Osteoarthritis of the knee joint is a disease of the musculoskeletal system, which is expressed in the 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, deforming osteoarthritis.The treatment of osteoarthritis of the knee joint does not have an unequivocal scheme or a single drug that will help everyone who suffers from this problem equally.Since arthrosis is a progressive disease, it is more often seen in women with excess weight, 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 resort to adequate treatment, since the neglect of this problem can lead to the final destruction of the cartilage and the exposure of the bone and, as a result, to the impairment of the person.
There are three stages of the disease:
- The initial stage of knee arthrosis is characterized by a loss of cushioning properties, and as a result, the cartilage rubs against each other during movement, causing severe discomfort to the patient.The cartilage thickens, deforms, dries up, and in an advanced stage of the disease even becomes covered with cracks.
- Due to reduced depreciation, deformation of the bones begins, which leads to the formation of osteophytes (growths on the surface of the bones) - this is the second stage of the disease.The new membrane of the joint and the 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 thicker, more viscous), poor circulation and deterioration of the supply of nutrients to the knee joint.Thinning of the lining between cartilaginous joints reduces the distance between the joint bones.
- The disease progresses rapidly and quite quickly passes 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, leading to damage to the person.
Most often, arthrosis or gonarthrosis develops after an injury or a bruise, while a person experiences constant severe pain in the knee, which significantly complicates his movements.
Reasons for the development of arthrosis
Arthrosis of the knee joint, the treatment of which takes a long time, can occur due to the following factors:
- Genetic predisposition.
- Injuries: dislocations, bruises, fractures.When treating an injured knee, the joint is fixed and the person cannot bend or straighten the leg for a certain time.This leads to deterioration of blood circulation, which most often provokes the development of post-traumatic gonarthrosis.
- Removal of the meniscus.
- Excessive physical activity disproportionate to the person's age, leading to injuries or microtraumas, as well as hypothermia of the joints.For example, running on asphalt or squats are not recommended for elderly people, because during these exercises there is significant pressure on the knee joint, which wears out with age and is not able to withstand such loads.
- Overweight and obesity.This factor leads to damage to the menisci, the injuries of which provoke the development of arthrosis of the knees.
- Loose connections or weak connections.
- Arthritis or other acquired joint diseases.The inflammatory process can cause accumulation of synovial fluid in the joint cavity or swelling.This provokes the destruction of the cartilage tissue of the knee, which leads to arthrosis of the knee joints.
- Metabolic disorders in the human body.The 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 shifts 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 is characterized by the following symptoms:
- Painful sensations.The pain occurs suddenly, depending on the physical load on the knee joint.Pain sensations can be of a different nature.In the initial stage, these are weak lumbago, to which a person usually does not pay much attention.Intermittent mild pain can be experienced for months and sometimes years until the disease progresses to a more aggressive stage.
- Visible knee deformity.This symptom appears in the later stages.Initially, the knee appears swollen or swollen.
- Accumulation of synovial fluid in the joint cavity or Baker's cyst.It is a dense formation on the back wall of the knee joint.
- Grinding joints.In patients in the second and third stages of the disease, sharp crunching sounds accompanied by pain are observed.
- Inflammatory reactions in the joint synovium, as a result of which the cartilage swells and increases in volume.
- Joint mobility decreases.It is observed in later stages.Bending the knee becomes almost impossible and is accompanied by severe pain.In the final stage, the knee can be completely immobilized.A person's 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 must be comprehensive.To date, there is no medical drug that can alleviate this disorder.One of the most 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 are faced with several tasks:
- Eliminate or reduce pain;
- Establish the supply of nutrients to the knee joint and thus increase its restorative function;
- Activate blood circulation in the knee joint;
- Strengthening of the muscles around the joint;
- Increase joint mobility;
- Aim 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 arthrosis of the knee joint
Pain relievers, anti-inflammatory drugs
To relieve or reduce the patient's pain, a course of non-steroidal anti-inflammatory drugs (NSAIDs) is usually prescribed.These 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.
Usually, patients prefer local treatment in the form of gels, ointments and warming patches.The effect of these painkillers does not occur immediately, but after several days (approximately 3-4 days).The maximum effect is achieved after one week of regular use of the drug.Such drugs do not cure the disease as such, but only relieve the pain, since it is impossible to start treating the pain.
