Treatment of osteoarthritis of the knee joint

Osteoarthritis of the knee joint-It is a dystrophic degenerative disease of cartilage, which leads to the exposure of bone heads and to an alteration of mobility in the joint.The disease has a non -inflammatory nature and is progressing slowly - the transition from the initial stage to disability takes several years to several decades.Osteoarthrosis of the knee joint is included in the 5 most common causes of disability and disability in the world.

More than 20% of people over 55 are subject to knee osteoarthritis (gonartrose), but the disease is quickly young - its symptoms are manifested at the age of 25.

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

Signs of osteoarthritis of the knee joint

The wear of the articular cartilage is accompanied by characteristics, the intensity of which depends on the stage of the disease.Most often, patients complain:

• Morning stiffness and reduction of mobility in the joint (wake -up is necessary);
• Pain and discomfort in the knees, which are improved after physical effort (long walking, running or standing) and are declined during rest;
• At the 2nd stadium - SO -SOAL departure pains that occur after a long stay in a position;
• Increased fatigue, which is often struck off for age -related changes;
• Dry coarse crunch, which is regularly repeated when kneeling and flexion;
• edema and other symptoms of inflammation which appear in the 2nd stage of the disease due to trauma of the period tissues;
• Weather sensitivity, increased symptoms of the cold season.

When you try to fold the knee struck by gonartrose, acute pain and a feeling of physical obstacle occur.In the last stages, even in the presence of a treatment of osteoarthritis of the knee joint, patients are disturbed in patients (becomes appreciated, patients walk on steep legs), deformation of the lower limbs in the form of letters "o" or "x" appears.

The nonsense of the disease lies in the fact that it can occur in a hidden form for years, and the first significant symptoms often appear only in the 2nd stage - when the complete restoration of synovial cartilage is already impossible.
Therefore, it is important to consult a doctor during the first signs of discomfort in the knees - for example, weak, as if they were pulling pain that occurs with insufficient production of synovial fluid.Do not forget: knee pain is not the norm regardless of age.Examination and timely treatment of osteoarthritis of the 1st degree knee can protect you completely from painful pain in old age joints.

What will happen if knee osteoarthritis does not treat?

In the event of self-medication, non-compliance with the doctor's recommendations or the lack of treatment, osteoarthrosis of the knee joint increases on average 3 to 8 times faster than with complex therapy.If gonarthrosis occurs aggressively, the patient may lose the ability to move normally before retirement age.

Effective treatment of knee osteoarthritis is particularly important in an exacerbation stage.Gross time, physical or emotional stress, allergies, poisoning, moving in the region with another climate - in a word, shaking everything for the body can cause it.The exacerbation of osteoarthritis is the destruction of a large amount of chondrocytes.In response to this, the body produces enzymes designed to treat and eliminate dead cells.However, if their concentration is too high, the healthy cartilage areas suffer - the cell membranes become thinner, the fireplaces appear on the synovial crisis of the joint.This process, if it is not stopped by treating knee osteoarthritis with drugs, can circulate in a few weeks and with chronic stress, lack of sleep or insufficient diet.

In the end, without treatment, knee osteoarthrosis leads to a complete reduction in the articular gap due to the growth of osteophytes.The difference necessary for the normal movement is closed and the patient cannot bend the leg even at 30-45 °.The difficulty represents not only the climbing of the stairs, but also an attempt to rise from the sofa or the ordinary movement.This condition is accompanied by pain from which ordinary pain relievers do not help.In such cases, an option for the treatment of osteoarthritis of the knee joint remains - surgical, with a complete replacement of joint architecture by a subsequent long -term prosthesis and rehabilitation.But in this case, most patients cannot go back to a completely normal life.

Treatment of osteoarthrosis of the knee joint

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

The treatment of osteoarthritis of the 1st degree knee joint is always carried out by conservative methods - in the event of the success of a combination of circumstances and good self -discipline, the patient can be obtained or a persistent remission.

The treatment of osteoarthritis of the 2nd degree knee joint, as a rule, is built on the use of all conservative effect 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 knee joint of 3 degrees almost always involves surgery.

Complex conservative treatment of osteoarthritis of the knee joint implies the elimination of pain and inflammation, the restoration of cartilage and an increase in the volume of movements in the joint.For this, the patient is prescribed by an orthopedic diet of charges and rest, system and local drugs (hormonal and non-hormonal, analgesic, chondroprotective and other).Innovative biological methods are also propagated - injections of drugs for the treatment of osteoarthritis of the knee joint directly in the joint bag.At the same time, PRP infections (blood plasma, enriched with platelets), as well as stem cell injections obtained from the patient's adipose tissue are used.In parallel, auxiliary and rehabilitation methods are connected - physiotherapy, massage, manual therapy, therapeutic gymnastics.

