Arthrosis of the knee joint is understood as a decrease in the performance of cartilage due to its curvature and destruction. Other terms are used to refer to this disease -gonarthrosisanddeforming arthritis. 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
Knee osteoarthritis usually develops gradually. As a rule, it occurs in women and older people who are overweight or have venous malformations. The disease can occur on one or both knees at once.
The main stages of development of arthrosis in the knee:
- Initial. There is a decrease in the damping parameters of the joint due to mutual friction of the cartilages and an increase in their roughness. Sometimes the formation of cracks is observed.
- Second. At this stage, the bone begins to become covered with growths (osteophytes). On the inner surface of the articular bag, the curvature is fixed, stiffness 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 mucosa, a reduction in the distance between the tibia and the 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 arthrosis of the knee joint are reason enough to consult a specialist. Otherwise, there is a real danger of becoming disabled.
Why osteoarthritis appears
The main causes of the development of arthrosis of the knee joint:
- hereditary tendency;
- temporary immobility of the knee joint as a result of 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 failure of the 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. The pain appears suddenly, against the background of physical exertion. At the first stage, there is talk of almost imperceptible lumbago, later the disease becomes more serious.
- Visual violation of the shape of the knee. This happens in later stages.
- Accumulation of fluid, Baker's cyst. These are tangible joints in the posterior region of the knee joint.
- The appearance of a crunch of cartilage, against the background of sharp pain. This indicates the second or third stage of gonarthrosis.
- Inflammation of the inner region of the articular sac. It is manifested by edema and an increase in cartilage.
- Stiffness of the knee due to intense pain, which can go as far as complete immobilization. This occurs in the advanced stages of the disease.
Treatment
Effective treatment of arthrosis of the knee joint is possible only with the use of an integrated approach. Modern medicine cannot yet offer a specific drug that can eliminate this disorder. The success of treatment procedures depends on the timeliness of detecting the problem, which allows you to begin the fight against gonarthrosis at an early stage.
When starting treatment, the specialist pursues several goals:
- reduce pain symptoms as much as possible;
- resume the normal flow of nutrients to the joint;
- increase the intensity of blood circulation in the knee area;
- restore the functionality of supporting muscles in the problem area;
- make the knee as mobile as possible;
- widen the space between the connected bones.
The exact processing 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.
Analgesics, anti-inflammatories
To eliminate or reduce pain in the knee joint, the doctor usually prescribes the use of nonsteroidal anti-inflammatory drugs. In pharmacies, they are represented by tablets, ointments and injections. Heating and anesthetic gels, ointments and patches demonstrate good efficacy for pain relief.
A positive result in this case is usually obtained in 3-4 days. It should be understood that these drugs 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 fixing 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 the pain associated with knee osteoarthritis, the doctor may prescribe hormone injections. This approach is used when NSAID efficacy is low in the context of progressive disease.
Hormones are prescribed for a short period (1-10 days) during exacerbations of arthrosis and fluid accumulation 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 process of cartilage regeneration, corrects metabolism, blocks destructive processes. Chondroitin sulfate disarms dangerous enzymes, increases the amount of collagen (this protein nourishes cartilage with moisture). According to eminent doctors, these drugs currently show the greatest positive effect in the treatment of gonarthrosis.
In especially critical cases, when the cartilage tissue has suffered severe abnormalities, chondroprotectors are ineffective. When prescribing glucosamine and chondroitin sulfate, the doctor indicates specific daily doses. Only a systematic approach to taking these drugs gives a chance to achieve positive results. On sale they are represented by tablets, capsules, injections, gels.
Vasodilators
To eliminate 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 warming ointment and attend therapeutic massage sessions.
Hyaluronic acid
In its chemical composition, this substance is very close to 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 drug after the cessation of exacerbation.
Therapeutic exercise
For knee osteoarthritis, resort to exercise therapy, but only under the strict supervision of the attending physician or an experienced trainer. Self-medication is strictly prohibited, given the enormous risks of careless movements and loads. Proper use of physiotherapy exercises helps keep the joint in working order, eliminates muscle spasms and alleviates 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 joint tissues. Before prescribing physiotherapy, the orthopedist conducts a detailed diagnosis of the problem area, prescribes general and special tests, sends an ultrasound or x-ray. This approach makes it possible to paint a real portrait of the problem and to 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 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. Improves the overall health of the patient by reducing pain, inflammation, muscle spasms. Magnetotherapy is usually prescribed when first fixing the symptoms of osteoarthritis of the knee. The standard number of procedures is 20-25 sessions of 30 minutes each.
