Arthrosis of the knee joint - symptoms, treatment. Deforming arthrosis of the knee joint

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Arthrosis of the knee joint - symptoms, treatment. Deforming arthrosis of the knee joint
Arthrosis of the knee joint - symptoms, treatment. Deforming arthrosis of the knee joint
Anonim

Osteoarthritis of the knee is a slowly progressive inflammatory and degenerative disease of the joints. Most often, this ailment is observed in middle-aged and elderly people and is the most common cause of musculoskeletal pain in the area of the knee joint and disability. From this publication you will learn how to treat osteoarthritis of the knee joint.

General Description

In the knee joint, the femur and tibia are covered with articular cartilage. The second type of cartilage tissue is also located there, forming the so-called menisci, which act as layers or shock absorbers. Joint fluid adds additional protection and smoothness of movement. Osteoarthritis begins to develop if the cartilaginous tissue that protects the bones is broken and damaged, as a result of which the surface of the bones is exposed, and the joint lubrication ceases to be produced in the required amount. In this case, both complete and partial loss of cartilage can be observed. This process is often isolated to a certain area in the joint, in such cases it can be caused by trauma and chronic wear of the joint.

Arthrosis of the knee joint
Arthrosis of the knee joint

Deforming arthrosis of the knee joint is characterized by the process of destruction of its cartilaginous membranes. In the future, nearby tissues, such as ligaments and bones, may also be included in the process. Gonarthrosis, or arthrosis of the knee joint, due to the loss of cartilage is accompanied by an increase in stiffness and deformation of the joint. Bone spurs (osteophytes), which are pathological growths of bones, can sometimes even be palpated from the outside. The surfaces of the bones are deformed and no longer close and do not fit together, as in he althy joints. As a result, movement restriction increases.

At the same time, pain occurs, which is especially severe when moving after prolonged immobility, for example in the morning, and also at night, which ultimately leads to a decrease in the quality of life. Stress can also cause pain in the affected joint. An indirect sign of a pathological change in cartilage is a visible narrowing of the joint cavity between the femur and tibia on an x-ray.

Reasons

There are several reasons for arthrosis: the process of aging and cartilage wear, overweight, trauma, autoimmune diseases, in which the immune system attacks its own articular tissue, causing inflammation and its subsequent destruction. An example is rheumatoid arthritis, in which both joints are affected at the same time and disability develops. Some experts combine such concepts as arthritis and arthrosis of the knee joint, the symptoms of these ailments are similar and often caused by the same cause.

Decreased blood supply to the femoral head can also cause cartilage deformation, in which case they speak of aseptic necrosis. Inadequate formation of the knee joint in early childhood can lead to displacement of the mechanical axis and degeneration of the knee joint. Post-traumatic arthrosis is secondary and develops as a result of damage to the meniscus, anterior or posterior cruciate ligament.

Symptoms

There are three degrees of arthrosis of the knee joint, each of which has its own signs. At the first stage, mild pain, discomfort in the sore spot and occasional swelling are noted. The second degree is accompanied by an increase in symptoms, the appearance of a crunch and limited mobility. When painful sensations practically do not leave a person, and the cartilage tissue is thoroughly destroyed, the disease turns into arthrosis of the knee joint of the 3rd degree.

deforming arthrosis of the knee joint
deforming arthrosis of the knee joint

Osteoarthritis pain can come on suddenly, but it usually develops slowly. A person may notice pain in the morning after getting out of bed. Knees can hurt when walking up the stairs, or when you have to kneel, and often the pain occurs just while walking. For weather-sensitive people, weather changes can also cause joint pain.

Puffiness is a consequence of inflammation, which periodically increases with arthrosis. Swelling can also be associated with the formation of a bone spur or the accumulation of excess fluid in the knee. They may be more pronounced after a long period of inactivity, such as in the morning or after sitting at a desk for a long time. The skin may become reddish and hot when touched. If chronic joint inflammation occurs, relief of pain and swelling is usually achieved by taking anti-inflammatory drugs.

Stability develops over time due to weakening of the muscles and instability of the entire system. From time to time, situations arise when a person is simply not able to bend or fully straighten the leg at the knee. This symptom usually accompanies arthrosis of the knee joint of the 2nd degree. The crunch is felt when moving because the cartilaginous surface has lost its original smoothness and the necessary amount of synovial lubrication. In advanced stages, the creaking sound may be caused by bone spurs rubbing against each other as you move.

How to treat osteoarthritis of the knee
How to treat osteoarthritis of the knee

Limited range of motion may be noticed when climbing stairs or during exercise. Many have to use a walker or cane to get around. Deformity of the knee joint is perhaps the most terrible symptom of arthrosis, since it indicates irreversible changes in the joint, turning a person into an invalid. The knees can be facing each other inward as well as outward. Knee deformity ranges from subtle to significant.

Diagnosis

Determining osteoarthritis of the knee begins with a physical examination by the doctor, taking a medical history and talking with the patient. Be sure to get your doctor's attention on what causes pain most often, and tell about cases of illness in the family, if any.

Additional diagnostics is carried out using:

  • radiography, which can show bone spurs and cartilage changes;
  • magnetic resonance imaging;
  • blood tests detect autoimmune disorders.
  • Degrees of arthrosis of the knee joint
    Degrees of arthrosis of the knee joint

How to treat arthrosis of the knee joint, what drugs are needed for this? Look for answers to these questions below.

Principles of treatment

Standard treatment of such an ailment as arthrosis of the knee joint is aimed primarily at eliminating pain and removing functional limitations. It is worth knowing that painkillers only relieve symptoms, but are not able to affect the course of the disease and restore damaged cartilage. Narcotic analgesics, non-steroidal anti-inflammatory drugs, slow-acting gold preparations, corticosteroids, methotrexate, etc. are used for treatment.

