Symptoms, causes, degrees and treatment of knee osteoarthritis
The legs are part of the locomotor system, which is subject to the greatest strain. Every day we travel a long distance, climb the steps, shifting the weight of our own weight to our feet.
Statistical facts about this disease are sad. According to rough estimates, they suffer 20 percent of all mankind. And this figure is growing every year. In addition, doctors note a certain tendency for women to be more vulnerable than men. A potentially dangerous age occurs after 40 years, and after 60 the probability of knee dysfunction increases at times.
The physiological essence of the disease
The ostearthrosis of the knee joint( in medicine there is also a special term - gonarthrosis) is a common disease that is chronic and has a significant destructive effect on the knee joint and surrounding bone tissue. The disease is accompanied by degenerative changes in the knee hyaline cartilage, which loses its strength and functionality. This is because osteoarthritis is accompanied by a cessation of normal supply of cartilage cells with the necessary amount of substances, which causes its dystrophy.
After the cartilage disappears completely( this occurs after a prolonged inflammatory process), the joint of the knee completely loses its mobility. This is because the hyaline layer acts as a shock absorber, softening the friction between the contiguous bone tissues. In a healthy body, hyaline cartilage is an elastic plastic mass resembling a gel and consisting of cells( chondrocytes) and matrix liquid.
The physiological cause of disorders in bone tissue in ostearthrosis is the occurrence of specific spines on the surface of the exposed bone and further pathological knee deformation.
One can often hear one more name of knee ostearthrosis - "salt deposition".But this designation is wrong, because the exchange of calcium salts has no effect on the occurrence of deformations.
Symptoms of knee osteoarthritis
The most obvious symptom of the disease is the pain in the knees. It is the occurrence of unusual sensations in this part of the legs that indicates the onset of inflammatory and destructive processes of bone tissue.
At first, osteoarthritis can make itself felt only by insignificant sensations of constriction and inhibition of movements during flexion-extension of the legs. At this stage, it is worthwhile focusing only on whether such symptoms have occurred earlier. Also, the light form of osteoarthritis is accompanied by a slight resistance of the joints and the difficulty of their movement after staying in a stationary state for a long time( especially after waking up in the morning).It is the stiffness in the morning hours, when the joints have not warmed up yet, and the liquid has stagnated in the intervals, serves as the main reference point.
Simultaneously with difficulty in the movement of the joints, a characteristic crunch and clicks occur in them when trying to stretch the legs. There are unpleasant pains that increase with physical activity and in the evening, when the joints get tired of prolonged activity during the day.
As progression progresses, tiring pain during physical activity increases. During particularly severe attacks, pain does not disappear during rest, causing discomfort even during sleep. A person acquires a characteristic lameness, trying to reduce the burden on the knee.
Degrees of knee osteoarthritis
Since the symptoms of the disease are initially weak and then increase with progressive intensity, there is a symbol for the three stages of knee ostearthrosis.
Osteoarthritis of the knee joint 1 degree
Pain sensations are not yet apparent, they are rather insignificant and irregular. That's why many people ignore these intractable alarm signals and do not go to the doctors on time. The initial stage is characterized by a feeling of stiffness in the inner side of the knee. Sensible discomfort occurs after rest or sitting position, but after a little warm-up everything passes. Disadvantages also result in long standing or walking, sports training.
Despite the first changes in the condition of the knees, no significant changes in their structure are observed. Functionality in general remains at the same level.
Knee Osteoarthritis of 2nd degree
At this stage, the patient pays attention to the change in his condition. But, alas, even at an intermediate stage, many do not think about clinical examination and consultation with a specialist. The adoption of necessary measures is limited to the removal of symptoms with the help of medications and self-treatment.
It is important to take into account that specialized treatment at this interval of the development of the disease is able to bring the maximum effect and restore the former physical capabilities of man.
The second degree of ostearthrosis of the knee joint is characterized by prolonged pains on the bend of the joint, even convulsions worse at night and evening are possible. Gradually, the violation of the integrity of the joint, the emergence of "cones" is gaining momentum. Periodically, the patient feels the full incapacity of the knee, there is persistent puffiness. Even after a warm-up, the characteristic crack in the knee does not disappear.
Osteoarthritis of the knee joint of the third degree
The most serious degree of the disease. It is in such a state that the diseased still decide to turn to the doctors. Pain syndrome takes a regular form, it can not be removed even with the help of strong medications. The patient is uncomfortable to be in any position( both in the horizontal and vertical), he practically does not rest, as the legs hurt even in a dream. There is a so-called meteosensitivity of knee joints to changes in the weather.
At the last stage of osteoarthritis, the person's gait changes significantly, he is no longer able to walk normally and lean on his aching leg. If the disease affects both legs, then the further possibility of movement is under big question. As a consequence, a patient with osteoarthritis can not do without a cane or even crutches.
