Osteoarthritis of the knee - symptoms, treatment. Deforming arthrosis of the knee
Osteoarthritis of the knee is a slowly progressive inflammatory-degenerative disease of the joints. Most often this disease is observed in people of middle and old age and is the most common cause of musculoskeletal pain in the area of the knee joint and disability. From this publication you will learn how to treat osteoarthritis of the knee joint.
In the knee joint, the femoral and tibial bones are covered with articular cartilage. There is also a second type of cartilage tissue, forming the so-called menisci, which act as layers or shock absorbers. The joint fluid adds additional protection and smooth movement. Osteoarthritis begins to develop, if the cartilage tissue protecting the bones is damaged and damaged, with the result that the surface of the bones becomes bare, and the joint lubricant ceases to be produced in the required amount.At the same time, both complete and partial loss of cartilage can be observed. This process is often isolated by a specific area in the joint, in such cases it can be caused by trauma and chronic wear of the joint.
Deforming arthrosis of the knee joint is characterized by the process of destruction of its cartilage membranes. In the future, the process may include the nearest tissue, such as ligaments and bones. Gonarthrosis, or osteoarthritis of the knee, due to loss of cartilage, is accompanied by an increase in stiffness and deformity of the joint. Bone spurs (osteophytes), which are abnormal bone growth, can sometimes even be palpable outside. The surface of the bones are deformed and no longer close and do not fit together, as in healthy joints. As a result, the restriction of movement increases.
At the same time, pain occurs, which is especially strong when moving after prolonged immobility, for example in the morning and also at night, which ultimately leads to a decrease in the quality of life. Stress can also provoke painful sensations in the area of the affected joint. An indirect sign of pathological changes in cartilage is a visible narrowing of the joint cavity between the femoral and tibial bone in the x-ray.
There are several reasons for osteoarthritis: the process of aging and deterioration of cartilage, overweight, trauma, autoimmune diseases in which the immune system attacks its own articular tissue, causing inflammation and its subsequent destruction. An example is rheumatoid arthritis, in which both joints are affected simultaneously and disability develops. Some experts combine such concepts as arthritis and arthrosis of the knee joint, the symptoms of these ailments are similar and are often caused by the same cause.
Decreased blood supply to the femoral head can also cause cartilage deformation, in which case they speak of aseptic necrosis. Inadequate formation of the knee joint in early childhood can lead to a shift of the mechanical axis and degeneration of the knee joint. Post-traumatic arthrosis is secondary and develops as a result of damage to the meniscus, anterior or posterior cruciate ligament.
There are three degrees of osteoarthritis of the knee, each of which has its own characteristics. In the first stage, there is a slight pain, discomfort in the sore spot and intermittent edema. The second degree is accompanied by increased symptoms, the appearance of a crunch and limited mobility.When the painful sensations practically do not leave the person, and the cartilage tissue is thoroughly destroyed, the illness passes into arthrosis of the knee joint of the 3rd degree.
Arthrosis pain may appear suddenly, but most often it develops slowly. A person may notice pain in the morning, after getting out of bed. Knees can ache when walking upstairs, or when you have to get up on your knee, and often painful sensations occur simply during a walk. For weather sensitive people, weather changes can also cause joint pain.
Puffiness is a consequence of inflammation, which periodically increases with arthrosis. Swelling can also be associated with the formation of bone spurs or the accumulation of excess fluid in the knee. They may be more pronounced after a long period of inactivity, for example in the morning or after a long stay at the desk. Skin may become reddish and hot when touched. If chronic inflammation of the joint occurs, the removal of pain and swelling is usually achieved by taking anti-inflammatory drugs.
Loss of stability develops over time due to weakening of the muscles and instability of the entire system.From time to time there are situations when a person is simply not able to bend or fully extend the leg at the knee. This symptom usually accompanies osteoarthritis of the knee joint 2 degrees. The crunch is felt when moving because the cartilage surface has lost its original smoothness and the necessary amount of synovial lubrication. In the later stages, a creaking sound may be caused by bone spurs rubbing against each other as they move.
A limited range of motion can be noticed when climbing a ladder or during exercise. Many are forced to resort to using walkers or canes to move. Knee deformity is perhaps the most terrible symptom of osteoarthritis, since it indicates irreversible changes in the joint, turning a person into a disabled person. The knees can be turned towards each other inwards as well as outwards. Deformity of the knee can be from subtle to significant.
The definition of osteoarthritis of the knee joint begins with a physical examination of the doctor, a medical history and a conversation with the patient. Be sure to pay attention to the doctor that most often causes pain, and tell about cases of illness in the family, if any.
Additional diagnostics is carried out using:
- X-ray, which can show the presence of bone spurs and changes in cartilage;
- magnetic resonance imaging;
- blood tests reveal autoimmune disorders.
How to treat osteoarthritis of the knee, what drugs are needed for this? Look for answers to these questions below.
Principles of treatment
Standard treatment of such a disease as osteoarthritis of the knee joint, is primarily aimed at eliminating pain and removing functional limitations. It is worth knowing that painkillers only weaken the symptoms, but are not able to affect the course of the disease and restore damaged cartilage. For treatment, narcotic analgesics, nonsteroidal anti-inflammatory drugs, slow-acting gold medications, corticosteroids, methotrexate, etc. are used.
