Knee joint nicks
It is known from history that the first injections were done in the middle of the 17th century. How and by what means, it is not clear, since syringes appeared a century later, in 1853.Since then, injections in the joint of the knee are the best way to deliver medicines to the sick body. Analogues of modern disposable plastic syringes were patented in America in 1956.The novelty greatly facilitated the work of medical personnel, the cases of transmission of infection through injections from one patient to another decreased.
Methods of injection of injections
Drugs in the human body can come in several ways:
- directly into the joint( intra-articular nyxes);
- is intraarterial;
Intravenous infusions are two types: inkjet and drip. A small amount of drugs is injected with a 10-20 ml jet of syringes. Large volumes of liquid are dripped with the help of disposable systems( droppers).Intra-arterial injections are necessary for large blood loss that occurs with open fractures of joints with tissue and vascular rupture.
The length of the medical needle can reach 90 mm, diameter - 2 mm
Intramuscular injections are the most common. Are made in the outer upper quadrant of the buttocks. The injection site for subcutaneous injections selects the upper part of the forearm or the anterior thoracic region of the thigh. For each type of infusion, a needle of the appropriate length and diameter( section) is taken.
|Needle insertion method||Needle length in mm||Cross section in mm|
|Subcutaneous||Up to 16||Up to 0.5|
|Intramuscular||30 - 40||0.6 - 0.8|
|Intravenous||40 mm and shorter||0,8 - 1, 1|
|Intraarticular injection||20 - 40||0,4 - 2|
For intraarticular injections, syringes with a capacity of 2-5 ml are used. The smaller the cross-section of the needle, the more painless it will be. Preparations-suspensions( suspensions) are poorly soluble. They can clog the lumen of the needle and make it difficult to administer the medication. For suspensions, needles of large diameter from-1.1 to 2 mm are needed.
Diseases and nyxes
Indications for injections in the joint area are a number of diseases, the classification of which is as follows:
- inflammatory - arthritis, tendovaginitis, synovitis, bursitis, Reiter's disease, enthesitis;
- degenerative-dystrophic - osteoarthritis, gonarthrosis;
- traumatic - joint fractures open or closed, tears, tears, sprains;
- arthralgia is a pain syndrome that arises in response to irritation of the neuroreceptors of the joint by various reagents - allergens, salt crystals, osteophytes( bone growths), etc.
One of the reasons for applying pricks to knee joints is the presence of strong, sometimes intolerable pain, swelling, hyperthermia( heat), inflammation. For their relief, such drugs are used:
- glucocorticosteroids - synthetic analogues of adrenal hormones;
- anti-inflammatory non-steroidal( non-hormonal) drugs;
- antimicrobials or antibiotics;
Diprospan - a corticosteroid with a prolonged action of
The action of drugs with the use of injections is aimed at relieving pain, restoring joint mobility, and reducing the period of incapacity for work of the patient.
Glucocorticosteroids( SCS)Still advised: Injections for the knee joint
( GCS) are most effective for inflammatory diseases, less for degenerative-dystrophic diseases. Local injections in the joint cavity create a high concentration of the drug. The therapeutic effect is not immediately apparent, but it takes quite a long time. Time depends on the type of medication, varies from 6 days to 21 days. The shortest period of action in hydrocortisone, long-lasting - at leaperspan. After injections, temporary exacerbations of the disease are sometimes observed. It is not necessary to be frightened, working capacity is restored quickly.
Of the other corticosteroids, the recent emphasis is on diprospan, Kenalog. Diprospan is used for intraarticular and periarticular administration( in the surrounding soft tissue).The advantage of the drug is a rapid anti-inflammatory, anti-allergic, analgesic and prolonged prolonged period.
This is an extensive group of drugs that have a complex effect - anti-inflammatory, analgesic, antipyretic. Their action is based on the blocking of substances that affect the appearance of an inflammatory reaction. Indications for use are diseases of the musculoskeletal system( joints, ligaments, tendons, muscles, synovial membrane), as well as other types of diseases.
An injection in the joint of the knee quickly removes pain
If acute or chronic knee pains are disturbed, injections of non-steroid drugs into the joint will quickly eliminate pain, prevent them from appearing in the future for a long time. To the group of non-steroid preparations are:
- ketorolag, analog - Ketanov;
- ibuprofen, analog - nurofen;
- diclofenac, analog - voltaren;
- oxicam, analogues - piroxicam, xephox;
- naproxen, analog - pentalgin;
- indomethacin, etc.
Analogues are medicines having a common active substance. Medicines with the same active substance, but different manufacturers can significantly differ in price, but not in quality. Reviews of patients using nonsteroidal drugs confirm that the therapeutic effect of nonsteroid and their analogs is approximately the same.
Preparations are indispensable for degenerative-dystrophic diseases of the knee joint, which occur with destruction of the cartilaginous tissue - osteoarthritis, gonarthrosis. With age, due to the physiological capabilities of the body, the state of the cartilage changes. It is more quickly destroyed, it regenerates worse( it is restored).
Fermatron - the best symptomatic for the knee
The injections of the fermatron are used directly for the treatment of the knee. In composition, it is similar to the synovial( joint) fluid. The active substance - sodium hyaluronate - positively affects the condition of the cartilaginous tissue, activates the formation of its own hyalurate. Simultaneously it is an articular shock absorber, an anesthetic.
Fermatron enters the pharmacy network in a special syringe filled with sodium hyaluronate. This form of release simplifies the introduction of the drug into the joint cavity. What other injections prevent the destruction of cartilage?