Related: Pain in the knee joint
Deforming osteoarthritis of the knee joint
The factors directly responsible for this common disease include both external and internal processes.
The most common causes of knee osteoarthritis:
Overweight. Obviously, the more a person weighs, the heavier his legs can withstand the daily load on them. If the mass is significantly higher than the norm, the knee joints are exposed to high 24-hour pressure, which increases several times during physical activity. The tissues of the joint do not have time to recover, the process of their destruction and deformation becomes irreversible.
Ingestion of harmful substances. Smoking and alcoholism affect all processes in the body, including the state of cartilaginous tissue. These substances literally "kill" the building material of hard tissues - chondrocytes. In addition, the negative consequences can have and the use of strong drugs. That is why any treatment should be coordinated with the doctor in charge.
Leg injuries. Contusions and fractures, even at a young age - are extremely dangerous, because their consequences can manifest themselves in tens of years. In the case of severe knee injury, posttraumatic arthrosis may develop.
Congenital pathology of the knees. In addition to various disruptions in the physiological development of cartilage and bone tissue, dysplastic knee osteoarthritis develops.
Failures in the endocrine system. In the high-risk zone - carriers of type 2 diabetes, which slows down metabolic processes in the vessels of the extremities. As a result, the cartilaginous tissue becomes thinner and loses its elasticity, the process of arthrosis starts.
Disorders of the hormone exchange of estrogen. This problem is poorly distributed among girls and young women, because their body independently regulates all processes. But with the onset of menopause, the female body is unable to maintain a rational metabolism in tissues. The lack of estrogen radically changes the principle of the functioning of the joint, which is the main cause of ostearthrosis.
Diseases of the vascular system. Varicosity and hypertension adversely affect the supply of nutrients and oxygen to the joint. Plasma lingers around the joint and prevents tissues from self-healing.
Related: Joint Diseases: Species, Symptoms and Treatment
Treatment of knee osteoarthritis
Targeted treatment for knee ostearthrosis must take place in both integrated and segmented directions. The primary goals of the course of treatment are the elimination of disease-provoking factors, the elimination of neglected inflammatory processes and the renewal of the functionality of the damaged knee site. To facilitate an overview of all possible treatments, they can be grouped into three large groups: physiological, drug and surgical therapy. Depending on the degree of the disease and the characteristics of the patient, these methods can be combined. In any case, the treatment is selected exclusively by a qualified doctor.
Physiological treatment of
In the initial stages, the use of special physical measures is effective, which establish a balance of load on the joint, its capabilities and endurance. These methods include regulating physical activity in accordance with changes in cartilaginous tissue, getting rid of excess weight and applying various procedures. It should be noted that small loads also serve as the best prevention of ostearthrosis of the knee joint.
Physiotherapy procedures are performed exclusively within the walls of specialized treatment facilities. Regularity of treatment ensures the acceleration of blood flow in the problem areas of the knee, reducing inflammation and relieving muscle spasms. Treatment in sanitary conditions includes the adoption of special baths, wraps and the use of mud packs. In addition, the patient rests morally, spending more time in the fresh air and reducing the level of stressful shocks.
Correct foot massage can after several sessions improve the general condition of the patient, relieve the pain syndrome, accelerate the transitivity of nerve signals in the cells of the joint. It is important that the masseur adhere to a measured pace when working with the kneecap, exposing it to minimal force.
Therapeutic physical training strengthens muscles and supports vital functions of knee joints. Atrophy of muscles carries a potential danger for the patient with osteoarthritis. Physical exercises with osteoarthritis are rather short and non-intensive, but they need to be performed quite often - at least two times a day. After charging, you need to rest in a lying position for about 40 minutes. Doctors say that the osteoarthritis should buy a subscription to the pool, since the swim is the most effective and painless of all types of exercise therapy in this disease.
Orthopedic correction is used to relieve excess burden on the knees. The most popular orthopedic products:
Shoes - in case of a limb reduction.
Knee pads - stabilize the position of the affected joint, fixing the calyx in a painless condition.
Supinators - the principle of action is similar or identical to the models applicable for flatfoot.
Orthoses - depending on the type of construction and its rigidity, the device stops further destruction of bone and cartilaginous tissues. Also, the lateral fixators provide the patient with maximum freedom in movement and are assigned to mandatory use in the postoperative period.
Non-steroidal anti-inflammatory drugs can reduce joint dysfunction. These medicines do not cure the disease, they only relieve symptoms and make life easier for the patient. Nonsteroid drugs can be taken no more than two weeks and only after basic meals. There are various dosage forms of this category of medicines: ointments, suppositories, solutions and tablets. They are characterized by a number of side effects and a tendency to get used to.