In addition, surgical intervention may be necessary, as well as physiotherapy and physiotherapy. Gymnastics with osteoarthritis of the knee joint significantly helps in treatment, exercises are selected by the attending physician. Despite the fact that in modern pharmacology, active research and development of the most effective and at the same time safe drugs for the treatment of arthrosis is being conductedmost drugs still have their own side effects and with long-term use disrupt the normal functioning of the systems and organs.
Drug therapy for knee arthrosis involves three main areas:
- the use of nonsteroidal anti-inflammatory drugs that are needed in order to relieve pain and reduce the intensity of the inflammatory process in the tissues;
- taking medications to restore cartilage, which include chondroprotectors: glucosamine and chondroitin;
- use of creams and ointments in the complex therapy of deforming arthrosis.
In combination with physical therapy, manual therapy, medication allows you to slow down the process of destruction of articular cartilage, speed up the regeneration of cartilage tissue and restore normal functioning of the limb.
The main goal of drug treatment is the elimination of pain syndrome, improvement of cartilage nutrition, activation of recovery processes, increase in joint mobility and normalization of blood circulation in the knee.
The most common treatment for osteoarthritis are nonsteroidal anti-inflammatory drugs such as Diclofenac, Indomethacin, Piroxicam, Ketoprofen, and others. They are used to relieve pain and reduce inflammation, but long-term treatment with these drugs is not recommended, because the drugs in this group have undesirable side effects, including negative effects on the gastric and intestinal mucosa, effects on the kidneys, liver and cardiovascular system. However, each drug has its own characteristics. And recently began to develop tools with minimal risk to the patient's health.
In addition, despite the need to use these drugs, some studies have found that NSAIDs can lead to a decrease in the production of proteoglycans, thereby dehydrating the cartilage tissue, so these drugs should be taken strictly according to a doctor's prescription and under its control. The frequency of side effects of NSAIDs increases with their prolonged use, which is a necessity for many patients with arthrosis. Experts recommend choosing selective anti-inflammatory drugs for long-term use.have fewer side effects and do not adversely affect the metabolism in the cartilage tissue.
From modern NSAIDs can be called means "Celebrex", "Nimesulide", "Naproxen", "Meloxicam". Most nonsteroidal anti-inflammatory drugs are available in different forms: in the form of capsules or tablets, in the form of a solution for injection and ointments or gels for local external use.
Means to restore cartilage
For the nutrition and regeneration of cartilage to its tissues, a constant supply of compounds such as glucosamine and chondroitin chondroprotectors is necessary. These are the most useful substances for people suffering from osteoarthritis of the knee joint. Their reception should be carried out for a very long time, from six months or more, only in this case, you can count on a positive therapeutic effect. Chondroprotectors improve the quality and quantity of synovial fluid, unlike NSAIDs, they increase the synthesis of proteoglycans and promote the regeneration of cartilage plates. However, because of the beneficial properties of these compounds, they should not be considered as the primary treatment for osteoarthritis.Deforming arthrosis of the knee requires the use of drugs chondroitin and glucosamine for at least 1.5 years. It is also considered that they are not able to repair completely destroyed cartilage.
Ointments and creams
Treatment of a disease such as osteoarthritis of the knee joint should include topical use of gels and ointments. These forms of drugs should not be relied on as the only treatment option, their use should be considered as a necessary supplement to the use of NSAIDs and chondroprotectors. Such drugs significantly reduce discomfort, pain, swelling, improve joint mobility.
This effect is explained by the fact that penetrating the blood through the skin, ointments and creams improve blood circulation in the joint, accelerate the metabolism in cartilage and, accordingly, its regeneration. Among these funds can be distinguished ointment "Indometacin", "Voltaren", "Fastum-gel" and others.
Applications for osteoarthritis have a greater effect than the application of ointments. For therapeutic compresses, Dimexid is often prescribed, which has a good anti-inflammatory and analgesic effect, and penetrates well into tissues.Also effective bischofite, accelerating metabolic processes in cartilage.
Within the knee joint synovial fluid is very viscous, it ensures the absence of friction of tissues. An important part of this lubricant is hyaluronic acid, which binds proteoglycans to stabilize the structure of cartilage tissue. In patients with arthrosis, the level of this compound in synovial fluid is significantly reduced, as a result of which the latter becomes less viscous, and friction increases.
Hyaluronic acid-based injections into the knee are able to slow the progression of osteoarthritis, but only half of those diagnosed with symptomatic relief. The course of injections is usually three weeks, with one injection every seven days. After six months, the procedure is recommended to repeat.
Osteoarthritis of the knee involves a comprehensive approach to treatment, and traditional medicine prescriptions act as an additional therapy. Means such as decoction of onion peel, infusion of dandelion leaves, a mixture of aloe, vodka and honey in equal volumes, night compresses of salt with honey and many others deserve attention. It is also recommended to eat more jelly and jelly.
If all the listed methods of treatment have failed, then an operation to replace the joint with an endoprosthesis is indicated. The main purpose of the operation is to restore the natural mechanical axis of the leg and complete relief from pain and discomfort. At the same time, either part of the joint or the entire joint can be replaced. Continuous improvement of surgical equipment and the quality of implants made this procedure quite successful and common.