How can I treat arthrosis of the knee joint
Arthrosis of the knee joint ranks first in the incidence of arthrosis and arthritis. Patients most often complain of the inefficiency of long-term treatment. In despair, they begin to think about endoprosthetics, treating it as the last remaining option. How to treat arthrosis of the knee joint, without resorting to an extreme radical method - we'll talk about this in this article.
No miracle cure for arthrosis of the knee joint: it is treated in a complex way
Complex treatment of arthrosis of the knee joint
Why it is impossible to abandon the conservative treatment of
Surgical operation only at first glance seems to be such a simple way:
The implantation of artificial joint will still require the use of medications that prevent inflammationand the rejection of a foreign object detected by the scouts of the immune system .
- After the operation, it may be necessary to artificially reduce the immunity of the patient, so that the implanted joint is adopted
- The endoprosthesis will have to be worked out for a long time, which means that rehabilitation with the entire set of exercises on special equipment and simulators
is needed. These arguments are not generally directed against the operation( sometimesit is the only way out), but against premature abandonment of conservative, softer methods of treatment.
Can I cure gonarthrosis?
There is no specific medicine or panacea for arthrosis of the knee joint.
To cure the disease in the first stages it is possible if many methods of treatment are used to treat :
- Medical treatment:
- IM and / or injection( intramuscular and intravenous injections and droppers)
- intraarticular injections
- external ointments
- Surgical treatment
- Manual therapy
- Sanatorium treatment
- Proper nutrition
Video: Nature of arthrosis with the example of the knee joint
For analgesia in gonarthrosis, NSAIDs
are used. The scheme of treatment of arthrosis in the acute stage is conservative, and has not changed since grandmother times: only medical preparations used to suppress the inflammatory reaction of pain suppression change.
They are called anti-inflammatory .Medication pain relief is performed with the help of the following non-steroid preparations:
- ketoprofen, etc.
Patient must spare his joint during this period, trying not to load it. To unload the knee, you can put a tight bandage on it for several days.
The use of NSAIDs brings apparent relief, but they can not stop the process of cartilage destruction, and even vice versa, lead to dehydration of the cartilage, and thus accelerate the degenerative process.
The second detrimental effect of NSAIDs is that all the drugs in this group have many contraindications:
- comes first - irritation of the intestinal mucosa and stomach
- long-term treatment of pain with NSAIDs is possible only with the GI tractors, for example, omeprazole
It is erroneous to assume that ifUse injections instead of tablets, NSAIDs become intestine and stomach harmless.
Intra-articular injections of
Do not inject with corticosteroids more than once every two weeks
In the chronic phase with frequent exacerbations often resort to:
- Injections of corticosteroids: hydrocortisone, celeston, diprospan
- Introduction of hyaluronic acid in the joint
- Oxygenotherapy( introduction of oxygen into the diseased joint)
- When prescribing medication with corticosteroids, the physician should remember:
- These hormonal drugs are effective for swelling of the joint caused by the accumulation of synovial fluid
- . Without the symptoms of synovitis, their appointment is unreasonable.
- Unreasonably frequent intake of corticosteroids can cause considerable harm, for example, enhance bone resorption.
- injecting with corticosteroids more often than once every two weeks:
Too frequent intraarticular injections can injure the joint, anddamage the ligaments and muscles
- Prodrugs should not be administered for prophylactic purposes.
- Hyaluronic acid has a very beneficial effect on the joint surface, creating a protective film on it:
- Hyaluronic acid preparations are prescribed for synovial fluid deficiency and play the role of lubricant
- Injections with acid also increaseelasticity of the joint and its elasticity
- Virtually no contraindications
- Treatment is conducted by courses:
Three to four injections with an interval of one or two weeksand repetition in half a year
- For injections used:
Ostenil, synviscus, duralan, etc. drugs
- Despite the high cost of the drug, its use is justified, as with proper therapy it avoids the operation of
- . The drug HYAstat of domestic production is cheaper than imported by 30%
It is not necessary to apply hyaluronic injections for exacerbation of inflammatory processes and synovitis, as they under such conditions are destroyed and are useless. Effective such drugs during the remission of
- Oxygenotherapy is prescribed with the objectives:
- To improve the metabolism in the joint
- To extend the remission period of
- The essence of it is to inject ozone irradiated with laser beam
- Four injections with an interval between them in two days
- The method is effective in earlystages
Chondroprotectors are designed to restore cartilaginous tissues of the joint, replacing the deficiency of glucosamine and chondroitin sulfate
Patients often complain about the high cost and neEffectiveness of these funds. Why is this happening?
