingredients are used - bee or snake venom, pepper extract.
In the presence of an allergic reaction (persistent redness and pain of the skin, rash), during pregnancy and lactation as well as in the presence of other contraindications, it is better to avoid heating ointments for the treatment of osteoarthritis of the knee joint and to limit yourself to warm baths, applications and external anti -inflammers.
Synovial fluid prostheses
If the synovial fluid in the joint is too small, gliding the articular surfaces is disturbed.And above all, the hunger of cartilage begins because the articular fluid, which it only drinks like a sponge, usually supplies nutrients for growth and maintaining cartilage tissue.In order to prevent the destruction of the cells and the mechanical abrasion of the knee cartilage, the doctor can prescribe injections of hyaluron lines with a high molecular weight.The injections of the drug in the treatment of the arthrosis of the knee joint (viscostering) are set up directly in the joint bags, which leads to a quick relief that takes 3 to 12 months at the end of the course.With the introduction of prostheses, however, there is a risk of necrotic changes or infections in the joint.
Anti -spas modos, analgesics, muscle relaxants
In cases where cramps and muscle tensions prevent the patient from causing pain during the movement, the doctor prescribes antipasmodic and muscle relaxants.
Simple analgesics in the treatment of osteoarthritis of the knee joint are not used because they mask the pain but do not relieve inflammation.You can use you or affordable NSAIDs without a medical recipe for up to 10 days, according to which an exam is required.
The form of the release of drugs for the treatment of the arthrosis of the knee joint
For the convenience of the patients, medication for the treatment of osteoarthritis of the knee joint in different forms is released.Is there a difference between you and which to choose?
The preparations for the treatment of knee arthrosis have different forms of release: Sasha, injections, ointments, tablets.Choose what is best suited for you.
Capsules, Sasha and tablets to treat the osteoarthritis of the knee joint
Non -steroidal anti -inflammatory drugs, corticosteroids, chondroprotectors and muscle relaxants are produced 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 passed.When taking chondroprotectors and NSAIDs, they have a fairly high bioavailability (especially in the form of Sasha).When taking a chondroprotekor in the periary region, more than 95% of the advantageous substances from the medicine will be obtained.
Injection solutions
In the form of injections you can take the already mentioned NSAIDs, civil code, chondroprotectors and muscle relaxants as well as synovial fluid prostheses.This method for the treatment of osteoarthritis of the knee joint shows maximum bioavailability.
This method for treating knee arthrosis is certain for digestion, but it is desirable that injections (intravenous, intramuscularly in the joint or intra -articular) create a qualified medical personnel.Instramuscular injections in the buttocks or thighs can be carried out independently of one another.
External use
Local growing, anti -inflammatory and chondroprotective ointments are used externally to treat the osteoarthritis of the knee joint.The advantage of such a drug is to guide the effects of the affected tissue.However, a skin barrier increases on the way of active substances - unfortunately only 5% of the active ingredients often reach the desired tissue layers.
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