The action of chondroprotectors is aimed at the resumption of cartilage layers. The most commonly prescribed is the complex administration of chondroitin sulfate and glucosamine. Their action is directed to the regeneration of cartilage, the stabilization of the formation of interchondrous fluid, the preservation of its properties.
If physicians prescribe injections for intra-articular injection, this means that the patient needs to remove the pain syndrome as soon as possible and stop the inflammatory process. The principle of the injection is to block excessive amounts of fluid. But these shots can not be used more than once in two weeks. Intraarticular medications are not prescribed to patients with the highest degrees of deformation of the joint and bones, painful attacks due to irreversible pathological disorders and carriers of serious chronic diseases( hypertension, diabetes).
Medicines based on hyaluronic acid. The active substances of this substance are responsible for the endurance of the cartilage, its resistance to mechanical damage. The level of hyaluron can be normalized by injecting chondroprotectors. The acid thus restored damages the mechanical interaction of the surfaces of the joints, protecting them from wear and tear. The usual course of treatment consists of 4-5 injections, with an interval of one week, it can be repeated no more than three times a year.
Related: List of modern medicines and joint preparations
Serious medical intervention is necessary with the highest degree of joint damage and inefficiency of the drug treatment. For light stages of ostearthrosis, arthroscopy is applicable. This mini-operation takes place through a couple of small punctures. The joint carries an endoscope that transmits a video image of the state of the cartilaginous tissues. The functions of arthroscopy include: diagnosis of the degree of dysfunction, the concentration of inflammation, as well as the dissection of external damaged joint tissues with the help of small blades, which are further dissolved by laser interference.
Internal knee prostheses are applicable in the last stages of ostearthrosis. As a result of a simple operation, an unusable knee joint is replaced with an artificial titanium joint. After rehabilitation, the operated patient is able to again move normally and return to the old rhythm of life.
On the topic: Effective home remedies
In conclusion, it should be said that you need to be careful about the health of your feet. Knee joints - the most vulnerable part of them and unauthorized treatment can have the most unforeseen consequences.
Author of the article: Kaplan Alexander Sergeevich, Trauma Physician, orthopedist
Deforming osteoarthritis of the knee jointOsteoarthritis takes the dominant position among all joint injuries, with the most common form is gonarthrosis, characterized by pathological changes of the knee joint. The disease is more typical for women suffering from obesity, the incidence increases with age. Also, gonarthrosis can form in young men with a history of joint trauma.
Gonarthrosis - what is it?
Deforming knee osteoarthritis belongs to a group of degenerative-dystrophic diseases. Has a chronic progressive course. It is accompanied by the development of the following pathological processes in the joint:
- degeneration of the hyaline cartilage - the elasticity of the cartilaginous tissue decreases, the brittleness increases, the defragmentation and its complete destruction;
- structural changes in the subchondral bone - osteosclerosis( densification) is formed, flattening of the underlying bone tissue, active proliferation with the formation of osteophytes;
- formation of reactive synovitis - inflammatory and fibrotic sclerotic phenomena develop in the synovial membrane surrounding the joint cavity.
The causes of gonarthrosis
The factors contributing to the formation of pathological processes in the knee joints include:
- heredity - plays a leading role in the formation of primary gonarthrosis;
- excess body weight - leads to increased stress on the knee joints;
- trauma in the knee area( meniscus, ligament, hyaline cartilage, fractures, including extraarticular, limb-changing limbs);
- flat feet - due to changes in walk biomechanics and, as a consequence, violations of congruence( conformance of the form) articular surfaces;
- arthritis of the knee in the anamnesis.
Signs of the development of the disease
The disease is characterized by a gradual onset. In the pathological process, as a rule, both knee joints are involved. The following symptoms come to the forefront:
- crunch( crepitation) in the knee joint during movement;
- pain occurs during the moment of loading( with walking, prolonged standing), passes in a state of rest, increases by the evening;
- presence of starting pains - unpleasant sensations arising at the beginning of walking and then passing;
- is characterized by increased pain at the moment of descending the stairs;
- , the possible occurrence of a so-called joint blockade due to the infringement of the "articular mouse"( free chondromic body) between the articular surfaces - is characterized by the appearance of acute intense pain;
- limitation of the volume of active movements in the joint;
- formation of joint deformation, increase in its size;
- at the time of exacerbation there is local hyperemia and edema.
Depending on the degree of functional disorders, it is customary to distinguish the following variants of gonarthrosis:
- without disrupting the function of the joints, movements are carried out in full, morning pain may start at the beginning of movement;
- gonarthrosis 1 degree - professional work capacity is preserved, painful sensations occur after a prolonged load, passing at rest, there are no visible changes in the joint region;
- gonarthrosis of the 2nd degree - professional disability is lost, long pains in the joint area are associated with mechanical stress, night pain, the volume of movements decreases, it is possible to develop a reactive synovitis accompanied by the appearance of local hyperemia and edema, the beginning of joint deformation;
- gonarthrosis of the third degree - the ability to self-service is lost, the contracture of the knee joint develops( a pronounced decrease in the amplitude of movements), its considerable deformation, pain is permanent, walking is possible with support.