- The first reason is incorrect advertising, in which "effective and quick elimination of pain" is promised.
Chondroprotectors are not an anesthetic, this is a protection for the cartilage
- The second is the use of the drug at the stage when the cartilage itself is completely destroyed, that is, there is nothing to protect and repair anymore.
In the third stage, the use of chondroprotectors is absolutely useless.
- Another reason is spontaneity and episodic treatment:
The patient went through one course, and then not completely or sometimes skipping the drug - and waiting for the result immediately. Meanwhile, treatment with chondroprotectors should be conducted cyclically, intermittently, and not for one year.
Even more useless are the ointment-chondroprotectors, which are primarily used by the patient with deforming arthrosis of the late stage of
. Due to unfair advertising of companies producing similar ointments, there is a wrong attitude towards these good drugs, really capable of slowing the degenerative process in the joints.
The following chondroprotective agents are used in the treatment:
- Elbona, etc.
Ointments for the treatment of arthrosis
Ointments of irritating and warming action for arthrosis
To anesthetize with arthrosis apply not only injections but also external preparations -
- Ointments of irritating and warming action :
Menovazine, Capsoicin, Nicoflex
- With synovitis, it is necessary to lubricate the knee with ointments containing NSAIDs :
Butadione and indomethacin ointment, Fastum gel, Voltaren
However, the effect of ointments is much less effective than injectionsOnly a small fraction of the drug penetrates to the joints.
Compresses for the knee joint
For arthrosis compressions it is recommended to use in such cases:
- For edema and fluid accumulation( synovitis)
- For joint mobilization( improvement of mobility)
Compresses from dimexide, bischofite, medical bile are used for pain relief, inflammation and edema
Dimexide and bischofite - chemical preparations, bile - natural
Compresses are more effective than warming and anti-inflammatory ointments, thanks to the best penetrating properties of
Bile can not be
Compresses are good for swelling and joint mobilization
- Knee joint decompression
It is achieved by:
- by the expansion of the synovium, which often forms folds around the joint in which pus accumulates
- with osteotomy - bone excision with joint repositioning( traumaticmethod)
- arthrodesis - artificial joint wedging( flexion and extension functions are lost, but pain is removed)
- VostaKnee joint :
- Arthroscopy - minimally invasive surgery to remove diseased sections of the meniscus and cartilage
- Arthroplasty - replacing part of the cartilage with a graft from own tissues or artificial material
Replacement of the knee joint is artificial when the joint function is completely lost and restored by other meansit is impossible
Manual therapy in the treatment of gonarthrosis
Manual therapy is a very effective way of joint development in the first-secondth stage of gonarthrosis, especially in combination with compresses, intraarticular injections and techniques of chondroprotectors
However, to cure a knee that has been suffering for more than one year can not be achieved in one session:
- The first session is aimed at revealing the degree of immobilization of the joint and partially releasing it
- .within three to four weeks, chondroprotectors are taken, compresses are made from dimexid and massage
- After that - a repeated session of manual therapy with knee stretching and its correction( that the jointin the unlocked and became in place, it can be judged by a specific click)
- The next two sessions fix the result of
- At the end of the course it is useful to make two intra-articular injections of ostenil
- Twice a year you need to repeat the reception of chondroprotectors
Video: Manual therapy with gonarthrosis
Physiotherapy with gonarthrosis
the following physiotherapy is applied to the treatment of gonarthrosis:
- shock wave
- thermal and cryogenic, etc.
LaseRotherapy with arthrosis of the knee joint well anesthetizes and stimulates healing.
In addition to this, the laser:
- Accelerates metabolism and intracellular metabolism
- Increases joint mobility
- Accelerates cartilage tissue regeneration
- Improves blood circulation and lowers blood viscosity
- Softens calcium deposits
- Relieves muscular tension
Gymnastics is a wonderful way to prevent gonarthrosis at any stage of it. In many cases, exercise therapy can avoid surgery. However, the load on the affected joint should not be large: the static exercises
should prevail. How to treat arthrosis of the knee with gymnastics and nutrition - in the following articles.