- Infrared laser therapy, UHF devices, SMW, ultrasound, therapeutic baths, etc.
If the disease has passed into the stage of dystrophic and deforming changes, the doctor recommends sanitary treatment. A specific list of procedures is compiled after careful study of the patient's history.
Operation
This approach, with proper implementation, is able to partially or completely resume the work of the knee joint. The formation of the algorithm for surgical intervention takes into account the level of destruction of cartilage tissue, the degree of inflammation, the amount of fluid collected, etc. As a rule, surgery is performed in the later stages of gonarthrosis. This approach involves partial or complete replacement of the affected joint with an endoprosthesis.
The main approaches to surgical treatment:
- Arthrodesis of the joint. During surgery, the surgeon fixes the leg in the most comfortable position for the patient, followed by immobilization of the knee joint. The 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. Surgical removal of damaged cartilage tissue is performed, which allows you to save a person from pain for several years (usually for 2-3 years).
- Stents. In this case, the knee joint or its separated part is replaced with a plastic, ceramic or metal implant that completely repeats the anatomical configuration of the natural joint. The endoprosthesis is now considered the most effective way to restore a full-fledged lifestyle to a knee suffering from osteoarthritis for the next 15 to 20 years.
Competent planning and implementation of surgical treatment helps to improve the patient's well-being and restore mobility (partially or completely). At the same time, it should be understood that after the operation a long recovery period will be required, attending physiotherapy exercises, mechanotherapy, dieting, etc.
Rehabilitation
On average, the rehabilitation period after surgical treatment lasts 90 days:
The main tasks of rehabilitation:
- the recovery of the patient's ability to move normally;
- optimization of the functioning of muscles and joints;
- creation of a protective block for the prosthesis.
The 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 painful symptoms sometimes persist for up to a year after the operation: this is due to the fact that the prosthesis needs time to heal. Elderly patients recover longer: to alleviate their condition, they are prescribed NSAIDs. 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 supervision of an experienced physiotherapist. When developing an exercise therapy course, the individual characteristics of the body are taken into account. Classes take place regularly (daily), with a gradual increase in load: this protects against injuries and tissue ruptures.
Period after release
At the end of the stay in the rehabilitation center, the patient is discharged with detailed recommendations regarding his future lifestyle. Dancing and light gymnastics are allowed after 6 months from the date of the operation. As for heavy loads (speed running, jumps, sports games, heavy weight squats), they should be completely excluded. Otherwise, the prosthesis will quickly fail.
Do not lift heavy objects weighing more than 25 kg. Inside the dwelling, it is necessary to install supporting handrails: they are placed on the stairs, in the shower room and in the bathroom. All furniture must be fully functional (especially chairs). These and other measures will maximize the life of the prosthesis. You should also be prepared for postoperative arthrosis of the knee joint, which can last up to 3 years.
Prevention of the onset of the disease
The best way to treat a disease is to prevent it from happening.
Effective meansprevention of knee osteoarthritis:
- Proper nutrition, maintaining a normal weight. It is best to eliminate fatty and fried foods, alcohol, coffee, etc. from your diet. . An experienced nutritionist can give you detailed advice on this.
- Be mindful when exercising. It is desirable to reduce the load on the joints as much as possible.
- Be alert to all diseases (especially infectious), treat them properly and avoid chronic stages.
- Watch your posture, do not neglect diseases of the bones and spine.
- Incorporate gentle physical activity into your daily routine (cycling, swimming, walking, joint-strengthening exercises).
- Avoid any self-treatment option for knee arthritis. At the first symptoms of the disease, you should immediately contact the clinic.
- Lead a calm life without stress or lack of sleep.
- Take measures to strengthen immunity (hardening, taking vitamins).
- Dress warmly during the cold season.
By applying the principles of a healthy lifestyle in your life and seeking timely medical help, you can minimize the chances of developing osteoarthritis of the knee joints. When choosing a clinic, preference should be given to proven treatment centers equipped with modern equipment.