- alflutope, rumalon - natural remedies from cartilage of animals and fish;
- glucosamines - regulate the metabolism( metabolism) of bone, cartilaginous tissue;
- hyaluronic acid and preparations based on it restores cartilage, are effective in the early stages of joint diseases;
- chondroitin sulfates are components of cartilaginous tissue, contain glucosamine. Keep water in the joints of the knee, prevent the destruction of connective tissue.
Vitamin preparations are an auxiliary but important means for the treatment of knee joint. Inclusion of them in a mandatory set of treatment procedures is explained by the influence on metabolic processes, the production of enzymes, activation of the body's defenses.
Mildamgam injections are an effective way to treat the knee joint.
Bones and joints need B vitamins, ascorbic acid, vitamin E, rutin. The complex of three vitamins "B" with lidocaine under the name of the injection of milgamma is widely used in the treatment of joints. The drug has a therapeutic and analgesic effect. Injections are made 5-10 days by intramuscular route.
How do the injections
The drug, dosage, way of injections is chosen and prescribed by the doctor, taking into account contraindications. Absolute contraindications are:
- inflammatory diseases of infectious nature;
- hemorrhage of joint tissues;
- deformation with narrowing of the joint space;
- marked osteoporosis, tissue necrosis.
Intra-articular drug administration - first aid for pain
Special preparation before injections is not needed. From the patient it is required a little: it should be pure, in neat clothes. If there is hair on the knee, they need to be shaved.
Injections are made in the treatment room of a medical institution( polyclinic, hospital) by an orthopedic physician, a surgeon, a rheumatologist, a traumatologist who owns this technique. The patient lies on the couch with his back. The injections are made with sterile disposable syringes. Their capacity is determined by the disease, the dose of the drug, it can be 2, 5, 10, 20 ml.
Inserting a needle into the joint is not more painful than a vein. Painful sensations often appear after the injection. Depending on the type of medication and the volume of fluid, there may be a burning sensation, joint flaring, aching pains.
Do not be afraid of injections. What is more important: constant pain, crunch, joint stiffness or minutes of patience and further active life without pain?
List of drugs for the treatment of arthrosis of the knee
Osteoarthritis of the knee joint( gonarthrosis) is a complex disease that does not always give in to treatment. Therefore, in this article, we have prepared for you a list of drugs that are most effective in treating this disease.
Fast navigation for the article:
1st group of drugs: anti-inflammatory drugs
What is the danger of taking NSAIDs?
2nd group of agents: chondroprotectors
What is important to remember when treating chondroprotectors?
Drugs for intra-articular injection
Warning: all information about medicines for arthrosis of the knee joint is published exclusively for informational purposes for personal review. Do not try to use them yourself without consulting a doctor: self-medication can cause irreparable harm to your health!
All medicines for the treatment of knee osteoarthritis can be divided into several large groups by the mechanism of action.
1st group: anti-inflammatory drugs
Aertal - one of the new drugs for gonarthrosis
It is with non-steroidal anti-inflammatory drugs( NSAIDs) that the treatment of osteoarthritis of the knee usually begins.
This group of drugs includes such drugs as aspirin( acetylsalicylic acid), phenylbutazone, etodolac, indomethacin, sulindac, ibuprofen, piroxicam, aceclofenac, tenoxicam, diclofenac, lornoxicam, naproxen, rofecoxib, ketoprofen, meloxicam, nabumetone, tiaprofenic acid, nimesulide, flurbiprofen, celecoxib and others.
NSAIDs differ in both the strength of the action and the likelihood of developing side effects.
These drugs do not contain anti-inflammatory hormones, but nevertheless, in most cases, they are good at coping with joint pain and reducing inflammation in them.
So, the greatest analgesic effect is usually possessed by ketoprofen, diclofenac, indomethacin, while aspirin, ibuprofen, amidopyrin relieve pain significantly worse. But since many people can have individual reactions to different medications, then the effectiveness of these drugs may differ significantly from the generally accepted norms - both in one and the other direction.
It is generally believed that such agents as indomethacin, diclofenac, and flurbiprofen have the greatest anti-inflammatory effect, while ibuprofen, aspirin and naproxen, on the contrary, are able to reduce inflammation worse.
Side effects of
Unfortunately, despite the fact that non-steroidal anti-inflammatory drugs usually help to effectively relieve pain in osteoarthritis and other diseases, they are not very safe for health and have quite strong side effects. That's why doctors usually appoint them not very long courses and whenever possible in small doses.
What is the danger of taking NSAIDs?
a) problems from the gastrointestinal tract, in the first place - the effect on the gastric mucosa
NSAIDs cause side effects from the stomach
The intake of NSAIDs dramatically increases the likelihood of erosion and even ulcers in the gastric mucosa. This is especially true of people who had previously( or at the moment) such diseases as gastritis and peptic ulcer of the stomach and duodenum, as well as elderly patients.
However, in recent years, NSAIDs of the new generation have been synthesized, in which the negative effect on the gastrointestinal tract is significantly reduced.
This group of drugs are called selective inhibitors of COX-2, and include agents such as nimesulide and celecoxib.
b) Side effects from the kidneys
NSAIDs reduce the rate of renal blood flow, and also promote the retention of water and sodium in the body, which can contribute to high blood pressure, as well as the development of acute heart failure and kidney failure.
c) Heart and blood vessel problems
Non-steroidal anti-inflammatory drugs, among other things, affect the blood coagulation system. If they are not properly taken, patients may develop blood vessel thromboses and even stroke or myocardial infarction. To medicines for which such an effect is characteristic, first of all those same COX-2 inhibitors, which reduce the risk of developing gastric complications, are considered.