Video: Treatment of gonarthrosis
What is the peculiarity ofgonarthrosis of the knee joint? Under gonarthrosis is meant the defeat of cartilage and bony proliferation arising on the joint, xytotic irritation of the articular tissue.
Knee Osteoarthritis - is a degenerative-dystrophic disorder .
This deviation is of 3 degrees of severity, the most common is gonarthrosis of the knee joint of 2nd degree, because only at this stage people notice the disease and are engaged in treatment.It should be noted that arthrosis is a problem of the current society, this deviation was earlier characteristic only of older people.
Now the disease has no age restrictions, appearing even among young people because of injuries.
Causes of the disease
The main cause of the disease is a mechanical factor.
Microtraumatization of the cartilage of the joint is observed, which is why its destruction begins. As a consequence - the load on individual parts of the joint surface increases, and then - its destruction.
It is also proved that with this violation, changes in metabolic processes in the cartilage .These changes consist in decreasing the amount of chondroitin sulfate, which is a special component of cartilage.
There are such causes of the lesion:
- fractures of the bones of the knee joint;
- arthrosis in Paget's disease;
- bone formation;
- rheumatoid arthritis and ankylosing spondylitis.
If you suffer from polyarthritis, treatment at home will be a great help to traditional medicine. Recipes and advice will be relevant at any stage of the disease.
The stages of the disease
The development proceeds in several stages:
- The initial stage of the disorder is the initial stage of the disorder, which is often neglected by patients. With it periodically there are pains, sometimes the composition swells, deformation of the joint is insignificant and imperceptible.
- Gonarthrosis of the 2nd degree is already significantly more serious, and therefore requires more attention, pains appear both after sleep and during physical exertion on the joint. On the x-ray, deformation of the subchondral parts of the bones and a decrease in the joint gap are observed. This degree is accompanied by the rapid fatigue of the and the occurrence of an average pain in the knee. Also a sign of difficulty in flexing and flexing, combined with a crunch in the joint, deformation and an increase in the volume of the knee is observed.
- The third stage of the is the heaviest stage. It is characterized by pain, arising both during movement and at rest, meteorological dependence is observed. The gait is greatly disturbed, the mobility of the joint is limited.
Types of the disease
There are such types of gonarthrosis:
- right-sided deforming arthrosis, affecting the right knee;
- left-sided is a disease that causes lesions in the left knee joint;
- unilateral - arthrosis, affecting only one knee;
- bilateral - a disease of both knees.
Basically, in the latter case, the cartilage tissues in both joints are destroyed at the same speed, but sometimes the lesion of one joint progresses faster than the other - this may be related to the specific work or sport that the patient is engaged in, as well as to congenital deformity of the joints.
Symptoms and symptoms of the disease
Arthrosis of the 2nd degree is more intense, and its manifestations are more worrisome to the patients.
Pain in the broken joint is increasing and increasing. In addition to the standard pains that appear in the morning or after a long rest, pain occurs after a long walk or standing. They last long and pass only at rest after a while.
Pain often increases with exercise. Patients spare the sick knee and try not to step on the leg slightly. Because of this, there may be underdevelopment of the muscles of the affected leg.
If there is a deviation at this stage, there is a crunch in the knee. As the changes develop, it increases and becomes more pronounced.
At this stage of the disease, the first manifestations of deformity of the unhealthy joint are observed. Patients often can not fully bend their legs in the knee.
Grade 2 gonarthrosis mainly occurs after the first stage of the disease, so the diagnosis of the patient is usually already known to the doctor. The progression of the lesion is indicated by the appearance of new manifestations: pain intensification, joint deformation, limitation of mobility, crunch.
Diagnosis consists of interviewing a patient, checking the volume of movement in the joint and examining the joint itself. Naturally, according to this information, only preliminary conclusions are made, and the leading ones are instrumental methods of diagnosis.
Most often this is an x-ray of the joints. Depending on the general picture of the disorder, the stage of the disease is determined. Also, if gonarthrosis is detected, arthroscopy and ultrasound are used.
How to treat
disease When diagnosed, treatment of grade 2 gonarthrosis should begin without delay. First you need to "unload" the joint.