Surgical treatment of osteoarthrosis of the knee joint is carried out in cases where drugs are helpless.With this pathology, the doctor may prescribe the following interventions:

• Arthroscopy of the knee joint.The collective name for a group of poorly invasive operations aimed at eliminating the broken zone of joint tissue or osteophyte, or partial excision of the joint shell.It allows you to delay or exclude prostheses, as well as to eliminate discomfort in the first stages of the disease.It is mainly used for the treatment of knee osteoarthritis in patients under the age of 60.
• Osteotomy.The operation to cut part of the OS and the correction of the load axis on the painful knee, which allows you to slow down degenerative changes.It is generally carried out in the treatment of osteoarthritis of the 2nd degree knee joint.
• Endoprosthetics.Partial or complete replacement of the knee joint by a titanium implant, which serves 15 to 20 years.This technique is an extreme measure because it has certain risks.Recommended for patients over 55.

All these operations require the recovery period and have a number of contraindications, so that 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 main therapeutic techniques, food therapy and other methods of lower body weight are used.To unload the painful joint, bandages and other orthotics are used (walking rods, orthopedic soles, etc.).

The treatment of knee osteoarthritis is prescribed by a rheumatologist or orthopedic.During the first reception, he palpates the articulation, made motor tests, then directs the patient towards tomography or radiography.

Therapeutic gymnastics for knee osteoarthritis

Medical physical education for members of the lower belt is considered to be the most effective method for reducing pain and treatment of osteoarthritis from 1st degree knee joint.The first results of therapeutic gymnastics occur after 2 to 4 weeks of continuous classes.The continuity of the treatment of osteoarthritis of the knee joint is one of the main factors that affect the effectiveness of the treatment of the exercise.A full lesson is carried out once a day a day, it is also recommended to do at least 3-4 heats up during the day.

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

The main task of physical exercises in the treatment of osteoarthrosis of the knee joint is to strengthen the muscles of the thigh and the bottom of the leg, maintaining the elasticity of 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 articulation to the periarticular structures - and, thus, slow down the mechanical abrasion of cartilage, reduce inflammation.

Exercises for the treatment of the osteoarthritis knee are performed for both legs!When acute pain appears, the lesson should be stopped or continues at a softer rate.

1. Starting position - Lying on the back.One leg is extended on the ground, the other is raised folded by 90 ° (the lower leg is parallel to the ground).We make movements with the lower leg high down, with regard to the amplitude of movements in the joint.
2. Starting position - Lying on the back.We perform the "bicycle" exercise.
3. Starting position - lying on the stomach.In turn, we arouse our feet, trying to bring the heels closer as close as possible to the buttocks.
4. The starting position is lying on the side, the hand is folded under the head or stretched on the head along a line with the body.The other hand rests on the side.We make swings upside down.We change the side.
5. Starting position - Lying on the back.We pull our legs forward on the ground before the heel (of ourselves), the socks look "ourselves".
6. Starting position - lying on the stomach.We do the "boat" exercise.If the physical preparation does not allow it, we put our palms on both sides of the chest and take back our legs, feeling stress in the posterior surface of the thigh and the bottom of the leg.
7. Starting position - Lying on the back.We turn our feet in turn, trying to describe the most complete circle with the socks.
8. Starting position - Standing against the wall.Squat slowly and gently, without looking at the eyes of the wall to distribute the load.When the legs are folded with 90 ° knees, we start to move smoothly.
9. The starting position is standing.Alternatively, we swing our feet forward, back and laterally.

Please note: Therapeutic gymnastics after the operations of the articulation has its own specificities and changes according to the number of days which have passed since the time of surgery.It is prescribed by a surgeon or rehabilitation.

Massage with knee osteoarthritis

A therapeutic massage for osteoarthritis of the knee is carried out on both legs.At the beginning, at least 10 to 12 sessions are necessary for a rehabilitation or equipment for hydromassage equipment, but a simple general reinforcement massage can be carried out at home.It includes the following types of movements:

• Surface caresses and friction (from top to bottom, software and in the antihorarous direction);
• Sound and stretch with the fingers of deeper fabrics;
• Tighten and type on the skin.

A massage with knee osteoarthritis must be carried out by a specialist who will not harm the sick joint.

Self-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 warming balm before or during the session.You can also take a hot bath before the procedure.

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

Dietotherapy for osteoarthritis

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

• Limit products and dishes rich in simple carbohydrates (white bread, confectionery, snacks, candies, potatoes, sugar);
• To exclude transformed (loans to use) and rich dishes - fast food, semi -finished products, sausages;
• Refuse alcohol, decoded coffee and oily meat.

Instead, you must include in the menu:

• germinated and whole grain dishes;
• oily fish from northern seas and poultry food meat;
• Cartilage (ears, nyushki, legs and other parts rich in collagen), cold and frozen men;
• Vegetables and fruits rich in vitamins and antioxidants (in particular, vitamins A, B12, C, E);
• Nuts and other sources of omega fatty acids and precious minerals.

