One of the most common diseases of the musculoskeletal system is the joint disease of the knee joint (if not Gonartrosis) is a chronic disease, accompanied by nourishment and destroying the joint structures of the knee.
The result of destruction processes is a strong limited or completely losing the mobility of the joint, and the result is - reducing performance and defects.
It is possible to prevent adverse consequences only when you are diagnosed early and treated promptly.
Reason
According to the origin, the knee joint is the main and secondary.It is developing as an independent disease that is often diagnosed in the elderly and in this case, due to age changes that occur in tissues.Secondary Gonarthrosis becomes the result of other diseases and disorders in the body.
The development of Gonarthrosis contributes:
- injury (dislocated joint, fracture, cartilage damage);
- Diseases of musculoskeletal system (congenital deformation of legs, knee dysplasies, chondrocalcinosis, arthritis, osteoporosis);
- High load continuously on joints due to professional activities, professional sports;
- overweight, obesity;
- Endocrine diseases, including diabetes, hypothyroidism, Acromigaly;
- metabolic disorders;
- Genetic trend.
Symptom
Arthritis of the knee joint comes with two main clinical manifestations - pain and edema.The intensity and frequency of the appearance of pain depend on the depth of damage to joint structures.In the initial stage, the pain was only felt with one load, quickly overcome when resting.With advanced Gonarthrosis, continuous pain, enhancement in movements, with changes in weather.
Other signs of knee joint disease:
- crisis when moving;
- hardness in joints, violating motor function;
- Deformation of knee (with forgotten gonarthrosis).
Gonarthrosis may come with an active inflammation (accumulating liquid in the joint) and the next formation of a Baker cyst (elastic formation at the back of the knee).
The degree of arthritis
The symptoms of knee arthritis vary depending on the depth of damage to the structures of the knee, and therefore, the three stages of pathology are distinguished.
- Arthrosis of knee joints 1 degreeIt is manifested as evidence of pain in the load (when resting at the same time), with mild hardness after sleep.In the X -ray picture, a negligible narrowing of the joint distance (less than one -third), the presence of single bone cells (bone development) is recorded.
- Arthrosis of knee joints 2 degreesIt comes with the characteristic pain and crisis in movements.Pain still exists for a while.Morning hardness, limiting amplitude of the motion recorded.The diagnostic procedures show a clear narrowing of the general gap (more than half) and many bone diseases.
- Arthrosis of knee 3 degreesIt comes with constant pain, during movement and at night, strengthening.The morning hardness is still longer than an hour with severe inflammation and at least half an hour - during the remission period.The mobility of the joint is limited or completely lost.In the image of X -ray, many large bone cells, cysts can be seen.The general distance is narrower than two -theds compared to the norm.
Depending on the level of joints of the knee joint, the patient is prescribed conservative treatment or surgery.
Diagnose
Diagnosis of knee joint disease includes visual examination, analysis of patients' complaints, laboratory tests (urine analysis, general blood tests and biochemistry) and tools to test tools.
The following diagnostic procedures allow you to confirm or reject the diagnosis:
- X -ray;
- Ultrasound (ultrasound);
- MRI (magnetic resonance images);
- CT (calculated class cutting);
- Endoscopy and radiography (with suspicion of tumor).
Using these methods, it is possible to detect the narrowing of the joint distance, the level of thinness and deformation of cartilage, the presence of liquid in the joint cavity, changing the structure in the epidemic membrane, the development of osteitis and the focal point of cartilage.
Conservative treatment
Conservative treatments can reduce pain and inflammation, improve blood circulation and nutrition of Periastate tissues, enhance muscle equipment.
Finally, they were held:
- Drug therapy;
- lockdown;
- physiotherapy and manual therapy;
- Medical physical education.
An important component of muscle disease treatment is the observation of a therapeutic diet.
Treatment of joint disease conservation of knee joints will be effective at the initial stage of the disease, when the small psychotic cartridges of cartilage, inflammation and the weakened functions of the epidemic case are recorded.
Medicine
Drug treatment includes an appointment:
- Anti -inflammatory drugs (NSAID);
- chondroprotector;
- Hyaluronic acid.
NSAID
Anti -inflammatory drugs are not inability to reduce inflammation, reduce its main symptoms -pulses and pain.
Preparations are specified in the form of solutions (for intramuscular management) or tablets, capsules (for mouth).The capsules and pills from the knee joint of the NSAID group are made in short courses, because drugs have a strong irritation effect on the stomach lining and can cause the development of stomach ulcers, there are many side effects.
In addition, external drugs are prescribed (ointment, gel, cream) based on anti -inflammatory ingredients that are not incorrect.Local therapy is allowed for a longer time.
NSAID has a clear anti -inflammatory effect, but with prolonged use contribute to the destruction of cartilage.
NSAID is symptomatic therapy.They help eliminate unpleasant symptoms of the disease, but does not affect the condition of cartilage.In contrast to these products, Chondroprotector and hyaluronic acid accelerate cartilage mode regeneration processes and slow down its destruction.
Chondroprotector
The medications of the chondroprotector group contain chondroitin and glucosamine (structural cartilage elements) and help restore the knee with the knee joint.They are available in the form of tablets, powder to drink, a solution to inject.