What to remember when taking NSAIDs
As you can see, non-steroid drugs are not nearly as harmless as it is commonly believed. That is why you should not prescribe yourself such treatment, but you need to see a doctor who will choose the drug that is right for you and its dose.If there is a need to take painkillers for arthrosis of the knee joint for a long time, it is better to use drugs of other groups for this, which, if taken for a long time, do not give such harmful side effects and have a large selective effect, without adversely affecting gastric, renal or cardiovascular diseases,cardiovascular system.
For these purposes, preparations like Movalis are more suitable, which can be taken in long courses - from several weeks to several months and more - but, of course, also only under the supervision of a doctor.
In addition, the intake of NSAIDs is fraught with the fact that it "obscures" the symptoms of arthrosis: as you know, pain is a signal from the body that something is wrong in it. If the pain is completely removed by the reception of these medicines, the likelihood is that a person with such a disease will wave a hand on the disease, relax and will not do anything for recovery, except for taking pain medications.
This approach is very dangerous, because despite the absence of pain, the disease continues to progress, the cartilaginous tissue is still destroyed, and a person can think that everything is in order with health and there is nothing to worry about.
In fact, the correct approach to taking NSAIDs should be as follows: it is necessary to take these medicines as prescribed by the doctor, but not to forget about the disease, but to create the opportunity to undergo complex treatment without joint pain: take other medications,which are necessary for the treatment of osteoarthritis, undergo the necessary physiotherapeutic procedures, massage courses and other medical measures that could not be carried out in the presence of pain.
The second group of agents: chondroprotectors
chondroprotectors are the most important drugs for arthrosis of joints.
Chondroprotectors( CP) are drugs that promote the protection of cartilage tissue and enhance its formation( synthesis) in the joints.
Unlike anti-inflammatory drugs, HP not only remove the symptoms of arthrosis of the knee joint, but also affect the very cause of osteoarthritis - they contribute to the improvement of cartilage tissue nutrition and its recovery. In this sense, chondroprotectors are one of the most important medicines for the treatment of this disease.
This group of agents includes such active ingredients as chondroitin sulfate and glucosamine. They can, in various combinations, be a part of various medications - such as Dona, Terafrex, Arthra, Structum, Chondroxide, Elbona, Chondroitin Akos, Chondrolon, Zinaxin, Arthrin and others.
Arthra is a combined preparation containing equally and glucosamine, and chondroitin sulfate( 500 mg each in one capsule).The drug is produced by the American company Unifarm, the cost of one of its packages, depending on the number of capsules, costs from 500 to 1,700 rubles. Arthra is considered one of the best chondroprotectors at the moment.
This medication is also combined: one capsule contains 500 mg of glucosamine and 400 mg of chondroitin sulfate, and is manufactured by the German company Bayer. Take teraflex, depending on the stage of the disease, 2-3 capsules per day. It is worth, depending on the number of tablets, from 600 rubles( for packing 30 capsules) to 1500( 120 capsules) and above.
Don contains only glucosamine. Produced by Don in the form of sachets( bags with powders for oral administration), capsules, as well as ampoules for intramuscular injection. For the most effective treatment, manufacturers recommend combining it inside with intramuscular injections.
This medicine is manufactured by Rottapharm( Rottapharm) and its price ranges from 1000 to 1300 rubles - both for capsules and sachets, and for ampoules.
This is a mono-drug of chondroitin sulfate, which is manufactured by the Russian pharmaceutical company Microgen. It is produced as a dry substance in ampoules for dilution and subsequent intramuscular administration.
One ampoule, which must be diluted in 1 ml of water, contains 100 mg of active substance. Enter chondrolone for 1 or 2( with good tolerability) of the ampoule every other day by a course of 25-30 injections. Its price at the beginning of 2013 is from 1000 to 1200 rubles per package of 10 ampoules.
Structum is also a mono-drug that contains chondroitin sulfate in the amount of 250 and 500 mg. Produced by Pierre Fabre Medicaments Productions( France).
It is prescribed in a dose of 1000 mg per day, i.е.It is necessary to take 2 capsules a day for 500 mg or four - about 250 mg. Packing with 60 capsules of this chondroprotector will cost you 1200-1300 rubles.
Elbona is a Russian remedy, which includes only glucosamine sulfate. This drug is produced in 2 ml ampoules( plus 1 ml ampoule with a solvent) for intramuscular injection;one ampoule contains 400 mg of active ingredient.
As seen from the name, this CP is also a mono-drug containing chondroitin sulfate in an amount of 250 mg of active ingredient in one capsule. This medicine, as well as the previous one, is produced in Russia.
ointment chondroxide for joints
This medication contains only one active ingredient - chondroitin sulfate, but is produced not only in the form of capsules( 250 mg each) but also as a 5% ointment. It is produced by the Russian pharmaceutical company Nizhpharm.
For the therapeutic effect, the dose of this drug, like other members of this group, should be 1000 mg of active ingredient per day, i.e.4 capsules per day.
Packing of 60 capsules will cost 400-500 rubles. Ointment in a 30 gram tube will cost from 250 to 300 rubles() .
What is important for a patient to remember when treating chondroprotectors?