This is achieved in several ways:
- weight loss;
- load limit;
- using a walking stick or crutches;
- exercises physical therapy, aimed at strengthening the muscles of the aching legs.
For this, non-steroidal anti-inflammatory drugs( ibuprofen, ketoprofen), non-narcotic analgesics are prescribed.
Arthrosis preparations containing cartilage tissue components( chondroitin-sulfate, glucosamine) are effective. They contribute to the restoration of cartilage, i.e.help the body repair it. They can be taken in tablets, in the form of injections in the muscle, ointment or cream.
In some cases, injections of hyaluronic acid into the joint can be prescribed. In the absence of inflammation, physiotherapy can be used.
Physical exercises should always accompany the treatment of any form of arthrosis. Gymnastics precludes the development of contractures, retains muscletone. Movement is the anticipation of any arthrosis.
Physiotherapy measures quickly eliminate pain, inflammation and restore the volume of movements in the knee. Laser and UHF therapy, phonophoresis, and massage are used. All procedures are appointed by a specialist.
For the fixation of the knee, knee pads and rigid orthoses are used.
With obvious disruption of the joint, the uselessness of conservative treatment and the destruction of cartilage, surgical methods are used:
- endoprosthetics - replacing the affected joint with an artificial one;
- osteotomy - excision of bone changes or restoration of the limb axis;
- arthroscopic intervention is performed by instruments injected through the puncture of the skin in the knee. By means of this low-traumatic method, parts of the destroyed cartilage are extracted from the joint cavity, drugs are introduced.
Read more about the treatment of knee joint gonarthrosis in our article.
Treatment of knee joint gonarthrosis - medications, chondroprotectors, sport and diet
Knee joint gonarthrosis is a common disease that is a gradual drying out of the cartilage tissue that causes joint deformity. ..
Forecast and complications
When the joint is damaged, the biomechanics of the spine and other joints,which causes the appearance of a herniated intervertebral disc and arthritis of other joints.
Treatment is carried out for life, because the process is constantly progressing. But with a competent selection of funds and timely start of treatment, it is possible to significantly stop the process and prevent disability.
- weight control and its reduction with excess body weight;
- regular physical education;
- preventing large loads on the knees;
- for injuries or inflammation of the knee - an urgent request to a specialist for help.
Gonarthrosis is a chronic disorder that is aggravated over time. In order for the process not to become neglected, every effort should be made to prevent and treat under the supervision of experienced doctors.
Video: Knee joint gonarthrosis 2-3 degrees
Application shock wave therapy( UVT) for the treatment of gonarthrosis knee joint 2-3 degrees.
Knee joint gonarthrosis 1, 2 and 3 degrees: treatment, causes, symptomsWhat is this - gonarthrosis is a non-inflammatory disease of the knee that disrupts the blood supply of the cartilage covering the joint surfaces of the femoral and / or tibia. As a result, the cartilage is destroyed, the parts of the bones begin to rub against each other, as a result of which they become denser and expand. This is often accompanied by inflammatory phenomena. Symptoms of the disease are due only to the above processes;calcium salts, if they are deposited in the joints, the cause of the pathology is not. Pathology most often develops in individuals 40 years and older, mainly women and people who are engaged in professional sports or having knee injuries. Articular cartilage does not regenerate, so the disease must be detected and treated early in the early stages.
Causes of gonarthrosisThe disease develops with a combination of several causes:
- fractures of the bones of the lower leg involving the knee joint;
- injuries of cartilage interlayers of the joint - meniscus;
- tears of knee joints;
- increased load on the joint - running, squatting, lifting weights from the vertical position of the body - after 40 years of age, especially if a person does not exercise regularly;
- excess weight
- joint inflammation( arthritis), which has a different - psoriatic, gouty, rheumatoid or reactive - etiology;
- genetically determined weakness of the ligamentous-capsular apparatus of the joint, because of which its loosening occurs;
- pathology of joint innervation, characteristic of craniocerebral and spinal cord injuries;
- metabolic disease.
- 1) Primary. It occurs against the background of full joint health( without pre-injury or inflammation).It is based on metabolic diseases, long reception of hormonal means, genetic predisposition of articular cartilage. The process is usually two-sided( although it can begin as one-sided).It develops more often in the elderly.
- 2) Secondary. Develops due to injuries, inflammations, tumors transferred to the joint operations. Can develop at any age. The process is usually one-sided.
