Complex treatment of osteoarthritis of the knee

Musculoskeletal disorders lead to significant limitations on human mobility. In order not to lead to complications of the situation, it is necessary to conduct timely treatment. Knee osteoarthritis is the most common form of skeletal joint damage and the most common cause of injury. But with a timely visit to the doctor you can get rid of the disease.

GENERAL INFORMATION

Osteoarthritis of the knee joint is the unofficial name of the disease. In medicine it is called osteoarthritis. The word consists of two ancient Greek words - bone and joint. Other synonyms:

• deforming osteoarthritis or DOA for a short time (the first word in the name reflects the main clinical symptom - joint deformity);
• gonarthrosis (from a combination of the ancient Greek words "knee" and "joint").

Sometimes the disease is mistakenly called arthritis, although traditionally the term refers to connective tissue disease that has nothing to do with osteoarthritis.

The essence of osteoarthritis is that the cartilage tissue covering the surface of the joint is damaged, as a result of which inflammation begins, the work of the bone joints is disrupted and pain occurs. Unfortunately, this is a very common pathology that is diagnosed mainly in the elderly (especially overweight) and in young athletes due to injuries.

For effective treatment, it is necessary to perform a complete examination of the patient with osteoarthritis, in particular to identify the causes that caused the problem with the musculoskeletal system. The following factors most often lead to the disease:

CAUSES AND SYMPTOMS

For effective treatment, it is necessary to perform a complete examination of the patient with osteoarthritis, in particular to identify the causes that caused the problem with the musculoskeletal system. Most often, the following factors lead to the disease:

• leg fractures;
• dislocations, cartilage injury, inflammation;
• impaired metabolism;
endocrine diseases;
• weakness of the ligament apparatus;
• hereditary predisposition;
• autoimmune diseases and infections that initiate joint tissue damage.

Late access to a doctor threatens constant pain in the knee area and complete loss of joint mobility.To prevent this, you should make an appointment with a specialist if you experience a crunch in the knee when walking and painful sensations that are exacerbated when descending or ascending stairs. If treatment is not started at this stage, the situation will worsen - the pain will stop, the movements will be limited, the knee will be deformed.

The longer you do not visit a doctor, the more difficult, time consuming and expensive treatment of gonarthrosis will be.

DEGREE OF THE DISEASE

Osteoarthritis is diagnosed by a doctor. It not only identifies the disease, but also determines its extent. There are three of them:

• First. It is possible to cure the disease in the initial stage, because at that time there are no morphological disorders of the tissue, the muscles are weakened but not yet changed and the joint begins to withstand the load worse due to dysfunctions of the synovial membrane and biochemical composition of the cavity. fluid that nourishes cartilage imenikusis. Excessive use leads to inflammation and pain.

• Second. At this stage, the cartilage and menisci begin to collapse, the load on them leads to pathological growths of bone tissue, narrowing of the joint space. As a result, the knee enlarges and appears deformed. The treatment of bilateral gonarthrosis of the knee joint of the 2nd degree is already more difficult than the first stage. Pain and inflammation become chronic.
• Third. This degree is already considered severe. At the same time, the bone deformation is clearly expressed, the axis of the limb changes, due to which the mechanical load is not distributed properly. The ligaments of the joint are shortened, the natural movements are limited due to this and then the leg can become completely immobile. Treatment of grade 3 knee osteoarthritis without surgery is impossible because the disease is very advanced.

If the pain seems tolerable for a long time, people think that they have osteoarthritis only in the first stage and postpone the visit to the doctor. But this opinion is not correct. Every day the load on the main elements of the joint, which are already beginning to collapse, increases and pathological changes can lead to complete destruction of the joint and severe dysfunction of the limbs.

CLINICAL CURRENT

The progression of the disease is accompanied by characteristic symptoms. The pain occurs in the middle of the night, even if the leg is immobile. In the morning you feel stiffness.

Walking becomes difficult when walking a certain distance, and then at the beginning of the movement. In severe cases, a person can not walk 100 meters normally, it becomes painful to stand and sit. You must move with the help of special equipment.

The slight lameness in the first stage subsequently becomes pronounced. As a result, walking, using public transport, performing professional duties, household functions and even self-care may become completely impossible.

METHODS OF TREATMENT

Folk recipes, pharmaceutical compresses and ointments will not help get rid of the disease, as the approach must be comprehensive.Recovery is usually only possible in a hospital where a doctor will treat osteoarthritis of the knee.What recommendations to give the patient, he decides on the basis of these complaints and related pathologies. The following points are usually required:

• reducing the load on the joints;
• observance of the orthopedic regime;
• physical therapy (exercise therapy);
• undergoing physical therapy.

All this helps to slow down the progression of osteoarthritis and prevent loss of motor function. It should be understood that the methods used will largely depend on the capabilities of the hospital and the availability of one or another physiotherapy equipment. It is best for the patient to have the opportunity to go to spa treatment or to a specialized orthopedic clinic, where a modern approach to the choice of drugs, diet, methods, etc. will be provided.