- primarily, chondroprotective medications are time-consuming drugs. This means that the effect of treatment develops very slowly, and it can be seen only after 3-5 months, and the course of treatment with these drugs is from 6 to 12 months and sometimes more;please be patient.
- CP only work in the early stages of arthrosis - at 1 and 2 degrees;at 3 degrees of this disease, chondroprotectors do not make sense anymore, because on it the entire cartilaginous tissue of the joint is already destroyed and there is simply nothing to restore.
- among doctors now there is no general opinion about whether it is worth taking glucosamine and chondroitin sulfate together or separately. There are studies that suggest that with the joint administration of these two substances they can weaken each other's action. But while this question remains open, it is better to leave it at the discretion of your attending physician and, if possible, give preference to the products of large, reliable pharmaceutical companies with high quality products.
Medications for intra-articular injection( injections inside the joint)
In addition to drugs administered internally and intramuscularly, a large therapeutic effect in osteoarthritis gives the introduction of various drugs directly into the joint cavity( intraarticular injections).Thanks to this method of administration, the drugs directly fall directly into the area of action-into the synovial fluid through which the cartilaginous tissue is fed.
Most often, corticosteroid anti-inflammatory hormones are used to inject the joint: hydrocortisone, Kenalog, celeston, diprospan, flosteron, and others. These drugs are injected into the joint, because when taken in tablets such medications give very many side effects. But when injected directly into the joint, they very quickly and effectively reduce pain and inflammation in the joint, facilitating the patient's condition.
Important point: corticosteroids, like NSAID preparations, do not treat osteoarthritis, but only have anti-inflammatory and analgesic effect. In order to really treat this disease, you need to use other drugs - the same chondroprotectors.
Also in recent years, such a method of treatment as intraarticular administration of hyaluronic acid( sodium hyaluronate) has been used. This tool acts on the joint as a "liquid prosthesis" or an additional synovial fluid that seems to create a protective layer in the joint that improves movement in the joint, helps to reduce the trauma of the joint during movements, moisturizes the cartilaginous tissue and improves its nutrition.
Sodium hyaluronate is available in the form of such drugs as fermatron, duralan, ostenil, synviscus. The therapeutic effect of the administration of these medications is usually very good, but, unfortunately, not everyone can afford this treatment.
So, one dose of a fermatron for intra-articular administration will cost 3500-4000 rubles, while the curative course is 3-4 injections once a week in each diseased joint. Therefore, a large price is the only factor that hinders the development of this method of treatment.
A good therapeutic effect in gonarthrosis is provided by various medications used locally.
So, such ointments as Fastum-gel, indomethacin and butadion ointments, Menovazine, Voltaren-gel, Nikoflex-cream, Espol, diclofenac-ointment, and many others have shown themselves as therapeutic ointments and gels for topical application.
They have a good curative effect, but it is important to remember that only 4 to 8% of the drug substance passes through the skin to the "destination" - the joint of the patient, therefore, anti-inflammatory and analgesic treatment with ointments, creams and gels is almost always necessary with drugs, taken orally or intramuscularly.
Various medicinal substances for external use can be used for the preparation of medical compresses. These include, for example, bischofite( an oil derivative that has a beneficial effect on arthrosis), dimexide( an anti-inflammatory and analgesic medicine that penetrates well through the skin), as well as a medical bile that has good warming and absorbing properties.
However, in order to keep under control such a complex disease as arthrosis of the knee joints, sometimes it is not enough to just take drugs in one form or another.
Medical treatment should be combined with physiotherapy procedures for arthrosis of joints, spa treatment, and if your doctor does not object, you can use effective folk recipes for treatment of gonarthrosis.
And remember: for effective therapy of arthrosis of the knee joint, it is dangerous to engage in self-medication. If you have joint pain, consult a doctor!
Effective injections into the cavity of the knee joint
Injections directly into the joint area have been conducted for a long time. They have recommended themselves as an effective, perfect method of treatment that can restore health to a person.
is applied, the joint is not a separate body. It consists of bones, periosteum, cartilage, tendons, fasciae, soft tissues. The pathological condition of one of the lesions adversely affects the function of the entire joint. It leads to the development of complications. Therefore, injections into the knee joint are not limited to injections into the interarticular capsule. In cases of necessity, they are made into soft tissues and tenosynovial cavities.
An example is a blockade - the cutting of a sore spot with a 2% solution of novocaine or lidocaine. Punctures are also made to remove effusion, rinse the cavities of the knee joint, with a diagnostic and therapeutic purpose.
According to indications in medical practice, injections of drugs into the knee joint are quite common. Performed by doctors orthopedists or rheumatologists in the following cases:
- as an emergency aid for acute pain;
- for joint flushing;
- for preventive purposes, preventing exacerbation of the disease;
- for osteoarthritis;
- for rheumatoid and osteoarthritis;
- for cartilage damage;
- for gout, periarticular bursitis, tendinitis, synovitis.
Intra-articular injections are performed in conjunction with other treatments, without substituting or excluding various therapies.
Contraindications for steroid therapy:
- unstable angina;
- circulatory failure;
- insulin-dependent diabetes mellitus;
- Inflammatory skin infections at the injection site;
- sclerotic encephalopathy of the 3rd stage.
Hyaluronic acid for the knee joint is a natural component and is well tolerated by patients. But a few restrictions to it still exist. These include allergy to the drug, fever, autoimmune diseases, pustules on the skin.