The minimum course of tablets and powder is 3 months.After rest, the course is repeated 2-3 times.The treatment process with a solution consists of 12-15 injections, repeated 2-3 times a year.
The first positive treatment results with Chondroprotector were only noticed just a few months after the beginning of treatment.
Hyaluronic acid
Hyaluronic acid is put into injection into the affected joint.The treatment of joints of the knee joint performs the role of lubrication - covering the joint surfaces, thus reducing the friction between them.
Hyaluronic acid therapy helps increase the elasticity of cartilage tissue, preventing the destruction of joint structures further, helping to improve the movement of joints, the symptoms of inflammation are reduced.The drug is well tolerated, does not cause side effects.Their only limitation is high cost.
Hyaluronic acid treatment usually consists of 3-4 injections, which are performed for 10-14 days off.
Lockdown
If the anti -inflammatory drugs are not caused by no, unable to relieve knee pain with Arthricis disease, a blockade is taken -a treatment in which the drugs are injected directly into the affected tissue to relieve pain and inflammation.In the therapy of arthritis, joints (injected in the joint cavity) and blockade of veins (in the perpendicular cavity) are used.
The main advantage of the method is an instant -purpose act, because with such introduction, the maximum concentration of the active substance is created accurately in the inflammatory area.In addition, drugs do not fall into the body blood, significantly reducing the risk of adverse reactions.
In the later stages of Gonartrosis, the distance is clearly narrowed, the bone grows, the joints are deformed, so it only allows the blockade of the circumference.
The blockade of knee joints for arthritis can be done by using anesthetic and corticosteroids.
Anesthesia is usually introduced in combination with steroid hormones to reduce pain of procedures.
Hyaluronic acid and chondroprotector can also be brought directly into the joints.But in this case, we do not talk about blockade, but in the internal injection, because these drugs do not prevent painful pulses, but activate the process of cartilage regeneration.
Physiotherapy and manual therapy
The main methods of physical therapy effects used in arthritis treatment include:
- laser treatment;
- Ultrasound therapy;
- cold pressure therapy;
- Therapy with paraffin and ozokerite;
- Mud.
The main task of all physical therapy processes is to stimulate blood circulation in nearby tissues, improve cartilage nutrition.
Exercise therapy
Pain syndrome forced a patient with Gonartrosis to limit movement, due to atrophic ligament and muscles.This condition negatively affects joint tissues, because it is in the process of moving, the nutrients penetrate from the solution into cartilage.If the joint is constantly resting, the difficult processes will become worse.
That is why physiotherapy exercises are an indispensable ingredient of conservative therapy.Moderate physical activity allows you to enhance muscle equipment, enhance the strength of joint structures, eliminate hardness and improve knee movement function.
The exercises of the treatment exercises are developed by the doctor for each patient, taking into account the depth of the lesion and the functional state of the joint structures.
General recommendations to conduct knee exercise therapy:
- Only start classes after stopping the signs of acute inflammation;
- Do all smooth exercises, no sudden movement;
- The load is increased gradually;
- Eliminate high loads on the joint (enhance the bending/expansion of the knee);
- If pain or discomfort appear, stop training.
Diet
With Gonarthrosis, products contain: contain:
- amino acids (dairy products, low meats);
- Collagen (dishes with gelatin);
- Irreplaceable fatty acids (vegetable oil, fish);
- Sulfur and selenium (beans, cereals, cabbage and apples, beef, chicken, eggs).
It is also important:
- Eliminate the use of smoked meat, pickles, marinated;
- Limit salt consumption;
- Comply with the diet 5 times;
- Observe the drink.
Excess body weight is one of the main factors that cause the development of knee joints.Therefore, the task of patients with excess weight is to reduce body weight.In this case, you can achieve results only with the help of a diet, as intensive sports are harmful to inflamed joints.
To reduce body weight, it is recommended to eliminate from the menu:
- like meat and fatty fish;
- Homemade cream, homemade cream and dairy products with high fat rates;
- Margarine, mayonnaise, many different sauces;
- confectionery;
- fast food;
- Sweet drinks.
Surgical treatment
Arthrosis of the knee joint of level 3 is unacceptable for conservative therapy, so the activity is the only way for patients.
There are two options for surgical intervention:
- Adjustable bone cutting- Performed at the initial development stage of the third phase of Gonarthrosis, if the cartilage is partially destroyed, it is possible to eliminate bone cells;
- Endrosthetic- The replacement of joints or its destroyed parts is done with the complete destruction of cartilage.
Forecast
Pathological changes in joint structure are progressive, irreversible.However, with early diagnosis and proper treatment, you absolutely can prevent inflammation and prevent dysplasia changes in cartilage tissue - Arthrosis of the knee joint of level 1 is good treatment for conservation therapies.
With the main disease at level 2, accompanied by the destruction of cartilage and the formation of bone cells, conservative methods allow you to slow down or suspend the deformation of cartilage, stop inflammation and improve the operation of the engine.However, doctors are often forced to use blockade and endoscopy.
Can not cure the joint of the knee joint in a conservative way.The only way to restore knee movement is surgical intervention.