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

The treatment of osteoarthritis of the knee joint with drugs - vitamin -mineral complexes (2 courses per year) is also recommended.

Physiotherapy for the treatment of knee osteoarthrosis

The following physiotherapeutic procedures are used for the effective treatment of knee osteoarthritis and the improvement of drug action:

• magnetotherapy;
• Laser therapy;
• UHF;
• ultrasound therapy;
• amplipulse;
• electrophoresis (including medicinal);
• Ozokerite and paraffin applications;
• Thermotherapy (cryotherapy, inductothermia);
• phonophoresis;
• Banneological therapy (sulfuric baths, hydrogen sulfide).

Acupuncture in the treatment of osteoarthritis of the 2 degree knee joint, 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.

Drugs for the treatment of osteoarthritis of the knee joint

The treatment of osteoarthritis of the knee joint with drugs is carried out symptoms and taking into account the individual patient reaction to selected drugs.Pharmacotherapy - injections, ointments or tablets for the treatment of osteoarthritis of the knee joint - is generally prescribed courses or if necessary.

In order to choose the right medication for the treatment of osteoarthritis of the knee joint, consult a doctor who, after the study, will select the necessary drugs.

In the treatment of osteoarthritis of the knee joint, there are several directions: the attenuation of the life of the patient, the improvement of the nutrition of the cartilage, the regeneration of the cartilage and the maintenance of the standard of the device of the muscle line.

Non-steroidal anti-inflammatory drugs

To relieve exacerbations of NSAIDs in tablets or capsules, they take courses (about 12 days) or if necessary, depending on the intensity of the pain syndrome.The uncontrolled reception of NSAIDs with altered instructions or recommendations from the doctor is heavy in stomach or intestines ulcer.They should be very careful to take them in combination with glucocorticosteroids and drugs affecting blood coagulation.Additional risk factors - aged over 65, smoking, alcohol consumption during the course.In these cases, doctors generally recommend the administration of injection of drugs by bypassing the gastrointestinal tract.With NSAIDs, it is advisable to take gastroprotectors.

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

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

Hormonal drugs (Civil Code) are generally used for blocking so-called the knee knee in cases where NSAIDs are not enough to calm pain and inflammation.

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

Chondroprotective in the treatment of osteoarthritis of the knee joint

Chondroprotective agents based on extracts from nuclei and cartilage of cattle, sea fish and molluscs contribute to the restoration of synovial cartilage, and are therefore irreplaceable for the effective treatment of osteoarthritis of the knee.Chondroprotectors contain a large number of glycosaminoglycans - natural polymers, from which cartilage is built.Therefore, they make chondrocytes (cartilaginous cells) more stable, contribute to their growth, enrich the synovial fluid.

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

Skin agents

External preparations for the treatment of knee osteoarthritis with a local growth effect improves blood circulation and the nutrition of the joint, and also distract the patient from the pain.To this end, ointments, gels, creams and balms based on natural ingredients are used - bee or snake venom, burning pepper extract.

In the presence of an allergic reaction (persistent redness and skin pain, rash), during pregnancy and lactation, as well as in the presence of other contraindications, it is preferable to avoid reheating ointments for the treatment of osteoarthritis of the knee joint and to limit yourself to hot baths, external applications and anti-inflammatory drugs.

Synovial liquid prostheses

If the synovial liquid in the joint is too small, the sliding of the joint surfaces is disturbed.And above all, the famine of the cartilage begins, because the joint fluid, which does not drink it as a sponge, normally provides nutrients for the growth and maintenance of the cartilage fabric.To prevent cell destruction and mechanical abrasion of knee cartilage, the doctor can prescribe high -weight derivative injections of hyaluron.The injections of the drug in the treatment of osteoarthritis of the knee joint (viscoster) are transformed 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 changes or necrotic infections in the joint.

Antispasmodic, analgesic, muscle relaxing

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

Simple pain relievers in the treatment of osteoarthritis of the knee joint are not used because they mask the pain, but did not relieve inflammation.You can use them or affordable NSAIDs without a prescription for a doctor up to 10 days, after which an examination is required.

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

For the convenience of patients, drugs for the treatment of osteoarthritis of the knee joint are released in various forms.Is there a 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 suits you the most.

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

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

Injection solutions

In the form of injections, you can take the NSAIDs already mentioned, the civil code, chondroprotectors and muscle relaxants, as well as synovial liquid prostheses.This method of treatment of osteoarthritis of the knee joint shows a maximum bioavailability.

This method of processing knee osteoarthritis is safe for digestion, but it is desirable that injections (intravenous, intramuscularly in the joint or intra-articular) put qualified medical staff.Intramuscular injections in the buttock or thigh can be done independently.

External use

Local growth, anti-inflammatory and chondroprotective ointments is used outside to treat osteoarthritis on knee joint.The advantage of such a medication is of direct effects on affected tissues.But on the path of active substances, a skin barrier increases - alas, often only 5% of the active ingredients reach the desired layers of tissues.

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