Treatment of arthrosis of the knee joint

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

Over 20% of people over 55 years old is subject to the knee arthrosis (gonartrosis), but the disease is rapidly young - more and more its symptoms are manifested at the age of 25 years.

In time, the treatment of arthrosis of the knee joint will help to avoid complications and destruction of cartilage.

Signs of arthrosis of the knee joint

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

• morning stiffness and reduction of mobility in the joint (wake -up is required);
• pain and discomfort in the knees, which are enhanced after physical exertion (long walking, running or standing) and are on the decline when rest;
• At the 2nd stage - the so -calledstarting pains that occur after a long stay in one position;
• increased fatigue, which is often written off to age -related changes;
• dry coarse crunch, which is regularly repeated when kneeling and bending;
• edema and other symptoms of inflammation that appear at the 2nd stage of the disease due to trauma of perioster tissues;
• Mete -sensitivity, increased symptoms in the cold season.

When trying to bend the knee struck by the gonartrosis, a sharp pain and a sense of physical obstacle occurs.In the later stages, even in the presence of treatment of arthrosis of the knee joint, patients are disturbed in patients (becomes enjoying, patients walk on stiff legs), deformation of the lower extremities in the form of the letters “O” or “X” appears.

The insidiousness 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 at the 2nd stage - when the complete restoration of the synovial cartilage is already impossible.
Therefore, it is important to consult a doctor at the first signs of discomfort in the knees - for example, weak, as if pulling pains that occur with insufficient production of synovial fluid.Remember: knee pain is not the norm regardless of age.Timely examination and treatment of arthrosis of the knee of the 1st degree can completely protect you from painful pain in the joints at old age.

What will happen if the arthrosis of the knee does not treat?

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

Especially important is the effective treatment of knee arthrosis in an exacerbation stage.Raw weather, physical or emotional stress, allergies, poisoning, moving to the region with another climate - in a word, any shake for the body can provoke it.Exacerbation of arthrosis proceeds with the destruction of a large amount of chondrocytes.In response to this, the body produces enzymes that are designed to process and remove dead cells.However, if their concentration is too high, healthy areas of cartilage suffer - cell membranes become thinner, foci of erosion appear on the synovial seizure of the joint.This process, if it is not stopped by treating the knee arthrosis with drugs, can flow within a few weeks, and with chronic stress, lack of sleep or insufficient diet, constantly.

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

Treatment of osteoarthrosis of the knee joint

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

Treatment of arthrosis of the knee joint of the 1st degree is always carried out by conservative methods - in case of successful a combination of circumstances and good self -discipline, the patient can be obtained or persistent remission.

Treatment of arthrosis of the knee joint of the 2nd degree, as a rule, is built on the use of all methods of conservative effects, but the doctor can decide on minor surgical interventions in the joint if the disease develops aggressively or with complications.

Treatment of arthrosis of the knee joint of 3 degrees almost always implies surgery.

Complex conservative treatment of arthrosis of the knee joint involves removal of pain and inflammation, restoration of cartilage, and an increase in the volume of movements in the joint.For this, the patient is prescribed an orthopedic regime of loads and rest, system and local drugs (hormonal and non -hormonal anti -inflammatory, analgesics, chondroprotectors and others).Innovative biological methods are also spread - injections of drugs for the treatment of arthrosis of the knee joint directly into the articular bag.At the same time, PRP-infections (blood plasma, enriched with platelets), as well as injections of stem cells obtained from the patient’s own fatty 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 medicines are powerless.With this pathology, the doctor may prescribe the following interventions:

• Arthroscopy of the knee joint.The collective name for a group of minimally invasive operations aimed at removing the broken area of articular fabric or osteophyte, or partial excision of the joint shell.It allows you to delay or exclude prosthetics, as well as eliminate discomfort in the early stages of the disease.It is used mainly for the treatment of knee arthrosis in patients under 60 years old.
• Osteotomy.The operation to cut part of the bone and correction of the load axis on the sore knee, which allows you to slow down degenerative changes.It is usually carried out in the treatment of arthrosis of the knee joint of the 2nd degree.
• Endoprosthetics.Partial or complete replacement of the knee joint with a titanium implant, which serves 15-20 years.This technique is an extreme measure, since it carries certain risks.Recommended for patients over 55 years old.

