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 a clear scheme or a single drug that can equally help everyone who suffers from this problem.Since arthrosis is a progressive disease, it is more often observed in overweight women, people with venous 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).When the first symptoms appear, it is necessary to resort to appropriate treatment, since neglecting this can lead to the final destruction of the cartilage and exposure of the bone, and consequently to human disability.
The disease has three stages:
- The initial stage of arthrosis of the knee joint is characterized by the loss of shock-absorbing properties, and as a result, the cartilages rub against each other during movement, causing severe discomfort to the patient.The cartilage becomes rough, deformed, dry, and in advanced stages of the disease, it is even covered with cracks.
- Due to the reduced depreciation, the deformation of the bone 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 exposed to deformation, the knee joint gradually atrophies due to the stiffness of the movement.The density of the synovial fluid also changes (it thickens and becomes more viscous), the circulation is poor, and the nutrient supply to the knee joint deteriorates.The thinning of the lining between the cartilaginous joints reduces the distance between the articular bones.
- The disease develops 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, which leads to human disability.
Most often, arthrosis or gonarthrosis develops after an injury or a bruise, while a person feels constant strong pain in the knee, which significantly hinders his movement.
Causes of arthrosis
Arthrosis of the knee joint, the treatment of which takes quite a long time, can manifest 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 causes the development of post-traumatic gonarthrosis.
- Removal of the meniscus.
- Excessive physical activity inappropriate for age, which leads to injuries or microtraumas, as well as hypothermia of the joints.For example, running on asphalt or squatting are not recommended for older people, as these exercises put significant pressure on the knee joint, which wears out with age and cannot withstand such loads.
- Overweight and obesity.This factor leads to damage to the meniscus, the injuries of which lead to the development of arthrosis of the knee.
- 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 provokes 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.Improper foot structure shifts the center of gravity and the load on the joint increases.
- Stress and nervous tension.
Symptoms of arthrosis of the knee
The clinical picture of the disease is characterized by the following symptoms:
- Painful feelings.The pain appears suddenly, depending on the physical load on the knee joint.Painful sensations can be of a different nature.In the initial stage, these are weak lumbagos, to which a person usually does not pay much attention.Intermittent mild pain can be observed for months, sometimes years, until the disease progresses to a more aggressive stage.
- Visible knee deformity.This symptom appears in later stages.At first, the knee feels swollen or swollen.
- Accumulation of synovial fluid in the joint cavity or Baker's cyst.This is a dense formation on the back wall of the knee joint.
- Crackling joints.In patients with the second and third stages of the disease, sharp screeching sounds accompanied by pain are observed.
- Inflammatory reactions in the joint synovium, causing the cartilage to swell and increase in volume.
- The mobility of the joints decreases.It can be observed in later stages.Bending the knee becomes almost impossible and is accompanied by severe pain.In the last 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 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 of extending the remission period and preventing the destruction and deformation of cartilage and bone tissue.
During the treatment, the doctor and the patient have to face several tasks:
- Eliminate or reduce pain;
- Creating the nutritional supply of the knee joint and thereby increasing its recovery function;
- Activates blood circulation in the knee joint;
- Strengthen the muscles around the joint;
- Increase joint mobility;
- Aim to increase the distance between the joint bones.
Treatment of the disease, depending on its stage of development, can be conservative or surgical.
Conservative treatment of arthrosis of the knee joint
Pain relievers, anti-inflammatories
To relieve or reduce the pain, the patient is usually prescribed a course of non-steroidal anti-inflammatory drugs (NSAIDs).These can be tablets, ointments and injections.The most common pain relievers include the following.These drugs can be used in two ways - orally or topically.
Patients typically prefer topical treatment in the form of gels, ointments, and heating patches.The effect of these painkillers does not appear immediately, but after a few days (approx. 3-4 days).The maximum effect is achieved after a week of regular use of the drug.Such drugs do not treat the disease, 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 can only be used in case of severe pain, as long-term and frequent use can lead to side effects and even accelerate the destruction of joint cartilage.In addition, long-term use of these drugs increases the risk of side effects, including stomach ulcers, duodenal ulcers, disruption of the normal functioning of the liver and kidneys, and allergic manifestations in the form of dermatitis.