Treatment of knee osteoarthritis
It is advisable to have the knowledge how to treat this disease in order to prevent irreversible changes in the joint and preserve its mobility. There are a number of directions in the treatment:
- therapy with non-medicament means;
- treatment of medicinal products;
- surgical intervention.
Non-drug therapy is an important component of gonarthrosis treatment. The following methods are used:
- compliance with certain dietary principles - diet in the presence of gonarthrosis should be aimed at reducing body weight, and also include foods rich in mucopolysaccharides;
- joint unloading - prolonged static load and long walking, heavy loads are forbidden, short-term rest during the movement is mandatory;
- physiotherapy methods - apply magnetotherapy;electrophoresis with hydrocortisone, laser, paraffin applications;
- therapeutic exercise is conducted in the absence of pain syndrome.
Conservative treatment of gonarthrosis is long-term. There are two main directions in drug therapy:
- basic therapy - drugs stimulating the synthesis of cartilaginous tissue( chondroprotectors) are prescribed;
- elimination of pain syndrome is achieved using non-steroidal anti-inflammatory drugs courses, intra-articular injections of corticosteroid drugs.
Surgical treatment is performed in case of persistent pain syndrome and in the presence of persistent disability. During the intervention, the following activities are carried out:
- extraction of free chondromic bodies;
- excision of the synovium;
- corrective osteotomy;
Treatment with folk remedies
Traditional medicine recipes are widely used as an auxiliary therapy for osteoarthritis of the knee joints. The following treatment methods are used:
- phytotherapy - the use of medicinal plants in the form of compresses, decoctions, tinctures, which can not only reduce pain, but also level the inflammatory phenomena;
- apitherapy - in the treatment of joint diseases, the products of beekeeping( honey, bee venom) have long been known for their medicinal properties;
- hirudotherapy - treatment with leeches has a good analgesic and anti-inflammatory effect in joint disease.
Gonarthrosis is characterized by a slow progressing course with the development of irreversible changes, so timely and comprehensive treatment is a guarantee of maintaining the normal function of the joint for a long time.
- Use for injections of corticosteroid hormones
Injections of glucocorticoids make sense if it is necessary to suppress inflammation in the joint, which is manifested by swelling of the knee and its swelling. The first intraarticular injection brings relief. And in the future this procedure is carried out even with mild discomfort. These funds include:
- triamcinolone( kenalog)
- betamethasone( flosterone)
It should be noted that this procedure does not cure osteoarthritis. It only stops inflammation. Moreover, frequent and unreasonable prescription of hormone injections can harm the joint. If the first injection was unsuccessful, then repeating them does not make sense. In addition, injecting hormones more than three times into one joint is undesirable because of the likelihood of side effects.
In case of joint swelling, chondroprotectors are not used( unlike hormones), as they almost do not cope with inflammation. But in the initial stages of knee osteoarthritis they act very well. In this case, chondroprotectors in the form of intraarticular injections partially restore the cartilaginous tissue.
The disadvantage of this type of treatment is the need for its course in the number of 510 injections. But after all, every injection, one way or another, but it traumatizes the articular tissues.
Hyaluronic acid in the form of injections
This is a new and quite effective way of treating knee osteoarthritis. Hyaluronic acid is a "lubricant" for the joints. Its composition is very close to the natural lubrication of the knee joint. When it is introduced into the joint, the friction of the deformed articular surfaces is reduced. The mobility of the knee is significantly increased.
Typically, hyaluronic acid injections are administered at a rate of 34 in each damaged joint. This course is repeated once a year. Preparations of hyaluronic acid have one drawback - a high price.
Since the knee joint under the skin is not deep, complex treatment should include the use of local remedies. Their action is to improve blood circulation in the joint and in some cases, the removal of pain.
One of the best local remedies is dimexide. It is a liquid that eliminates edema in the joint and has an anti-inflammatory effect. For the compress, dimexide is diluted in water in a ratio of 1: 4. Meanwhile, it should be used with caution. It can cause a severe allergy, and especially sensitive people can even get a burn. That's why, before applying it, you should make a test for sensitivity.
Other ointments are usually less effective, since they do not have very high absorption. However, in some cases, they can be a good result. The condition of patients with knee osteoarthritis can facilitate warming ointments or ointments with anti-inflammatory substances.