All these operations require the recovery period and have a number of contraindications, so the best option remains prevention (exercise therapy, chondroprotectors) and the treatment of arthrosis of the knee joint in the early stages.

In addition to the main therapeutic techniques, diet therapy and other methods of lowering body weight are used.To unload the sore joint, bandages and other orthoses are used (walking canes, orthopedic insoles, etc.).

Treatment of arthrosis of the knee is prescribed by a-rhumatologist or orthopedist.At the first reception, he palpates the joint, makes motor tests, and then directs the patient to tomography or radiography.

Therapeutic gymnastics for arthrosis of the knee

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

Therapeutic gymnastics for arthrosis of the knee during periods of remissions 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 lower leg, maintaining the elasticity of ligaments and tendons, as well as the fight against muscle atrophy, which is characteristic of arthrosis.This allows you to transfer the load from the joint to the periarticular structures - and, thereby, slow down the mechanical abrasion of cartilage, reduce inflammation.

Exercises for the treatment of arthrosis knee are performed for both legs!When a sharp pain appears, the lesson should be stopped or continued at a more gentle pace.

1. Starting position - lying on your back.One leg is extended on the floor, the other is raised bent by 90 ° (the lower leg is parallel to the floor).We perform movements with the lower leg up and down, as far as the amplitude of movements in the joint allows.
2. Starting position - lying on your back.We perform the exercise “Bicycle”.
3. Starting position - lying on the stomach.In turn, we dangle our feet, trying to bring the heels as close to the buttocks as possible.
4. The starting position is lying on the side, the hand is bent under the head or stretched over the head along one 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 your back.We pull the legs forward on the floor ahead of the heel (from ourselves), socks look “at ourselves”.
6. Starting position - lying on the stomach.We do the exercise “boat”.If physical preparation does not allow, we put our palms on both sides of the chest and take turns taking our legs back, experiencing stress in the posterior surface of the thigh and lower leg.
7. Starting position - lying on your back.We turn in the feet in turn, trying to describe with socks the most complete circle.
8. Starting position - standing against the wall.Slowly and smoothly squat, without looking up with your back from the wall to distribute the load.When the legs are bent at the knees by 90 °, we begin smooth movement up.
9. The starting position is standing.Alternately, we are swinging our feet forward, back and sideways.

Please note: therapeutic gymnastics after operations on the joint has its own specifics and changes depending on how many days have passed since the time of surgery.It is prescribed by a surgeon or rehabilitologist.

Massage with arthrosis of the knee

Therapeutic massage for arthrosis of the knee is carried out on both legs.At first, at least 10-12 sessions are required for a rehabilitologist or equipment for hydromassage equipment, but a simple general strengthening massage can be performed at home.It includes the following types of movements:

• superficial stroking and rubbing (up and down, software and counterclockwise);
• probing and stretching with the fingertips of deeper fabrics;
• Tighten and tapping on the skin.

Massage with arthrosis of the knee should be done by a specialist who will not harm the diseased joint.

Self -massage can be combined with the treatment of arthrosis of the knee joint with drugs: it will not be superfluous to apply a warming ointment or balm before or during the session.You can also take a warm bath before the procedure.

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

Dietotherapy for arthrosis

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

• limit products and dishes rich in simple carbohydrates (white bread, confectionery, snacks, sweets, potatoes, sugar);
• to exclude processed (ready for use) and rich dishes - fast food, semi -finished products, sausages;
• Refuse alcohol, decoderized coffee and fatty meat.

Instead, you should include in the menu:

• dishes of sprouted and whole grains;
• fat fish of the northern seas and dietary meat of poultry;
• cartilage (ears, nyushki, legs and other parts rich in collagen), cold men and jelly;
• Vegetables and fruits rich in vitamins and antioxidants (in particular, vitamins A, B12, C, E);
• Nuts and other sources of fat omega acids and valuable minerals.

The diet with arthrosis of the knee joint provides a balanced diet, which helps to restore cartilage tissue.

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

Physiotherapy for the treatment of osteoarthrosis of the knee

The following physiotherapeutic procedures are used for the effective treatment of knee arthrosis and enhancing the action of medicines:

• magnetotherapy;
• laser therapy;
• UHF;
• ultrasound therapy;
• amplipulse;
• electrophoresis (including medicinal);
• ozokerite and paraffin applications;
• thermotherapy (cryotherapy, inductothermia);
• phonophoresis;
• Balneological therapy (sulfuric, hydrogen sulfide baths).