Types of drugs
Treatment is carried out mainly by two types of drugs: corticosteroid hormones and hyaluronic acid. Radioactive colloids are used less often.
Hormones are effective in stopping inflammation. Quickly suppress pain, relieve swelling. But they do not affect the cause of the disease. Rather have a temporary symptomatic effect. For injections in joints, corticosteroids are more commonly used: hydrocortisone, kenalog, flosteron, methylprednisolone, cileston and other drugs of this group. In the same joint, injections are done no more often than once every two weeks.3 to 4 procedures are sufficient for the course.
Hyaluronic acid is needed to restore the structure of the cartilage. When injected into the joint cavity, it increases the viscosity of the intraarticular fluid, thereby preventing damage to the cartilage tissue. Hyaluronic acid preparations with low and high molecular weight are especially effective in osteoarthritis. The course of treatment shows three intra-articular procedures with an interval of one week. In Russia, mainly imported preparations are used - Ostenil, Synvisc, Dyuralan, Fermatron.
How the injections are made
For intraarticular knee injections, a 21 gauge needle with an injection cylinder length of 35 to 38 mm is used. You need sterile gloves and disposable syringes. The skin at the puncture site is treated with medical alcohol or iodonovidone.
If there is an effusion, it is better to remove it before treatment, and seal the joint with an antiseptic. Treatment will be more effective, and the terms of recovery will be reduced. Intraarticular injections by some clinicians are performed under local anesthesia. Others do not see it necessary. The procedure is not too painful, quite tolerable and takes a minimum of time.
Injections are made in the lateral surface of the
knee Advantages of the
- method reduce the risk of side effects;The
- medication is delivered directly to the sore spot in full;
- rapid impact on the pathological focus;
- decreases the doses of other drugs;
- practical absence of side effects.
Complications of stitches in the joints are few. Are reduced to a small percentage of allergic reactions, a temporary exacerbation of the current disease. In rare cases, there is infection of the joint.
How much is
When treating intraarticular injections, you have to pay for medicines, disposable instruments, treatment. The price of hyaluronic acid preparations is high. One shot exceeds 3,000 rubles.
Hyastat - hyaluronic acid for insertion into the joint cavity
An alternative to expensive hyaluronic acid preparations is the domestic Hyastat. Its cost is 30% lower than foreign peers. Prices for corticosteroids are relatively low - from a few tens to hundreds of rubles. Recently, for known reasons, the cost of imported drugs has increased dramatically. But in Russia there are enough not less effective inexpensive domestic corticosteroids. One of them is a suspension of hydrocortisone in a package of 10 ampoules at a price of 200 rubles.
Healthy joints are walking, traveling, favorite sports. You can return a full active life. And intraarticular injections will help in this.
What drugs are used to treat arthrosis of the knee joint?
What is arthrosis of the knee joint?
Osteoarthritis of the knee joint( or, as it is also called, gonarthrosis) is a disease of the knee joint, accompanied by pains, impaired motor functions and deformation of the cartilaginous cartilage of the knee joints. Usually it appears in people of an age prone to fattening - and women suffer from gonarthrosis more often than men. It is accepted to divide this disease on a stage, each of which intensifies and complicates the coping and treatment of the disease.
Osteoarthritis of the knee joint, treatment and preparations for which it is necessary to select with the mind is a disease, a frequent problem now, especially in the elderly. The first stage of arthrosis of the knee joints is almost not detected by ordinary residents, since the pain is episodic, not particularly strong, joint deformities do not occur. It can last very long - from several months to several years in a row. Usually, pains persecute people after the beginning of active activity, in the process of heavy physical labor and some time after it, after which they disappear to the following significant loads.
Sometimes this is accompanied by a so-called Baker's cyst - an abnormal accumulation of articular fluid in the back of the knee. She usually descends after taking a course of anti-inflammatory drugs - to operate Baker's cyst in any case is not worth it, since it is not associated with cancer.
The second stage is much heavier. The pains appear at the beginning of walking, the joints begin to crack painfully and click, the leg with difficulties bends at an angle of less than 90 degrees. A person with the second stage of gonarthrosis becomes difficult to get up on his feet, many types of physical activity become inaccessible: the pains become too strong. Abnormal accumulation of articular fluid manifests itself in more than half the cases. There is an initial deformation of the osseous cartilaginous tissues of the knee joints, they are "flattened", becoming wider.Osteoarthrosis
The third stage is the most severe for a patient with gonarthrosis. Pain in the knees does not recede for a minute, even at rest it is difficult to find a position in which it would become tolerable. The knee can not be bent at an angle of less than 90 degrees and it is very painful to straighten the leg completely. The bones and cartilages of the knee joint are subject to noticeable erosion, and physical loads are simply impossible. This is truly the end of a healthy human life.
How to deal with arthrosis of knee joints and is there any means to treat it?
The first thing to remember a person who has revealed signs of at least the first stage of gonarthrosis is to consult a specialist in the nearest hospital. It is necessary to avoid excessive loads on the affected joints, to lose excess weight to facilitate walking and functioning of the lower extremities. Also, knee joint injuries should not be tolerated - they significantly increase the risk of arthrosis symptoms.
If you are already exposed to later stages of this unpleasant illness, then it must be treated. Fortunately, this is possible.
First of all, under the strict supervision of your attending physician you need to buy NSAIDs( non-steroidal anti-inflammatory drugs for arthrosis).They will stop the spread of excess articular fluid, remove possible edema and reduce pain when working joints. It should be remembered that this is only the beginning of treatment, the removal of only some of the symptoms, and not the very cause of gonarthrosis. Do not be deceived - it is still very far from the true cure.