Symptoms of gonarthrosis of the knee jointHow the disease manifests itself will depend on how far the degenerative process has progressed. Depending on this, three stages of the disease are distinguished, each of which has its own symptomatology. As a rule, the first degree of gonarthrosis of the knee joint is manifested by certain symptoms, which should be noted:
- a feeling of contraction under the knee;
- stiffness in the knee, which manifests itself after sleep, prolonged sitting or prolonged immobility of the joint;
- joint pain:
- arising from prolonged walking, squats, walking on stairs;
- aggravated after standing or physical exertion
- joint swelling may occur for a short time, passes by itself.
- joint pain becomes more intense, lasts longer. It disappears after rest.
- pain is felt inside the joint or on the inside of the knee.
- there is a crunching in the knee when walking.
- in the morning it is impossible to unbend the knee.
- closer to night and at night there are pains in calves. The
- does not fully extend the leg.
- joint swells, acquires signs of initial deformation.
- 1) Pain in the joint is worried constantly, regardless of the physical activity of the person.
- 2) Pain syndrome increases with changing weather.
- 3) The mobility of the joint is limited, due to which the person limps.
- 4) The knee is enlarged and deformed. When the process progresses, the joint becomes an X-shaped or O-shaped.
Diagnosis of gonarthrosisIt is possible to suspect the presence of gonarthrosis of the knee in the patient already on the basis of his complaints and objective examination data. The diagnosis is confirmed with the help of such instrumental studies:
- 1) Radiography. This method may be uninformative at the first stage of the disease, but subsequently it visualizes the narrowing of the joint gap, the compaction of the bone zone below the articular cartilage, and the sharpening of the edges of the condyles.
- 2) Computed tomography of the joint. This is more expensive, but more informative( even at stage I) method based on x-ray radiation. Visualizes the joint itself and surrounding tissues in more detail and layer by layer.
- 3) Magnetic Resonance Tomography - a method based on a non-radiological, considered harmless radiation, which can be used for contraindications to CT.Also layer-by-layer displays the picture in the joint, but is more informative regarding the surrounding soft tissues.
- 4) Arthroscopy is an invasive technique for joint research, when a fiber optic device is inserted into the hole made under local anesthesia, allowing the specialist to examine the joint from the inside.
- 5) The knee ultrasound is informative for the diagnosis of such complication of gonarthrosis as synovitis.
Treatment of knee joint gonarthrosisA doctor who is treating this disease is an orthopedist. Drug therapy of the disease includes the following groups of drugs:
- 1) Non-steroidal anti-inflammatory and pain medications: Voltaren, Celebrex, Rofika, Nimesil, Movalis.
- 2) Chondroprotectors: "Artra", "Arthron", "Dona", "Teraflex", "Chondroitin complex".These drugs are taken for at least six months in the dosage prescribed by the doctor.
- 3) In the joint with pronounced inflammatory phenomena, enter "Hydrocortisone" or "Kenalog" no more than 3 times.
- 4) The preparations of hyaluronic acid are shown, which must be inserted into the joint when the inflammatory phenomena in it subsided: "Hyalurum", "Ostenil", "Sinocrom".These medications show a very good effect, they are administered only a few times, while having a fairly high cost.
- 5) Heating compresses with "Dimexid", "Bischofite", medical bile to improve the blood supply of the joint, increase the production of "lubricating" liquid in it.
- 6) The preparation on the basis of drawing from soya and avocado plants - "Piascladin" - has also proved to be an effective tool in the treatment of gonarthrosis of the knee joint. At the same time, the treatment course is not less than six months.
Physiotherapy for gonarthrosisIn an acute period a person needs to provide complete peace for a diseased knee. Then proceed to the gradual introduction into his regime of the day of physical exertion. Exercises are carried out in the position of the patient lying on his back, they consist mainly in lifting the straightened legs, keeping them in the raised position. It is important to perform exercises smoothly, carefully, so that they do not cause pain. Begin with 10 minutes, gradually, 2 minutes a day, increasing the duration of classes. Increase and the amplitude of movements, which should be selected by specialists individually for each.
Two-way gonarthrosis: diagnosis of the disease and its treatment
Most of us rarely pay attention to discomfort, periodic pain in the knee, writing off this for an old bruise. And in vain, this may well be the beginning of a very serious disease - gonarthrosis. This is called arthrosis of the knee joint, when the cartilage tissue undergoes changes and eventually loses mobility.
