Osteoarthritis of the knee joint is understood as a decrease in the performance of the cartilage due to its curvature and destruction. Other terms are used to refer to this disease -gonarthrosisAnddeforming osteoarthritis. Currently, several methods of treating the disease are used - a specific option is selected taking into account the individual characteristics of the patient.
Specificity of the disease
Osteoarthritis of the knee usually develops progressively. As a rule, it occurs in women and the elderly who are overweight or have venous defects. The disease can occur on one or both knees at the same time.
The main stages of development of osteoarthritis on the knee:
- Initial. There is a decrease in the amortization parameters of the joint due to the mutual friction of the cartilage and an increase in their roughness. Sometimes the formation of cracks is observed.
- According to. At this stage, the bone begins to become covered with growths (osteophytes). On the inner surface of the articular bag, the curvature is fixed, rigidity is observed in the work of the limb. As a result, the knee joint gradually reduces its functionality. Due to the decrease in the thickness of the intercartilaginous lining, a reduction in the distance between the tibia and femur is observed.
- Third. If nothing is done, the pain in the knee area becomes permanent due to irreversible damage to the cartilage tissue. The patient at this stage is no longer able to move normally.
The first symptoms of osteoarthritis of the knee joint are reason enough to consult a specialist. If not, there is a real danger of becoming disabled.
Why arthrosis appears
The main causes of the development of arthrosis of the knee joint:
- hereditary tendency;
- temporary immobility of the knee joint following an injury;
- surgical removal of the meniscus;
- high physical activity, constant hypothermia;
- obesity, overweight problems;
- rupture of ligaments (their weakening);
- other joint diseases (arthritis, swelling, various inflammations);
- failures of normal metabolism, calcium deficiency in the body;
- flat feet (the lack of center of gravity increases the pressure on the joint);
- stress, general fatigue, lack of sleep.
Symptoms
Signs of the probable presence of osteoarthritis of the knee:
- Pain in the knee joint. Pain appears suddenly, against the background of physical exertion. In the first phase we speak of almost imperceptible low back pain, later the disease becomes more serious.
- Visual violation of the shape of the knee. It happens in the later stages.
- Accumulation of fluid, Baker's cyst. These are tangible seals in the posterior region of the knee joint.
- The appearance of a cartilage crunch, against the background of severe pain. This indicates the second or third stage of gonarthrosis.
- Inflammation of the internal region of the joint bag. It manifests itself with edema and increased cartilage.
- Stiffness of the knee due to severe pain, up to complete immobilization. This happens in the advanced stages of the disease.
Treatment
Effective treatment of osteoarthritis of the knee joint is possible only with the use of an integrated approach. Modern medicine cannot yet offer a specific medicine capable of eliminating this ailment. The success of treatment procedures depends on the timeliness of identifying the problem, which allows you to begin the fight against gonarthrosis in the early stages.
Starting the treatment, the specialist pursues several objectives:
- reduce pain symptoms as much as possible;
- resume normal flow of nutrients to the joint;
- increase the intensity of blood circulation in the knee area;
- restore the functionality of the supporting muscles in the problem area;
- make the knee as mobile as possible;
- expand the space between the connected bones.
The exact treatment algorithm is determined on an individual basis. Distinguish between conservative and surgical techniques.
conservative method
This approach is used in the early stages of the onset of the disease and consists in the use of various drugs and therapeutic exercises.
Pain relievers, anti-inflammatory drugs
To eliminate or reduce pain in the knee joint, the doctor usually prescribes the use of non-steroidal anti-inflammatory drugs. In pharmacies they are represented by tablets, ointments and injections. Warming and anesthetic gels, ointments and patches prove to be effective in relieving pain.
A positive result in this case is usually obtained in 3-4 days. It should be understood that these medicines do not eliminate the disease, but only reduce pain. It is recommended to take painkillers only on the advice of a specialist and only when correcting unbearable pain. The fact is that NSAIDs provoke the appearance of various side effects (especially the gastrointestinal tract suffers).
Hormonal drugs
In some cases, to relieve pain in osteoarthritis of the knee, the doctor may prescribe hormone injections. This approach is used when the effectiveness of NSAIDs is weak against the background of a progressive disease.
Hormones are prescribed for a short time (1-10 days) during exacerbations of osteoarthritis and the accumulation of fluid in the knee joint.
Chondroprotectors
To restore and nourish the cartilage layer at the beginning of the development of the disease, the so-called. chondroprotectors (glucosamine, chondroitin sulfate). Glucosamine starts the cartilage regeneration process, corrects metabolism, blocks destructive processes. Chondroitin sulfate disarms dangerous enzymes, increases the amount of collagen (this protein nourishes the cartilage with moisture). According to leading doctors, these drugs currently demonstrate the greatest positive effect in the treatment of gonarthrosis.
In particularly critical cases, when the cartilage tissue has undergone severe abnormalities, the chondroprotectors are ineffective. When prescribing glucosamine and chondroin sulfate, the doctor indicates specific daily doses. Only a systematic approach to taking these drugs gives the possibility of positive results. On sale are represented by tablets, capsules, injections, gels.
Vasodilators
To remove spasms of the vascular system, optimize blood flow and metabolism in the knee area, the doctor prescribes funds for vasodilation. As a rule, they are prescribed in combination with chondroprotectors. If, against the background of arthrosis, fluid in the knee is not collected, it is permissible to rub the joint with a warming ointment and participate in therapeutic massage sessions.
Hyaluronic acid
In its chemical composition, this substance is very close to the intra-articular fluid. After being introduced into the joint, the acid generates a film that protects the cartilage from mutual friction. It is allowed to use the medicine after the cessation of exacerbation.