It is also necessary to take chondroprotektorov - drugs that help the body to repair damaged cartilage tissue and eliminate the effects of joint deformation. Unfortunately, they work slowly and can not be cured for a cure - at the third stage of arthrosis, when the cartilage is subjected to almost total entropy, these drugs will be powerless. However, the less that chondroprotectors can do is to stop the patient's condition, restore minor cartilage damage and normalize the production of articular fluid, restoring the necessary lubricating properties( which, of course, will prevent further deterioration of knee joints).Ointments help to relieve pain
Do not forget about the presence of ointments and creams from pain in the joints and muscles. They, although they do not have any curative effect, quite well restore the circulatory system( especially - warming ointments), which contributes to the early restoration of the joint and the rehabilitation of the surrounding muscles. In general, treatment of gonarthrosis with ointments helps patients to relieve pain in the knees and accelerate the recovery process - this should not be discounted, limited only to chondroprotectors and NSAIDs.
Like ointments, compresses are also used. Experts in this matter advise them much more than warming ointments: the effect of using compresses is similar, but much stronger and versatile. Of these medicines, medical bile, bischofite and dimexide are especially prominent. We recommend reading: Osteoarthritis of the knee joint of the 1st degree
All these agents not only produce an external warming effect, but they are able to soak through the skin, acting directly on the disease center from the inside( unlike the advertised gels and ointments of all colors,external warming effect).When using any medicine, be sure to consult a specialist who is treating you.
Also have the right to life intraarticular injections. They differ in their types and uses and have the greatest number of restrictions to use and contraindications. Many modern doctors make the grossest mistakes in the use of these drugs, which is quite unfortunate for the patients.
The injections do not work at once - between injections it is necessary to take a break in the area of two weeks, and no more than five injections into one joint for the course of treatment. Hormonal injections relieve inflammatory processes without producing any other positive effects. Preparations with arthrosis on hyaluronic acid envelop the damaged joint surfaces, preventing further erosion of bone-cartilaginous tissues. Unfortunately, for all its high efficiency, hyaluronic injections are very expensive;The treatment course will cost you no less than a thousand dollars. However, this is one of the most effective methods of treatment of gonarthrosis without surgical intervention.
Do not forget about manual therapy of knee joints. When treating the initial stages of arthrosis of the knee joints, it has a truly miraculous effect. Already after a small number of procedures, the overwhelming majority of patients feel tremendous relief and improvement of the situation with the diseased knees. Experienced specialists of manual therapy raised to their feet a huge number of patients with gonarthrosis, which otherwise were subject to surgery.
Remember the benefits of using exercises of therapeutic gymnastics and the use in walking of walking walking sticks. Exercise individually, according to your situation and stage of the disease, after consulting with an experienced doctor. The walking stick should be chosen taking into account the distance from the floor to the wrist of your hand, stretched down. A cane is worn in the hand opposite the leg with a diseased knee joint( say, the left leg is susceptible to gonarthrosis, and in the right you wear a cane).At each step on a sick leg, transfer your center of gravity to the cane: this helps to reduce the load when walking.
What does this have to endure?
It is necessary to understand the danger of diseases of knee joints, including arthrosis. Preparations for the treatment of joint arthrosis should be chosen carefully, taking into account all the nuances. At the first signs of pain in the knees, try to find an experienced doctor who can give you the correct and effective instructions for the prevention of this problem. Remember: in the initial stages of gonarthrosis is much more treatable than late. If you want to live your life without pain and unnecessary complications, keep an eye on your health and the health of your knees.
Injections in the knee for arthrosis - Advantages of injections
An injection in the joint with arthrosis is done with corticosteroid hormones, hyaluronic acid and chondroprotectors.
Corticosteroid injections: the pros and cons of
The most effective corticosteroids are Kenalog, hydrocortisone, flosteron, celeston, diprospan. They relieve inflammation and instantly( in a few minutes) relieve pain.
But corticosteroids do not cure the disease and are not able to repair the damaged cartilaginous tissue. In addition, they lead to microtrauma, causing the risk of penetration into the joint of the infection.
Frequent injections in the knee inhibit the regeneration processes in the joint, narrow the blood vessels, contribute to the destruction of tissues, increase hypertension, peptic ulcer, diabetes mellitus. Therefore, injections of corticosteroid hormones are done only in the period of severe exacerbations, if other means do not give results. You can not inject drugs more than 2 times a month.
Injections of hyaluronic acid
"Liquid prosthesis" - the so-called hyaluronic acid. It serves as a complete replacement of synovial fluid.
Injections injecting hyaluronic acid form a thin film on the surface of the joint. It plays the role of lubrication and protects the cartilage from damage and friction.
Due to the ability to retain water hyaluronic acid has a moisturizing and nutritional effect, protects the joint from drying out and makes the cartilaginous tissue elastic and elastic, improving the mobility of the foot.
Hyaluronic acid does not have side effects and can be used for a long time. Its only drawback is high cost.
Usually do 3-4 injections of medication per year. They give an effective result at the first and second degree of defeat. In the third stage of arthrosis, the administration of hyaluronic acid gives only a temporary effect.