Physiotherapy methods of treatment can significantly alleviate the patient's condition with knee osteoarthritis. These methods include:
- laser therapy
- mud treatment
- electrophoresis of drugs
These procedures lead to better blood circulation in the joint and the general condition of the tissues, relieve painful muscle spasm, reduce inflammation. However, physiotherapy has contraindications. It should be used with caution in the following conditions:
- heart disease;
- tumors( including benign);
- exacerbation of knee osteoarthritis with its redness and swelling.
In case of exacerbation of osteoarthritis, it should first be eliminated, and then proceed with physiotherapeutic treatment of .
The effect of therapeutic physical training
Among the methods of treatment of knee osteoarthritis, exercise therapy occupies a special place. It should include a combination of exercises for the gradual increase in walking time and strengthening the muscles of the lower limbs. Osteoarthritis of the knee reduces the strength of the quadriceps muscle by at least 60%.That is why its strengthening is extremely important for the functioning of the whole knee joint.
Musculature is strengthened by isometric contractions of the quadriceps muscle by tension of the knee joint, flexion of the ankle joint with tension. If within six months to strengthen the quadriceps muscle of the thigh, it will lead to an improvement in the functions of the knee joints and a reduction in pain.
Surgical treatment of
If the osteoarthrosis of the knee has gone very far, an operation is performed to partially or completely replace the joint. It gives a good result and returns work capacity even in the fourth stage of the disease. However, the patient then undergoes a long recovery period.
It should be borne in mind that the operation is expensive and time-consuming. Therefore, a physiatrist or rheumatologist should help a patient do without an operation or delay it as much as possible.
The most effective preventive measure is the fight against overweight, including diet and rational physical activity.
For osteoarthritis of the knee joint, it is recommended to wear a special knee. It fixes the knee joint, helping to reduce pain. It is especially important to wear a knee pads during long walking, sports, wearing weights. Knee pads differ in the degree of fixation.
A good result is given by insole shoe in shoes. With their help, the joints are maintained in the correct state. Not the last role in osteoarthritis of the knee belongs to the shoes themselves. When the heel touches the ground, a shock spreads along the limb and traumatic cartilage. Shoes with a wide low heel with an elastic soft sole extinguish this blow. Very important is the sufficient width of the shoes and the presence of a soft top in it. These requirements are met in most sports shoes.
A patient with knee osteoarthritis should not tolerate overstrain of the knee joints, for which physical activity should necessarily alternate with rest.
Knee osteoarthritis is an incurable disease. However, if you correctly select individual therapy, then the progression of the disease can be delayed. Correct treatment reduces pain, improves joint function. In other words, ultimately, the quality of life improves. Given the impossibility of complete restoration of the original structure of the joint, it is extremely important to diagnose the disease as early as possible and start its treatment in time.
Knee Osteoarthritis( gonarthrosis): a disease that prevents living |Portal of your health ZdravoE
Morning stiffness of movements, swelling and pain in the knees during walking and at rest - the symptoms of osteoarthrosis of the knee( gonarthrosis).
How does osteoarthritis of the knee joint develop( gonarthrosis)?
The knee joint is formed by the surfaces of several bones at once: the femoral, tibia and tibia, and is supported by several groups of ligaments.
It is enclosed in a sealed capsule( synovial) filled with a special "cushioning"( synovial) fluid and in the joint capsule.
The articular surfaces of the bones are covered with cartilages, providing cushioning and smooth sliding of bones during various movements in the joint, during walking, running, jumping.
A healthy articular cartilage of 98% consists of a cartilaginous matrix( matrix), the main components of which are collagen, which forms a strong fibrous framework and proteoglycans, providing elastic-elastic properties of the cartilage.2% of cartilage mass are chondroblasts and chondrocytes - cells that synthesize almost all matrix components.
Under the influence of biological and mechanical adverse factors that destroy the cartilage of the knee joint, gonarthrosis develops. The basis of the cartilage( matrix) loses its elasticity, crackles, exposing the articular surfaces of the bones.
The synovial membrane of the knee joint is inflamed. The viscosity and elasticity of the synovial fluid decreases. Thickening of the joint capsule. In the bone under the cartilage, cysts appear and bone spines( osteophytes) grow, which cling to each other, hinder movement.
As a result of such changes in the knee joint, the main symptom of gonarthrosis is painful sensation.
Why develop osteoarthritis of the knee( gonarthrosis)?
Most often gonarthrosis is affected by women, elderly and middle-aged people, overweight people, sportsmen( football, tennis and wrestling).Gonarthrosis is also caused by heredity, inadequate or excessive exercise;microtrauma, long-term use of corticosteroids, glucocorticoids, immunosuppressors, etc.
Modern methods of treatment of osteoarthrosis of the knee joint( gonarthrosis)
Currently, for the treatment of gonarthrosis, pain medications are widely used that have a quick but short-term effect.
Often, in connection with the rapid progression of gonarthrosis surgical treatment is carried out ─ joint replacement.