Acupuncture in the treatment of arthrosis of the knee joint 2 degrees, as a rule, is not used.

Before visiting the procedures, it is necessary to consult a doctor - many types of physiotherapy are contraindicated in exacerbation of the disease.

Medicines for the treatment of arthrosis of the knee joint

Treatment of arthrosis of the knee joint with drugs is carried out symptoms and taking into account the individual reaction of the patient to the selected drugs.Drug therapy - injections, ointments or tablets for the treatment of arthrosis of the knee joint - is usually prescribed courses or as necessary.

In order to choose the right medicine for the treatment of arthrosis of the knee joint, consult a doctor who, after the study, will select the necessary medicines.

In the treatment of arthrosis of the knee joint, there are several directions: alleviation of the patient’s life, improving the nutrition of cartilage, regeneration of cartilage, and maintaining the norm of the muscular-liner apparatus.

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 impaired instructions or recommendations of the doctor is fraught with ulcer of the stomach or intestines.They should be extremely careful to take them in combination with glucocorticosteroids and drugs affecting blood coagulation.Additional risk factors - age over 65 years old, smoking, alcohol intake during the course.In these cases, doctors usually recommend injection administration of drugs by bypassing the gastrointestinal tract.Together with NSAIDs, it is advisable to take gastroprotectors.

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

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

Hormonal drugs (Civil Code) are usually used for the so -calledThe steroid blockade of the knee in cases where the NSAID is not enough to calm down pain and inflammation.

Injections of glucocorticoids are considered an extreme measure in the treatment of arthrosis of the knee joint with drugs.They provide relief 20 minutes after administration, but hormonal disorders and damage to cartilage tissue in violation of the rules of administration may lead to.Due to side effects, many orthopedists prefer an operation on the knee of prolonged CC therapy.

Chondroprotectors in the treatment of arthrosis of the knee joint

Chondroprotective agents based on extracts from cores and cartilage of cattle, sea fish and mollusks contribute to the restoration of synovial cartilage, and therefore are irreplaceable for the effective treatment of knee arthrosis.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 contraindications.They provide a cumulative, prolonged effect-the first improvements occur after 1-3 months of admission, and the duration of the course is 3-6 months.

Skin-sprouting agents

External preparations for the treatment of arthrosis of the knee with a locally growing effect improve blood circulation and nutrition of the joint, and also distract the patient from pain.For this purpose, 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 soreness of the skin, rash), during pregnancy and lactation, as well as in the presence of other contraindications, it is better to avoid warming ointments for the treatment of arthrosis of the knee joint and limit yourself to warm baths, applications and external anti -inflammatory.

Synovial fluid prostheses

If the synovial fluid in the joint is too small, the sliding of the articular surfaces is disturbed.And most importantly, the starvation of cartilage begins, because the articular fluid, which only drinks it like a sponge, normally supplies nutrients for growth and maintaining cartilage tissue.To prevent cell destruction and mechanical abrasion of the knee cartilage, the doctor may prescribe injections of high molecular weight derivatives of hyaluron.The injections of the drug in the treatment of arthrosis of the knee joint (viscostering) are made directly into the articular 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 necrotic changes or infections in the joint.

Antispasmodics, analgesics, muscle relaxants

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

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

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

For the convenience of patients, drugs for the treatment of arthrosis 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 arthrosis of the knee have several forms of release: Sasha, injections, ointments, tablets.Choose what is most suitable for you.

Capsules, Sasha and tablets for the treatment of arthrosis of the knee joint

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

Injection solutions

In the form of injections, you can take the already mentioned NSAIDs, Civil Code, chondroprotectors and muscle relaxants, as well as synovial fluid prostheses.This method of treating arthrosis of the knee joint demonstrates maximum bioavailability.

This method of treating the knee arthrosis is safe for digestion, but it is desirable that injections (intravenously, intramuscularly in the joint or intraarticular) put a qualified medical staff.Intramuscular injections in the buttock or thigh can be done independently.

External use

Locally growing, anti -inflammatory and chondroprotective ointments are externally used to treat arthrosis of the knee joint.The advantage of such a drug is to direct effects on the affected tissue.But on the path of active substances, a skin barrier rises - alas, often only 5% of active ingredients reaches the desired layers of tissues.

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