In addition, surgery may be needed, as well as exercise therapy and physiotherapy. Gymnastics for arthrosis of the knee significantly helps in the treatment, the exercises are selected by the attending physician. Despite the fact that modern pharmacology is actively researching and developing the most effective and at the same time safe drugs for the treatment of arthrosis, most drugs still have their side effects and, with prolonged use, disrupt the normal functioning of systems and organs.

Gymnastics for osteoarthritis of the knee joint
Gymnastics for osteoarthritis of the knee joint

Treatment with drugs

Drug therapy for osteoarthritis of the knee has three main areas:

  • the use of non-steroidal anti-inflammatory drugs, which are needed in order to relieve pain and reduce the intensity of the inflammatory process in the tissues;
  • taking medications to restore cartilage, which include chondroprotectors: glucosamine and chondroitin;
  • use of creams and ointments in the complex therapy of deforming arthrosis.

In combination with physical therapy, manual therapy, taking medications can slow down the process of destruction of articular cartilage, accelerate the regeneration of cartilage tissue and restore the normal functioning of the limb.

The main goal of drug treatment is to eliminate pain, improve cartilage nutrition, activate recovery processes, increase joint mobility and normalize blood circulation in the knee.

Non-steroid drugs

The most common for the treatment of arthrosis are non-steroidal anti-inflammatory drugs such as Diclofenac, Indomethacin, Piroxicam, Ketoprofen and others. They are used to relieve pain and reduce inflammation, but long-term treatment with these drugs is not recommended because drugs in this group have undesirable side effects, including negative effects on the lining of the stomach and intestines, effects on the kidneys, liver and cardiovascular system. However, each drug has its own characteristics. And recently, drugs with minimal risk to the he alth of the patient began to be developed.

In addition, despite the need to use these drugs, some studies have shown that NSAIDs can lead to a decrease in the production of proteoglycans, thereby dehydrating cartilage tissue, so these drugs should be taken strictly according to a doctor's prescription and under his control. The frequency of side effects of NSAIDs increases with their long-term use, which is a necessity for many patients with arthrosis. Experts recommend choosing selective anti-inflammatory drugs for long-term use, which have fewer side effects and do not adversely affect cartilage metabolism.

From modern NSAIDs, one can name Celebrex, Nimesulide, Naproxen, Meloxicam. Most non-steroidal anti-inflammatory drugs are available in various forms: in the form of capsules or tablets, as a solution for injections and ointments or gels for topical external use.

Arthrosis of the knee joint symptoms
Arthrosis of the knee joint symptoms

Means for cartilage repair

To nourish and regenerate cartilage, its tissues need a constant supply of compounds such as chondroprotectors - glucosamine and chondroitin. These are the most useful substances for people suffering from osteoarthritis of the knee joint. Their reception should be carried out for a very long time, from six months or more, only in this case you can count on a positive therapeutic effect. Chondroprotectors improve the quality and quantity of synovial fluid, unlike NSAIDs, they increase the synthesis of proteoglycans and promote the regeneration of the cartilage plate. However, due to such beneficial properties of these compounds, they should not be considered as the main treatment for arthrosis. Deforming arthrosis of the knee joint requires the use of chondroitin and glucosamine preparations for at least 1.5 years. It is also taken into account that they are not able to restore completely destroyed cartilage.

Ointments and creams

Treatment of a disease such as arthrosis of the knee joint should include the local use of gels and ointments. These forms of drugs should not be relied upon as the only treatment option, their use should be considered as a necessary addition to taking NSAIDs and chondroprotectors. Such drugs significantly reduce discomfort, pain, swelling, improve joint mobility.

This effect is explained by the fact that penetrating into the blood through the skin, ointments and creams improve blood circulation in the joint, accelerate the metabolism in the cartilage and, accordingly, its regeneration. Among these funds, ointments "Indomethacin", "Voltaren", "Fastum-gel" and others can be distinguished.

Compresses

Applications for osteoarthritis have a greater effect than applying ointments. For therapeutic compresses, Dimexide is often prescribed, which has a good anti-inflammatory and analgesic effect, penetrates well into tissues. Bischofite is also effective, accelerating metabolic processes in cartilage.

Injections

Within the knee joint, the synovial fluid is very viscous, which ensures that there is no tissue friction. An important component of this lubricant is hyaluronic acid, which binds proteoglycans to stabilize the structure of cartilage tissue. In patients with arthrosis, the level of this compound in the synovial fluid is significantly reduced, as a result of which the latter becomes less viscous, friction increases.

Hyaluronic acid-based injections into the knee can slow the progression of osteoarthritis, but only half of people with this diagnosis receive symptomatic relief. The course of injections is usually three weeks, with one injection every seven days. After six months, the procedure is recommended to be repeated.

Folk remedies

Osteoarthritis of the knee provides an integrated approach to treatment, and traditional medicine recipes act as an additional therapy. Noteworthy are such remedies as a decoction of onion peel, an infusion of dandelion leaves, a mixture of aloe, vodka and honey in equal volumes, night compresses of s alt with honey, and many others. It is also recommended to eat more aspic and jelly.

Folk remedies for arthrosis of the knee joint
Folk remedies for arthrosis of the knee joint

Joint Replacement

If all the above methods of treatment did not bring results, then an operation to replace the joint with an endoprosthesis is indicated. The main goal of the operation is to restore the natural mechanical axis of the leg and completely relieve pain and discomfort. In this case, either part of the joint or the entire joint can be replaced. The continuous improvement of surgical equipment and the quality of implants has made this procedure quite successful and common.

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