Along with this, in the treatment of knee osteoarthritis chondroprotectors are used - drugs that prevent the destruction of cartilage and contribute to their recovery.
The active substance of many chondroprotectors is chondroitin sulfate necessary for the restoration of cartilaginous tissue.
At the same time, scientists studying the treatment of osteoarthritis note the special value of chondroprotectors, the active substance of which is chondroitin sulfate. Chondroitin sulfate is a natural component of cartilage, which plays a biologically active role in many processes of various joint structures.
Structum - a unique drug for the treatment of osteoarthrosis of the knee( gonarthrosis)!
Structum is a product of French origin, which contains special chondroitin sulfate 4 and 6 types. Structum was tested in France, Germany, Switzerland, Russia, Ukraine, Belarus and other countries and is used in clinical practice for osteoarthrosis for more than 25 years.
The European League of Rheumatologists recommends the appointment of Structum for osteoarthritis of various localizations.
Unlike other chondroprotectors, chondroitin sulfate, which is part of Structum, has the highest degree of sulfation. Sulfation characterizes the property of the substance to attract and retain water. Due to the maximum sulfate content( 100% active ingredient), Structum contributes more to moistening cartilage, retaining moisture in the cartilage, improving the elasticity and elasticity of the cartilage more than other preparations. Chondroitin sulfate in the structure of Structum has a special composition and structure of chondroitin: it is obtained from the trachea of young chickens. At the same time, science absolutely accurately confirms that this type of chondroitin is type 4 and 6, most closely by the biological nature of the composition and structure of human cartilage.(A comparison was made with chondroitin derived from cartilage of fish and other animals.)
In addition, the lowest of all such preparations, the molecular weight of chondroitin, allows Structum to penetrate more deeply into the joint through the synovial membrane and be used by cartilage cells for self renewal and recovery. Cartilage tissue as a result restores its properties, the load on the joints is more amortized. Due to the high quality of chondroitin sulfate and such unique properties against the background of the use of Structum, unlike other chondroprotectors, the clinical effect is much faster and more pronounced. Pain in the joints and in the back is noticeably reduced, which makes it possible to significantly reduce or completely abolish anesthetics. This helps to avoid such side effects of painkillers( non-steroidal anti-inflammatory drugs) such as: exacerbation of gastric and duodenal ulcers, bleeding from the stomach and duodenum, toxic effects on the liver and kidneys, on hematopoiesis and even heart attacks and strokes. Most patients note that using Structum, movements in the knee, hip and other joints are more pronounced, the flexibility of the spine improves significantly.
And waking up in the morning, there is no such stiffness in the joints, puffiness of the joint, you can button up without the help of relatives, bend over the book, easily turn the water tap, turn the key in the lock, climb or go down the stairs. Those.feel freer and less dependent on others. This is what in the West is called to get a higher quality of life.
Today there are various chondroprotectors, some have evidence of efficacy only with arthrosis of the knee joints, for example glucosamine. And such a chondroprotector as Structum has evidence of effectiveness in the lesions of all joints - both the knee, and the hip and phalanges of the hands. Therefore, applying the Structum, the healing effect will "feel" all the joints of
at the same time. It should be remembered that the effect does not come immediately, but in a few weeks. But it is very important that the clinical effect - a significant reduction in pain and stiffness, marked improvement in mobility in joints - against the background of the drug Structum persists after the end of treatment. The duration of preservation of the effect even after the termination of therapy by Structum is considered the longest in comparison with other chondroprotectors.
So after the completion of the 6-month course of treatment, pain reduction persists for another 4-5 months, depending on the severity and localization of osteoarthritis. On average, the effect of aftereffect lasts almost as long as the reception of Structum
. But the removal of the pain symptom is not a key point in the treatment of joint osteoarthritis. Structum as a chondroprotector( protector of cartilage) slows down degenerative processes in the cartilage - stops the progression of osteoarthritis of the joints and osteochondrosis. And this means that Structum prevents the transition of the disease to a more severe stage, reduces the risk of disability, removes the need for joint replacement.
Side effects are very rare, as chondroitin sulfate Structum has a high degree of purification and French production does not tolerate any impurities that often give allergic reactions in other drugs.
Dosage regimen The structure is very simple: 1 capsule( 500 mg of chondroitin sulfate) 2 times a day. Those.only 2 capsules per day. Capsules are swallowed whole and washed down with a large glass of water. The duration of the course is from 3 to 6 months. The drug does not increase blood sugar, which is very important for long-term use in patients with diabetes or a predisposition to it.
Before using Structum, read the instructions for use carefully and do not hesitate to seek advice from your doctor!
Knee osteoarthritis: what is it and how to treat it?