Hormones
Sometimes hormonal drugs are prescribed in the treatment of arthrosis of the knee joint.They are prescribed when NSAIDs are no longer effective and the disease itself begins to progress.Most often, hormonal drugs for the treatment of the disease are used in the form of injections.
Treatment with hormonal drugs is usually short and prescribed during a severe exacerbation, when inflammatory fluid accumulates in the joint.The hormone is injected into the joint about once every ten days.
Chondroprotectors
In the initial stages of the disease, glucosamine and chondroitin sulfate, so-called chondroprotectors, are prescribed for the restoration and nutrition of the cartilage tissue.This is by far the most effective treatment for osteoarthritis.They have almost no contraindications and side effects are rare.
vasodilators
Vasodilators are prescribed to relieve spasm of small blood vessels, improve blood circulation and delivery of nutrients to the knee joint, and eliminate vascular pain.It breaks down together with chondroprotectors.If the knee joint is not accompanied by fluid accumulation, the use of warming ointments, gels, and liquids is also recommended.
Therapeutic practice
An exercise therapy can be very useful and only brings good results if it is prescribed by a doctor and is carried out under supervision and at the suggestion of a specialist or trainer.Self-medication is dangerous to health.Exercise therapy serves to further prevent the destruction of cartilage tissue, slow down the development of stiffness, and relax muscle spasms that cause pain.During the period of exacerbation, exercise therapy is contraindicated.A course consisting of special individual exercises, which takes into account not only the stage of the disease and the location of the cartilage, but also the age of the patient, must be developed by a competent specialist in this field.
Physiotherapy
Physiotherapy is used as a method of conservative therapy - electrophoresis, laser therapy, acupuncture, diadynamic currents, UHF.Local massage also gives positive results.Physiotherapy methods work in several directions - relieve pain, reduce inflammation, normalize the metabolism within the joint and restore its usual 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 condition of the joints.
Physiotherapy for pain relief includes:
- Mid-wave ultraviolet irradiation (SUV irradiation).The contact of the ultraviolet light with the skin of the knee lasts until a slight redness appears.Substances are formed in the tissues that dampen the sensitivity of nerve fibers, thanks to which a pain-relieving effect can be achieved.The duration of the treatment is prescribed by the doctor, depending on the symptoms, frequency and severity of the pain.On average, the duration of the treatment is about 7-8 sessions.
- Local magnetic therapy aimed at general restoration 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 stage.The treatment process 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, prescribed to improve blood circulation in the joint.
Health resort treatment is of no small importance.This treatment is prescribed for deforming and dystrophic osteoarthritis.This treatment, like the ones listed before, has its own contraindications, so the treating doctor carefully examines the patient's medical history before recommending the health-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 function of the joint.The methods and forms of surgical intervention depend on the degree of joint damage and 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 with the use of movement therapy, mechanotherapy and other tools to be a significant disadvantage of surgery.
There are several types of surgical interventions for arthrosis of the knee joint:
Prevention of knee arthritis
In order to avoid the disease, people at risk (athletes, the elderly, overweight, company workers) must follow certain instructions:
- Proper nutrition and the fight against overweight.Unhealthy foods should be excluded from the diet - fatty foods, fried foods, alcohol, and it is better to consult a nutritionist who will individually help you choose the right diet.
- During sports, monitor the load on the joints and reduce it if necessary.
- Monitor your health and treat infectious diseases in time, preventing them from becoming chronic.
- Timely and appropriate treatment of spinal diseases, if any, and the development of correct posture.
- Sports activities (cycling, swimming, walking, special joint gymnastics exercises).
- No self-healing!Go to the clinic at the first symptoms of knee arthritis.
- Avoid stress, sleep well.
- Systematically increase your immunity (harden yourself or take a vitamin course at least 2-3 times a year).
- Avoid hypothermia of the body, especially of the lower limbs.
A healthy lifestyle and timely treatment are the best ways to prevent knee arthritis.