Injection with chondroprotective agents
Chondroprotectors are recommended to be administered after the inflammation from the knee has been removed. They nourish the cartilage and stimulate the processes of its regeneration. An injection in the joint with arthrosis is much more effective than the administration of chondroprotectors orally, since it has a pinpoint effect. Usually the treatment consists of 5-10 injections.
How is intraarticular injection done?
An injection in the joint with arthrosis is performed only in the clinic by a trauma doctor. It is advisable to administer the drugs in the joint under the supervision of ultrasound.
After the injection, redness, swelling and swelling in the joint area, as well as increased pain and stiffness, are possible. These symptoms can be observed for several hours or days.
Injections with arthrosis have a cumulative effect. Their number depends on the stage of the disease. With minor joint damage, the effect manifests itself quickly enough. If the disease is started, then the treatment can last for months and years.
It is recommended to inject hyaluronic acid and chondroprotectors with courses so that the body can start the recovery processes in the joint. Each course consists of 10-20 procedures.
Injections in the knee for arthrosis are contraindicated when:
Injections for arthrosis of the knee
Pain sensations in the knee joint most often speak of the destruction of the cartilaginous tissue. Such degenerative processes are caused by a disease such as arthrosis. To treat this ailment, complex therapy is used, which includes taking medications, injections, physiotherapy and therapeutic gymnastics. It is the pricks with arthrosis of the knee joint that play a huge role in restoring the lost functions of the knee.Table of contents: to the table of contents ↑
Efficacy of medical injections
Age changes, weight gain, prolonged high-heel walking, professional sports, and low intake of B vitamins are the main reasons for the development of arthrosis of the knee joint. The destruction of cartilaginous tissue, accompanied by constant aching pains can not only deprive a person of sleep and rest, but also make him disabled.
Avoiding severe consequences of the disease will help to inject from arthrosis. The therapeutic blockade with the use of medications is designed to reduce pain, to stop inflammatory and degenerative-dystrophic lesions of the knee joint. Also, injections perfectly relieve swelling, improve the structure of cartilage and increase the amount of synovial fluid. In comparison with tablets and ointments, the injection blockade allows to achieve immediate results without side effects on other organs of the body.
For arthrosis of the knee joint, several types of injections may be prescribed by a specialist:
• intramuscular;• intra-articular;• Painkillers.
As the practice of treating arthrosis shows, it is almost impossible to achieve full recovery without using injections. Therefore, the only way to preserve the ability to work in a sick person remains a complex approach with the mandatory inclusion of an injection blockade.to table of contents ↑
For intramuscular administration in degenerative-dystrophic processes in the knee joint, specialists usually prescribe a number of drugs that are selected based on the course of the disease, the age of the patient and the degree of knee joint damage.to table of contents ↑
Non-steroidal anti-inflammatory drugs
Injections using non-steroidal anti-inflammatory drugs are designed to reduce inflammation in the cartilage tissue of the knee joint. In addition, they effectively stop pain, remove puffiness from the affected area. The main advantage of this type of injection is the speed of the reaction.
The disadvantages of non-steroid drugs include the negative impact that they have on the work of the digestive tract. NP injections cause ulcers on the gastric mucosa, the work of the liver and gallbladder worsens.
For this reason, injections are prescribed in a process that has a neglected form of the disease and only short courses in a strictly defined dose. After completing the course, the patient must necessarily take a vitamin course with a high content of vitamins B1, B6.
The following injections of NP from arthrosis are widely known to date:
The appointment of analgesics( analgin, baralgina) for arthrosis is necessary to relieve the pain syndrome, so when the cartilage tissue in the knee joint is destroyed, they strongly disturb the patient. Sometimes the pain is so strong that without the injection of an analgesic, it can not lead a habitual way of life. However, like the previous preparations of analgesics, they only reduce the symptoms of the disease, and they do not restore cartilaginous tissue in the knee joint.
Very often there is a need to remove spasm of muscle tissue, which inevitably appears with arthrosis. In this case it is recommended to use Midokalm, Baclofen, Sirdalud. The course of treatment is about a week. There are practically no contraindications, except for pregnancy, lactation and allergic reaction to the components of the drug.to the table of contents ↑
In cases of severe knee injury, in some cases steroid injections may be prescribed by a specialist. The most famous and often used drug today is Ambien. Its effectiveness is manifested in the rapid removal of pain in the knee, reducing the inflammatory process and the restoration of the joint.
However, feedback after using such tools can be heard is not the best. The presence of highly active aggressive components in the preparation causes the cartilage to be weeded out to the ability to form new cells. Therefore, it is desirable to resort to the appointment of steroid drugs in the most extreme cases.to contents ↑
The vitamin complex containing vitamins B1, B6, B12 is an indispensable preparation for the restoration of cartilaginous tissue in the knee joint. Usually for intramuscular injections are used Kombilipen, Neurorubin, Copligam B, Trigamma, Milgamma. The intake of the vitamin supplement reduces the pain syndrome and improves the conductivity of the impulse along nerve fibers that innervate the affected joint.to the table of contents ↑
The introduction of a medicinal preparation directly into the knee is the most effective method of treating arthrosis, as the substance enters the affected area quickly and in a concentrated form. Injections into the knee joint are especially necessary in the first stage of degenerative processes.
Blockade of arthrosis in a similar way is the suppression of infection due to the introduction of an antimicrobial drug in the knee( antibiotic, antiseptic).Drainage of the joint can also be prescribed as an aid.