Therapeutic exercise
For osteoarthritis of the knee,resort to physical therapy, but only under the close supervision of the attending physician or an experienced trainer. Self-medication is strictly prohibited, given the enormous risks of any careless movements and loads. Proper use of physiotherapy exercises helps to keep the joint in working condition, removes muscle spasms and relieves unpleasant symptoms. It is strictly forbidden to engage in physiotherapy exercises during exacerbations or in inappropriate conditions.
Physiotherapy
By applying physiotherapy techniques correctly, you can significantly reduce pain in the knee area, relieve inflammation, and improve the flow of nutrients to the joint tissue. Before prescribing physiotherapy, the orthopedist makes a detailed diagnosis of the problem area, prescribes general and special tests, sends an ultrasound or X-ray. This approach allows you to get a real picture of the problem and select the best methods.
The following types of physiotherapy have a good analgesic effect:
- UV radiation. Due to exposure to ultraviolet rays, there is a decrease in the sensitivity of the nerve endings and a decrease in pain. As a rule, it is prescribed in the later stages of the disease. The standard duration of treatment is 7-8 sessions.
- Local magnetotherapy. It improves the patient's overall health by reducing pain, inflammation, muscle spasms. Magnetotherapy is usually prescribed at the first fixation of the symptoms of knee osteoarthritis. The standard number of procedures is 20-25 sessions of 30 minutes each.
- Infrared laser therapy, UHF, SMW devices, ultrasound, therapeutic baths, etc.
If the disease has passed to the stage of dystrophic and deforming changes, the doctor recommends sanitary treatment. A specific list of procedures is compiled after a careful study of the patient's history.
Surgery
This approach, with proper implementation, is able to partially or completely resume the work of the knee joint. The formation of the surgical intervention algorithm takes into account the level of destruction of the cartilage tissue, the degree of inflammation, the amount of collected fluid, etc. As a rule, surgery is performed in the late stages of gonarthrosis. This approach involves a partial or complete replacement of the affected joint with an endoprosthesis.
The main approaches to surgical treatment:
- Joint arthrodesis. During surgery, the surgeon fixes the leg in the most comfortable position for the patient, followed by immobilization of the knee joint. Defective cartilage is completely eliminated. Such a radical approach is relevant only in extreme cases.
- Arthroscopic debridement. It is used in the second stage of development of osteoarthritis of the knee. A surgical removal of damaged cartilage tissues is performed, which allows you to save a person from pain for several years (usually for 2-3 years).
- Endoprosthesis. In this case, the knee joint or its separate part is replaced with an implant made of plastic, ceramic or metal that completely repeats the anatomical configuration of the natural joint. Endoprosthesis today is considered the most effective way to restore a full-fledged lifestyle to a knee affected by osteoarthritis for the next 15-20 years.
Competent planning and implementation of surgical treatment makes it possible to improve patient well-being and restore mobility (partially or completely). At the same time, it should be understood that a long recovery period will be required after the operation, attending exercises in physiotherapy, mechanotherapy, diet, etc.
Rehabilitation
On average, the rehabilitation period after surgical treatment lasts 90 days:
The main tasks of rehabilitation:
- the resumption of the patient's ability to move normally;
- optimization of the functioning of muscles and joints;
- making a protective block for the prosthesis.
Drainage is removed 2-3 days after the operation, after which you can try to walk carefully. To relieve pain, the doctor prescribes drugs with a cooling effect. Small pain symptoms sometimes persist for a year after the operation: this is due to the fact that the prosthesis takes time to heal. Elderly patients heal longer: to alleviate their condition, NSAIDs are prescribed. In some situations, the attending physician prescribes hormonal agents that have a pronounced effect.
A week later, the patient enters the rehabilitation center under the care of an experienced physiotherapist. When developing a course of physical therapy, the individual characteristics of the body are taken into account. Classes are held regularly (daily), with a gradual increase in loads - this protects against injury and tissue breakdown.
Period after discharge
At the end of the hospitalization in the rehabilitation center, the patient is discharged, providing him with detailed information on his future lifestyle. Dances and light gymnastics are allowed after 6 months from the date of the operation. As for serious loads (fast running, jumping, sports games, heavy squats), they must be completely excluded. Otherwise, the prosthesis will quickly fail.
Do not lift heavy objects weighing more than 25 kg. Inside the house it is necessary to install support handrails: they are located on the stairs, in the bathroom with shower and in the bathroom. All furniture must be fully functional (especially the chairs). These and other measures will maximize the life of the prosthesis. You should also be prepared for postoperative knee joint osteoarthritis, which can last up to 3 years.
Prevention of the onset of the disease
The best way to deal with any disease is to prevent its onset.
Effective waysprevention of osteoarthritis of the knee:
- Proper nutrition, maintaining a normal weight. It is better to remove fatty and fried foods, alcohol, coffee, etc. from the diet. . An experienced nutritionist can give detailed advice on this.
- Be careful when playing sports. It is desirable to reduce the load on the joints as much as possible.
- Be alert to any diseases (especially infectious ones), treat them correctly and avoid chronic phases.
- Watch your posture, do not be negligent for bone and spine diseases.
- Include gentle physical activity in your daily routine (cycling, swimming, walking, joint strengthening exercises).
- Avoid any self-treatment options for knee arthritis. At the first symptoms of the disease, you should immediately contact the clinic.
- Lead a calm lifestyle without stress and lack of sleep.
- Take measures to strengthen immunity (hardening, taking vitamins).
- Dress warmly in the cold season.
By applying the principles of a healthy lifestyle in your life and seeking medical help in a timely manner, you can minimize the risks of developing osteoarthritis of the knee joints. When choosing a clinic, preference should be given to proven treatment centers equipped with modern equipment.