We used to think that such diseases are the destiny of the elderly. In fact, now the disease occurs at any age, although people more than 40 years old are more inclined to it. The reason is simple - changes in the cartilaginous tissue begin after knee injuries, which is very often the case with lovers of an active lifestyle. The cause may be an infection, a violation of blood supply in the presence of varicose veins, especially if there is excess weight.
Types of the disease
The disease manifests itself in different ways. For example, one leg can be affected - right-sided or left-sided, or two - then it is called bilateral gonarthrosis.
In its origin, gonarthrosis can be of two types:
- Primary - its victim is any healthy person. Too large, regular physical activity, age-related changes in cartilage, diseases with metabolic disorders, overweight. .. All this directly or indirectly leads to deformities. Primary gonarthrosis can be bilateral.
- Secondary gonarthrosis appears after a trauma or other disease, for example - arthritis. Bad, incomplete treatment of one disease over time leads to its manifestation.
Both primary and secondary gonarthrosis eventually leads to pathological deformation of the cartilaginous, bone tissue of the knee joints, which greatly reduces their mobility, and without adequate treatment may eventually lead to disability.
The course of the disease
This disease does not begin immediately, it has certain clearly defined periods. They are divided into 3 degrees:
- 1 degree - knee joints can sometimes hurt after a long walk or running. Sometimes the knee can swell a little, but after rest everything passes. Although this is only the very beginning of the disease, but there is also a bilateral gonarthrosis of 1 degree, with the defeat of both legs.
- 2 degree - even with a small load a person begins to feel a strong pain. Passing a small distance or raising a small weight for him becomes torture. It becomes heard a crunch when bending the knee, extension. The diseased knee becomes more healthy, the stiffness of movements appears. Two-way gonarthrosis of the 2nd degree is able to severely limit the life of a sick person.
- 3 degree - pain in the knee is almost all the time, regardless of whether a person is sitting or walking. Constant pain can prevent a person from sleeping. It is well noticeable that the joint is greatly enlarged compared to the healthy one. The deformation of the diseased knee causes a noticeable curvature of the legs. The joints at this stage are very limited in movement.
As a rule, the disease of 1 degree goes unnoticed - it does not bother the person, but go to the reception because of a slight pain in the knee. .. Many people think this is just not serious, and very wrong - because it's possible to cure the disease at this stage almost completely quickly.
To see a doctor usually get with gonarthrosis of 2 degrees, as a rule - bilateral. The disease goes too far, causing irreversible changes in the joints, so you can not completely get rid of it - you can only move the offensive of the 3rd degree for a long time.
Diagnosis of the disease
Of course, in neglected form, you can visually determine the increase, deformation of the knee. But much more reliable methods of research work - radiography, ultrasound, computed tomography, MRI - magnetic resonance imaging. Any of these methods can show changes in the cartilaginous tissue, and even more so - bone growths around the joint heads.
For a complete diagnosis, the doctor will prescribe a blood test. Particularly help him analyze the rheumatoid factor. Other diagnostic methods are assigned more to clarify the individual characteristics.
Diseases of the joints - not one that can be treated independently. It is possible to be treated only under the control and on prescription of the doctor. Especially self-treatment is fraught with consequences in bilateral gonarthrosis, and even 2 degrees - you can aggravate the situation and become a complete disabled person.
The doctor will correctly assess the course of the disease, prescribe appropriate physiotherapy, treatment. Therapy is aimed at improving the blood supply to the affected leg, increasing its mobility. In addition, they can prescribe injections or tablets from the group of non-steroidal anti-inflammatory drugs - to reduce the inflammatory process, anesthesia. All this is quite effective when the disease is not started.
In severe cases, when the knee function is completely broken, it is severely deformed, causes permanent pain, the doctor can decide that surgery is necessary. Methods of surgical treatment are different - from the superposition of metal structures, to the replacement of its parts with artificial ones. In particularly difficult cases, the surgeon will replace the entire joint.
As you can see, the path from an untreated knee injury to such a serious illness as gonarthrosis is very small. So do not treat such "little things" scornfully. Any sore should be cured completely, then it will not have to receive such "surprises".