USE OF MEDICINES

Inflammatory processes and painful sensations make the treatment of osteoarthritis of the knee impossible without drugs in the form of tablets, creams, ointments and injections. In the first stage you can use non-steroidal anti-inflammatory drugs - diclofenac, indomethacin, nimesulide and others. On the second and third you often have to fight inflammation with steroid drugs - triamcinolone, hydrocortisone. These same hormones are used during periods of acute pain.

In addition, intramuscular and intra-articular injections of drugs that improve the condition of cartilage tissue (vasodilators and chondroprotectors) will be needed.

METHODS OF PHYSIOTHERAPY

Significant improvements can be achieved with physiotherapy. The following techniques are considered the most effective:

• Shock wave therapy. This method has worked well for the last 20 years. Its essence lies in the impact on the affected area with a special device that emits radial acoustic waves that activate the blood supply and stimulate tissue repair.
• Myostimulation. This therapy targets the muscles around the joint. Low current impulses increase the mobility of the legs, relieve pain and increase endurance during exercise.
• Phonophoresis. This technique harmoniously combines ultrasound therapy and the use of products in the form of ointments, gels and creams. Typically, such dosage forms are absorbed by only 5-7%, but high-frequency ultrasonic vibrations heat the tissues and the absorption increases several times. In addition to the good therapeutic effect, it saves the consumption of expensive drugs.
• Ozone therapy. The anti-inflammatory and analgesic effect can be achieved by acting on the joint with active oxygen. This is a good addition and in some cases an alternative to taking hormonal drugs.

MEDICAL EXERCISE

Pain during exercise on the joint leads to the fact that the person tries to avoid it. In the long run, this threatens physical inactivity, which leads to muscle atrophy and weakness of the ligaments. Of course, in the period of exacerbation, the load on the joint should be completely removed, but a few days after the relief of inflammation and pain it is necessary to begin physiotherapy exercises.

It is believed that properly and consistently performed exercise exercises can save the patient from the need for surgery. Currently, experienced specialists have developed many special methods of daily training that strengthen muscles and increase their strength and endurance, inhibit pathological tissue destruction, restore joint mobility and range of motion.

The most important thing in this type of treatment is regularity.A good effect is achieved only by those patients who understand the need for lifestyle changes and strictly follow the doctor's recommendations for the ratio of physical activity and periods of joint rest.

PASSIVE KINESITHERAPY

Lymphatic drainage, massage, manual therapy are good additions to medication, physiotherapy and exercise. They are indispensable for sedentary patients and can improve the condition of their muscles, joints and ligaments.

Another method of passive kinesitherapy is mechanotherapy. Uses special devices - vibration simulators, weights, mechanical massagers that improve the effectiveness of treatment.

Elongation of the joints, in which the space of their cavity increases mechanically, allows you to get rid of the pain and stop the destructive processes. Regular use of this therapy prolongs the health of the knee for years.

COMPLIANCE WITH DIET

Because obesity is often the cause of osteoarthritis, patients with such a diagnosis should take care of weight loss. Weight loss will reduce stress on the joint and will facilitate participation in physiotherapy exercises. Sometimes diet is not enough, then bariatric surgery is required, but such situations are rare.

Another indication for following a certain diet can be any pathology associated with osteoarthritis. If there is no obesity or other diseases accompanied by the need to change eating habits, there is no need for a special diet. However, you can help your body strengthen the affected cartilage tissue by including collagen-rich foods in your diet, which include jelly and aspic, fish oil, fruits and berries. It is better to refrain from consuming unhealthy foods such as sugar, carbonated and alcoholic beverages.

SURGICAL INTERVENTION

In advanced cases, the quick solution to problems with the musculoskeletal system is to perform operations. In osteoarthritis, the following types of surgery are prescribed:

• The puncture allows you to get rid of the accumulated fluid in the joint cavity. As a result, the inflammation decreases, due to which the mobility of the knee is restored.
• Arthroscopy makes it possible to clean the surface of the joint from pieces of destroyed tissue. It is performed with the help of thin flexible instruments with the help of a video camera, thus avoiding dissection of the joint cavity.
• Periarticular osteotomy allows you to change the angle of one of the bones that make up the knee joint, so the load is redistributed, mobility is increased and pain is relieved. This intervention is quite traumatic, as the bone must be cut.
• Endoprosthesis allows the replacement of a diseased joint with a biocompatible structure. At the same time, the previous range of motion is restored, but the operation is quite new and very complicated, after which a long rehabilitation is required.

Rarely is surgery required in the first stage. The second is needed only sometimes, but the third can not do without it.

PATIENT EXAMINATIONS

Which of the many treatment methods will be used in each case depends on the doctor. The specialist will choose the best method, and the patient's task is to strictly follow the recommendations of the orthopedist. This is the only way to get a good result quickly. This is confirmed by patients diagnosed with gonarthrosis.