Painkillers should be taken strictly as prescribed by the doctor;they should only be used in severe pain, as long-term and frequent use can lead to side effects and even accelerate the destruction of articular cartilage.In addition, with long-term use of these drugs, the risk of side effects increases, including stomach ulcers, duodenal ulcers, disruption of the normal functioning of the liver, kidneys 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 NSAIDs are no longer effective and the disease itself begins to progress.Most often, hormonal drugs for the treatment of this disease are used in the form of injections.
The course of treatment with hormonal drugs is usually short and is prescribed in a period of severe exacerbation, when inflammatory fluid accumulates in the joint.The hormone is injected into the joint approximately once every ten days.
Chondroprotectors
To restore and nourish cartilage tissue in the initial stages of the disease, a course of glucosamine and chondroitin sulfate, the so-called chondroprotectors, is prescribed.This is the most effective treatment for arthrosis.They have almost no contraindications, and side effects occur in rare cases.
Vasodilators
To relieve spasm of small vessels, improve blood circulation and delivery of nutrients to the knee joint, as well as eliminate vascular pain, vasodilators are prescribed.They are crushed together with chondroprotectors.If knee arthrosis is not accompanied by fluid accumulation, it is also recommended to use warming ointments, gels and liquids.
Physical therapy
A course of exercise therapy can be very useful and lead to good results only when it is prescribed by a doctor and is carried out under supervision, on the recommendations of a specialist or trainer.Self-medication is dangerous to health.Exercise therapy is used to further prevent the breakdown of cartilage tissue, slow the development of stiffness, and relax muscle spasms that cause pain.During periods of exacerbation, exercise is contraindicated.A course of special individual exercises that take 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 specialist in this field.
Physiotherapy
As one of the methods of conservative therapy, physiotherapy is used - electrophoresis, laser therapy, acupuncture, diadynamic currents, UHF.A course of local massage also gives positive results.Physiotherapy methods act in several directions - they relieve pain, reduce inflammation, normalize the exchange of substances in the joint and restore its usual functions.The method and duration of physiotherapy treatment are determined by the patient's medical history and are prescribed only after a thorough diagnosis and examination of the condition of the joints.
Pain-relieving physical therapy includes:
- Medium wave ultraviolet radiation (SUV radiation).The contact of ultraviolet light with the skin of the knee continues until the appearance of slight redness.Substances are formed in the tissues that dull the sensitivity of nerve fibers, which is why an analgesic effect is achieved.The duration of the treatment course is prescribed by the doctor depending on the symptoms, frequency and strength of the pain.On average, the course of treatment is approximately 7-8 sessions.
- Local magnetic therapy aimed at the complete restoration of the patient's body.This procedure relieves inflammation, removes pain and neutralizes muscle spasms.It is effectively used for arthrosis of the knee joint in the initial stages.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, which is prescribed to improve blood circulation in the joint.
The sanatorium-resort treatment is also of no small importance.This treatment is prescribed for deforming and dystrophic osteoarthritis.This treatment, like those listed earlier, has its contraindications, so the attending physician carefully studies the patient's medical history before recommending the sanatorium-resort 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 functioning of the joint.The methods and forms of surgical intervention depend on the degree of damage to the joint, as well as on the patient's medical history.
Late arthrosis of the knee joint can be treated only surgically - the knee joint is replaced in whole or in part with an endoprosthesis.Surgical treatment allows not only to improve well-being, but also to restore the patient's ability to work in the last stages of knee arthrosis.Many believe that the long recovery period with the use of exercise therapy, mechanotherapy and other means is a significant disadvantage of the operation.
There are several types of surgical intervention for arthrosis of the knee joint:
Prevention of knee arthritis
To avoid this disease, people at risk (athletes, elderly people, overweight people, businesses) must follow certain instructions:
- Proper nutrition and the fight against excess weight.It is necessary to exclude from your diet unhealthy foods - 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 promptly treat infectious diseases, preventing them from becoming chronic.
- Timely and adequate treatment of diseases of the spine, if any, development of correct posture.
- Sports activities (cycling, swimming, walking, special gymnastic exercises for the joints).
- No self-medication!At the first symptoms of knee arthritis, go to the clinic.
- Avoid stress, sleep well.
- Systematically increase your immunity (harden yourself or at least take a course of vitamins 2-3 times a year).
- Avoid hypothermia of the body, especially of the lower extremities.
A healthy lifestyle and timely treatment are the best ways to prevent knee arthritis.