Deforming arthrosis or osteoarthrosis of the knee joint is a chronic non-inflammatory disease in which gradual cartilage destruction occurs, and later the functions of the entire articular environment are lost. In other words, this term refers to the wear and tear of a joint that occurred prematurely under the influence of various negative factors.IMPORTANT TO KNOW!A new means of restoring joints in 99% of subjects. The pain goes away 100%!Read more here - & gt;
This disease is very unpleasant and painful in the last stages, so its detection and treatment in the initial period is a very important investment in your future active and comfortable life. Osteoarthrosis is irreversible, but there are a number of methods that slow its development of and allow you to maintain normal joint function for years to come.
To understand what osteoarthritis of the knee is, and how to deal with it, it is necessary to consider the main factors that are the impetus for the onset of this pathology. Consequently, changing the way of life and working conditions, as well as the treatment of primary sources of the problem, will create all the prerequisites for successfully overcoming the disease.
Osteoarthritis of the knee joints develops slowly enough for a long time. Since the human body is a complex system in which a huge number of processes occur simultaneously, the exact cause of the formation of the disease is unknown. However, a number of predisposing factors have been identified, whose effects can be obvious, and elimination - decisive for treatment:
- endocrine diseases affecting the metabolism in the cartilaginous tissue;
- metabolic syndrome due to eating preservatives;
- inevitable hormonal changes in the body, for example, in pregnancy or menopause;
- single or permanent overloads on the joint, including obesity;
- consequences and complications of injuries - for example, a dangling meniscus erasing cartilage;
- circulatory disturbance in the limbs and, accordingly, cartilage nutrition;
- frequent and prolonged experiences, in which there is a spasm of muscles, and an excess of stress hormones, in turn, reduces the production of hyaluronic acid and worsens the quality of synovial fluid;
- long-term inflammatory disease of the joints( arthritis);
- congenital dysplasia - for example, when the bone surfaces are rubbed against each other during movement due to an incorrect structure.
In the overwhelming majority of cases, arthrosis of the knee joint initially manifests itself as unpleasant sensations. Then the pain intensifies, the stiffness and limited movements join, ending with the worst development of events with complete immobility. In addition, there is muscle atrophy and a sensation of tilting the legs, a rough crunch in the knee. In 50% of cases there is a varus( the letter "O") or valgus( the letter "X") deformation of the joint.
It should be noted that sudden pain for arthrosis is uncharacteristic. If suddenly it arises, then it may be about the concomitant pathologies. In the case of osteoarthritis of the knee joint, the symptoms of complications that often accompany the disease can be observed as follows:
- synovial inflammation - swelling, joint enlargement, fluid appearance, local temperature increase;
- blockade( pinching the meniscus or ligaments between bones) - the inability to bend-unbend the knee, any movements are accompanied by severe pain;
- osteonecrosis of the femur( usually the result of thrombosis( infarction) of local vessels) - sudden pain, the bone segment may separate;
- blood in the joint( hemarthrosis) - most often spontaneous internal bleeding.
Degrees of development of arthrosis
The degree of joint damage( or disease stage) is usually determined by a hardware examination, the most common and accessible of which is the radiography method. If the result is doubtful or the patient's complaints do not match what he saw in the picture, then an MRI is prescribed.
Based on the results of the study and the patient's polls, the following disorders are identified, corresponding to different stages:
- , osteoarthrosis of the knee joint of the 1st degree is characterized by unsharp pain after physical exertion, which passes at rest, the joint is not changed;
- osteoarthritis of the knee joint of the 2nd degree can be diagnosed with the appearance of constant pain during activity and at rest, a specific crunch and limited movement in the joint, initial cartilage and meniscus fractures occur, the bone growths and changes in shape are seen in the picture, the joint slit decreases by 2/3;
- osteoarthritis of the knee joint of the third degree is supposed when all the symptoms have the maximum expression, muscles are atrophied, movement is almost impossible, the gap between the bones almost disappears, and the connection is increased in volume and deformed.
Conservative treatment of
How to treat osteoarthritis of the knee joint? Disease 1-2 is usually fairly well suited to conservative treatment, which includes a number of methods aimed at improving the state of cartilage and restoring the function of the joint, as well as getting rid of concomitant inflammatory diseases and, of course, alleviating the pain syndrome.
If you have a problem, than treat osteoarthritis of the knee joint, - the most simple remedy comes to mind - pills and injections. However, not everything here is so simple. According to research, non-steroidal anti-inflammatory drugs that relieve pain and swelling reliably, with prolonged use, actively reduce the synthesis of substances necessary for cartilage repair, and accelerate its destruction by approximately 30%.
The medications containing indomethacin and ibuprofen are particularly responsible for this negative process, therefore it is better to take the treatment only in the acute stage and by exceptionally short courses. As anti-inflammatory analgesics, Aspirin, Voltaren, Diclofenac, Metindole, Nimesulide, etc. are also most often used. Sometimes it is better to use these substances topically, in the form of an ointment or cream, in the maximum possible dosage.
