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, deforming osteoarthritis.The treatment of arthrosis of the knee joint does not have an unequivocal scheme or a single drug that could equally help everyone who suffers from this problem.Since arthrosis is a progressive disease, it is more often observed in women with excess weight, vein disease 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, because ignoring this problem can lead to the final destruction of cartilage and bone exposure and, as a result, disability.
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 cartilages rub against each other during movement, causing serious discomfort to the patient.Cartilage becomes rough, deformed, dries out, and in advanced stages of the disease even becomes covered with cracks.
- Due to reduced depreciation, bone deformation begins, which leads to the formation of osteophytes (growths on the bone surface) - 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 the cartilaginous joints reduces the distance between the joint bones.
- The disease progresses rapidly and quite 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 lead to the disability of people.
Most often, arthrosis or gonarthrosis develops after an injury or bruise, while a person feels 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 quite a long time, can be manifested 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 period of time.This leads to deterioration of blood circulation, which most often causes the development of post-traumatic gonarthrosis.
- Removal of the meniscus.
- Excessive physical activity that is not appropriate for the person's age, which leads to injuries or microtraumas, as well as hypothermia of the joints.For example, elderly people are not recommended to run on asphalt or do squats, because during these exercises there is a 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 meniscus, whose injuries cause the development of knee arthrosis.
- Loose 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 causes the destruction of the cartilage tissue of the knee, which leads to arthrosis 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 irregular 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 has the following symptoms:
- Painful sensations.The pain appears suddenly, depending on the physical load on the knee joint.Painful feelings can be of different nature.In the initial stage, these are weak lumbago, to which a person usually does not pay much attention.Periodic mild pain can be observed for months, and sometimes years, until the disease progresses to a more aggressive stage.
- Visible knee deformity.This symptom appears in the later stages.At first, the knee appears swollen or swollen.
- Accumulation of joint fluid in the joint cavity or Baker's cyst.This is a dense formation on the back wall of the knee joint.
- Cracking joints.Sharp crunching sounds, which are accompanied by pain, are observed in patients in the second and third stages of the disease.
- Inflammatory reactions in the joint synovium, which causes the cartilage to swell and increase in volume.
- Joint mobility decreases.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.Movement of the person 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 alleviates this disorder.One of the most important conditions for successful treatment is timely diagnosis.The earlier the treatment of knee arthrosis is started, the greater the chance to extend the period of remission and prevent the destruction and deformation of cartilage and bone tissue.
During the treatment, the doctor and the patient face several tasks:
- Eliminate or reduce pain;
- To establish the supply of nutrients to the knee joint and thereby increase its recovery function;
- Activate blood circulation in the knee joint;
- Strengthen the muscles around the joint;
- Increase joint mobility;
- Try to increase the distance between the joint bones.
Treatment of the disease, depending on the stage of development, can be conservative or surgical.
Conservative treatment of arthrosis of the knee joint
Painkillers, anti-inflammatory drugs
To relieve or reduce pain, the patient is usually prescribed a course of non-steroidal anti-inflammatory drugs (NSAIDs).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.
Typically, patients prefer topical treatment in the form of gels, ointments, and heating patches.The effect of these painkillers does not occur immediately, but after a few days (approximately 3-4 days).The maximum effect is achieved after a week of regular use of the drug.Such drugs do not cure the disease as such, but only relieve the pain, because it is impossible to start the treatment of the pain.
Painkillers should be taken strictly according to the doctor's prescription;they should be used only for severe pain, because long-term and frequent use can lead to side effects and even accelerate the destruction of joint cartilage.In addition, the long-term use of these drugs increases the risk of adverse reactions, including ulcers on the stomach and duodenum, disruption of the normal functioning of the liver and kidneys, and allergic manifestations in the form of dermatitis are also possible.
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 about once every ten days.
Chondroprotectors
To restore and nourish the cartilage tissue in the initial stages of the disease, a course of glucosamine and chondroitin sulfate, so-called chondroprotectors, is prescribed.This is by far the most effective treatment for osteoarthritis.They have almost no contraindications, and side effects occur in rare cases.
Vasodilators
Vasodilators are prescribed to relieve spasm of small vessels, improve blood circulation and deliver nutrients to the knee joint, as well as eliminate vascular pain.They break down together with chondroprotectors.If knee arthrosis is not accompanied by fluid accumulation, the use of ointments, gels and heating fluids is also recommended.
Therapeutic exercise
A course of exercise therapy can be very useful and bring good results only if it is prescribed by a doctor and carried out under the supervision of a specialist or trainer.Self-medication is dangerous to health.Exercise therapy is used to further prevent the destruction of cartilage tissue, slow the development of stiffness, and relax muscle spasms that cause pain.During the period of exacerbation, exercise therapy is contraindicated.A course of special individual exercises, which 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 competent in this field.
Physiotherapy
Physiotherapy is used as one of the methods of conservative therapy - electrophoresis, laser therapy, acupuncture, diadynamic currents, UHF.The course of local massage also gives positive results.Physiotherapy methods work in several directions - they relieve pain, reduce inflammation, normalize the 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 detailed diagnosis and study of the condition of the joints.
Physiotherapy for pain relief includes:
- Medium-wave ultraviolet radiation (SUV radiation).The contact of the ultraviolet light with the skin of the knee continues until a slight redness appears.Substances are created in the tissues that dull the sensitivity of nerve fibers, which is why an analgesic effect is achieved.The duration of the course of treatment is prescribed by the doctor depending on the symptoms, frequency and severity of the pain.On average, the course of treatment is approximately 7-8 sessions.
- Local magnetic therapy aimed at the overall recovery of the patient's body.This procedure relieves inflammation, eliminates 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 takes 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.
Sanitary treatment is of great importance.This treatment is prescribed for deforming and dystrophic osteoarthritis.This treatment, like those mentioned earlier, has its own contraindications, so the doctor carefully examines the patient's medical history before recommending a sanitary-healing method.
Surgical treatment of arthrosis of the knee joint
It 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 on the patient's 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 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 surgery.
There are several types of surgical intervention for arthrosis of the knee joint:
Prevention of knee arthritis
In order to avoid this disease, people at risk (athletes, elderly people, overweight people, workers in companies) must follow certain instructions:
- Proper nutrition and the fight against excess weight.It is necessary to exclude unhealthy food from the diet - fatty food, fried food, alcohol, and it is better to consult with a nutritionist who will individually help you choose a suitable diet.
- When you play sports, monitor the load on your joints and reduce it if necessary.
- Monitor your health and treat infectious diseases in a timely manner, preventing them from becoming chronic.
- Timely and adequate treatment of spinal diseases, if any, development of proper posture.
- Sports activities (cycling, swimming, walking, special gymnastic exercises for joints).
- No self-medication!At the first symptoms of knee arthritis, go to the clinic.
- Avoid stress, sleep well.
- Systematically increase your immunity (harden up or at least take vitamins 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.