It should be borne in mind that intraarticular injections for arthrosis are complex procedures and require some practice. Therefore, it is best to contact a qualified specialist who has experience in administering such drugs to the knee.to the table of contents ↑
The most powerful drugs to date are hondoprotectors. In composition they are very close to the structure of the cartilage of the knee joint, which allows very quickly to heal and regenerate the damaged tissue. Components of the medicine are made on the basis of substances of animal origin: cartilage, tendons and ligaments.
However, practice shows that it is very difficult to cure arthrosis with injections using only these drugs. Therefore, in order to obtain the maximum effect, they should be administered in combination with other drugs. Most often, the chondoprotectors consist of several active ingredients - glucosamine and chondroitin sulfate. And to obtain the desired result, as an auxiliary, it is desirable to add hyaluronic acid injections to the course of hondoprotectors.
The disadvantage of using such drugs is the duration of the course. To obtain a long lasting effect, it is necessary to inject the drug into the knee joint for half a year. Given the high cost of hondoprotectors, such treatment is considered an expensive exercise and not every patient can afford it.to table of contents ↑
How to choose the hondoprotector
The purpose of the injection is the initial stage of the disease, in which there are still small patches of cartilage in the knee that are capable of synthesizing new cells and increasing the synovial fluid in the joint bag.
Good reviews after using intraarticular injections were obtained for the following types of hondoprotectors:
- alfputop. Usually it is prescribed 1-2 mg( 1-2 ampoules) once in 3-4 days. The course of treatment is 5-6 injections;
- don. The composition of the drug includes glucosamine. Assign 1 injection to the knee joint 3 times a week. The course of treatment is 12 injections with a mandatory repeat in 4-6 months;
- chondrolon. The drug is chondroitin. The course of treatment is about 20-25 injections.
Of the above described drugs, you can not single out any and say that it is the best. Each medicine has its own particular components that have a certain effect. Therefore, when choosing a hondoprotector for the knee joint, it is mandatory to undergo a diagnosis, after which the doctor determines which drug is suitable in this case.to table of contents ↑
Especially popular preparations containing corticosteroid hormones were received for rapid removal of pain syndrome and suppression of the inflammatory process. Immediately after the first session, the patient feels relieved.
However, this drug does not contribute to the synthesis of cartilaginous tissue and does not restore blood circulation, it only removes inflammation in the affected areas. Therefore, it is usually prescribed in combination with vitamins of the group B.
Nodules in the knee with arthrosis
Last time, unfortunately, the number of people who complain of periodic or persistent severe pain in the knee, difficulty walking, limping during walking increases. These symptoms belong to a common and rather dangerous disease - arthrosis, which affects the knee joints.
The disease is characterized by the fact that under the influence of various factors( most often this is an excessive load), the gradual destruction of the cartilaginous layer of the joint lining its inner part begins. As a result, there is a friction between the bones, which causes painful pains, inflammation, the formation of bone spines and other unpleasant consequences. This ailment is dangerous because, if it is not treated, a person can completely lose the opportunity to move.
Treatment of this disease depends on the stage of its development and involves the use of medicines, physiotherapy, physiotherapy and, if necessary, surgical intervention. But the operation is always a risky, undesirable event, which is best avoided if there is such an opportunity.
Fortunately, there is such an opportunity - this is the use of intra-articular pricks with arthrosis. This non-operative treatment method, which is offered by modern medicine, is extremely effective. Its essence is that a drug is injected into the affected joint by injection, which slows down or stops the process of destruction of the cartilaginous tissue.
For the treatment of injections, several types of drugs with different prescriptions are used. The main ones are corticosteroids, chondroprotectors, hyaluronic ointment.
Hormonal preparations of a corticosteroid type: hydrocortisone, kenalog, flosteron, diprospan, celeston and others. Corticosteroids are unable to rid themselves of the disease itself, so they can not be used alone. The need to use pricks in the joint with arthrosis is caused by the fact that these drugs have a powerful anti-inflammatory, analgesic effect. They can only remove symptoms, have an auxiliary function in conjunction with the main methods of treatment.
It should be noted that corticosteroids are hormones that, despite all the effectiveness, have many side effects. They are not completely safe for the body, so they are prescribed only if non-steroidal medications and usual painkillers do not help, and this is usually the already started stage of the disease.
Periodicity and dosage of injections in the knee for arthrosis should be determined by a physician. A number of rules are required to make hormone therapy safe:
- frequency of injections no more than twice a month;
- if after the first injection there is no anti-inflammatory, analgesic effect, perhaps this drug does not suit you. The doctor will replace it with another, however, if in this case the expected effect does not occur, it can be regarded as a contraindication to hormone therapy;
- Inadequate anesthesia may indicate that the site of the injection is indicated incorrectly. Adjustment of the injection site is necessary.
The next kind of pricking with arthrosis, called chondroprotectors, is used to restore the destroyed cartilage. It is used only when symptoms of inflammation are absent. Chondroprotectors can be taken internally, but injections have undoubted advantages, as they act point-by-point and have a quick positive effect literally from the first time.
The essence of the action of this drug is that getting into the cartilage, the active substance stimulates the production of healthy cartilage cells, which replace the damaged cells with time.
The action of hyaluronic acid is analogous to the action of the synovial fluid that bathes the joint, providing a slip. Acid does not replace cartilage, but it significantly facilitates movement, helps to relieve inflammation, pain. The injections of hyaluronic acid for arthrosis of the knee joints are absolutely harmless, they are applied in 3-5 injections every 1-2 weeks once a year. This drug is used both in complex therapy and outside it.