Unfortunately, not everyone knows that there is an basic treatment of cartilage pathologies - the use of chondroprotectors. These drugs have the ability to improve local metabolism, stimulate the synthesis of cartilage tissue elements and stop its destruction, and also have an analgesic and anti-inflammatory effect. However, to achieve a noticeable result, long-term therapy is usually required.
To overcome the concomitant inflammation, for example, synovitis, the following scheme has proved to be the most well-proven:
- prescription inside NSAIDs, hormones, muscle relaxants and drugs to improve microcirculation;
- injection into the joint( blockade) of hormones and chondroprotectors.
Therapeutic physical training
Properly performed gymnastics with knee osteoarthritis is a very effective way to prolong the life of cartilage. As a result of improving blood circulation in the joint, nutrition is established, the spasms are removed from the necessary movements and the muscles that create the strengthened armor for fixing it are strengthened.
Exercises for osteoarthritis of the knee should be carried out in accordance with certain rules:
- to avoid vertical loads, jumps and sudden movements;
- gymnastics is better spent lying or sitting;
- not to allow sharp pain, which is not a natural indicator of the correct tension;
- if possible, doing exercises in water, swimming.
Very well helps postisometric muscle relaxation( PIER).The method consists in alternating relaxation and muscle tension, controlled by a doctor. As a result of the session, spasm and pain are removed, muscles and ligaments are stretched, joint functions are restored. However, conduction is possible only in the absence of signs of an inflammatory process.
"Running without a push" is a good way to reduce weight and pump up muscles without a dangerous load on the joint. It is possible on a special simulator, where the imitation of cycling is performed, but smoothly and standing, which is very important for gonarthrosis.
The load created by its own weight is one of the most serious causes of arthrosis, so a diet for knee osteoarthritis for the treatment of obesity is extremely necessary. It happens that with significant weight loss the compound becomes much easier: metabolism improves, pain recedes, in the early stages the process of cartilage destruction is completely frozen.
As cartilage diseases are the main cause of metabolic disorders, in recent years, arthrosis has grown younger due to the enthusiasm of fast food and the emergence of a metabolic syndrome. Consumption together with food preservatives promotes the accumulation in the joints of chondrocalcinates and uric acid, which significantly impair the quality of the joint fluid.
Therefore, in the diagnosis of osteoarthritis of the knee joint diet should include a medium-calorie, balanced food from natural products. To improve the composition of the synovial fluid and the state of the cartilage, it is necessary to limit the use of salt, exclude semi-finished products, sausage products, "syringed" preservatives or fatty meat and fish, as well as broths prepared from them and, contrary to the generally accepted opinion, a cold.
There is a widespread myth that the cause of arthrosis is the deposition of excess salt, supplied with food. In fact, nothing is delayed on the joints. And osteophytes taken for "salt" are bone growths, and it is dangerous to "break" them.
Treatment of late stages of osteoarthritis with conservative methods is ineffective, and surgical intervention for various reasons is not always possible, therefore orthopedics offers a number of auxiliary tools that relieve pain and joint load.
The most widely used of these are:
- orthopedic footwear and insoles - for example, anti-virus and anti-vulgar;
- orthosis is a modern rigid fixation method that replaces plastering, but is more convenient to use;
- bandage( knee) - a variant of the middle fixation of the joint;
- cane or crutches are the oldest orthopedic devices, thanks to which, nevertheless, movement is possible with severe joint damage.
Surgical treatment of
If the osteoarthrosis of the knee reaches the last stages, in which the mobility of the joint is completely disturbed, and there is a constant pain syndrome( especially at night), the most recent remedy is the surgical intervention. In modern surgery, preference is given to the low-traumatic method - arthroscopy, in which manipulations are performed with minimal incisions and under the control of a video camera.
Local contraindications to surgical treatment are osteoporosis and inflammation. Types of operations performed with osteoarthritis of the knee:
- arthroplasty - "cleansing" of bony outgrowths and other elements blocking movement in the joint, as well as giving the optimal shape to the deformed bones and meniscus;
- arthrodesis is a palliative type of joint surgery, when other methods can not be performed, but there is severe pain. As a result, complete immobility of the joint is created to reduce irritation of the receptors;
- endoprosthetics is a cardinal method of solving a problem in which a part of damaged bones is replaced by an implant of metal and ceramics. Thus, after a short recovery period, the patient acquires the opportunity to live a full life.
Knee osteoarthritis is a serious disease that, in most cases, occurs slowly, for decades, but at its last stage it ends with a disability. Therefore, it is better to take precautionary measures at the very beginning, than then to conduct a long, not cheap and, unfortunately, not always successful treatment.