Arthrosis of the knee joint-This is a degenerative-dystrophic disease of cartilage, which leads to exposure to bone head and affected mobility in the joints.The disease has non -burning properties and slowly develops - the transition from the beginning to the defect takes several years to decades.Osteoarthrosis of the knee joint is included in the 5 main causes of defects and defects worldwide.
Over 20% of people over the age of 55 are subject to knee arthrosis (gonartrosis), but the disease is younger - more and more of the symptoms are shown at the age of 25.
In time, the treatment of knee joint arthrosis will help prevent complications and destruction of cartilage.
Signs -The knee joint arthrosis
The articular cartilage clothing is accompanied by the characteristics of the characteristics, the intensity of the disease.Often, patients complain about:
- Morning stiffness and reduction of mobility in the joints (wake -up required);
- Pain and discomfort in the knee, which is enhanced after physical work (walking, walking or standing) and is deteriorating while resting;
- In the 2nd stage - the initial pain that occurs after a long stay in one position;
- increased fatigue, which is often eliminated to age -related changes;
- Dry lack of dry, which is often repeated when kneeling and bending;
- edema and other symptoms of inflammation that appear in stage 2 of diseases due to perioster tissue trauma;
- Metey -sensitivity, increased symptoms in winter.
When trying to bend the gonartrosis knee, sharp pain and physical obstruction occur.In later stages, even in the presence of knee joint arthrosis treatment, the patient is disturbed in the patient (to enjoy, the patient walks on the feet), the lower leg deformation in the form of "o" or "x" appears.
The hatred of the disease lies in the fact that it can occur in hidden form for years, and the first important symptoms often appear only in the 2nd stage -when complete recovery of synovial cartilage is impossible.
Therefore, it is important to consult a doctor on the first signs of discomfort in the knee -for example, weak, as if it is a pain that occurs with inadequate synovial fluid production.Remember: Knee pain is not a norm regardless of age.Timely examination and the treatment of first degree knee arthrosis can protect you from painful pain in the joints of old age.
What will happen if the knee arthrosis is not treated?
In the case of self-medication, non-compliance with a doctor's recommendation or the absence of treatment, osteoarthrosis of the knee joint lasts average 3-8 times faster than complex therapy.If gonarthrosis occurs aggressively, the patient may lose the ability to move normally before retirement age.
Especially important is the effective treatment of knee arthrosis in the severity.Raw weather, physical or emotional stress, allergies, poisoning, moving to the region with another climate - in one word, any shaking for the body can trigger it.The increase in arthrosis runs with the destruction of a large number of chondrocytes.In response to this, the body produces enzymes designed to process and remove dead cells.However, if their concentration is too high, the healthy cartilage suffering - the cell membrane becomes thinner, the focus of erosion appears on the seizure of synovial joints.This process, if not stopped by treating knee arthrosis with medication, can flow within a few weeks, and with chronic stress, lack of sleep or inadequate diet, always.
In the end, without treatment, knee osteoarthrosis leads to complete reduction in the joint lumen due to the growth of osteophytes.The gaps needed for normal movement are closed, and the patient cannot bend the legs even at 30-45 °.The difficulty of representing not only climbing the stairs, but also attempts to get up from the sofa or ordinary movement.This condition is accompanied by pain from which normal analgesics do not help.In such cases, an option for the treatment of knee joint waste arthrosis - surgery, with the replacement of articular architecture complete with prosthesis and subsequent recovery.But in this case, most patients cannot return to a completely normal life.
Treatment of osteoarthrosis of the knee joint
Depending on the level of the disease and the condition of the joint treatment, the conservative or surgery of the knee joint arthrosis is used.
The treatment of knee joint arthrosis in the first stage is always carried out by conservative methods - if successful combination of conditions and self -discipline, the patient can be obtained or persistent remission.
Treatment of knee joint arthrosis from the 2nd degree, as a rule, is built on the use of all conservative effects, but doctors may decide on small surgical intervention in the joints if the disease develops aggressively or with complications.
Treatment of 3 -degree knee joint arthrosis almost always implies surgery.
Conservative treatment of complex arthrosis of the knee joint involves the removal of pain and inflammation, cartilage recovery, and an increase in the amount of movement in the joints.For this, patients are prescribed orthopedic regime loads and rest, local systems and drugs (hormones and non -Hormonal anti -inflammation, analgesics, chondroprotectors and other).Innovative biological methods are also spreading - injection of drugs for the treatment of knee joint arthrosis directly into the articular bag.At the same time, PRP infections (blood plasma, enriched with platelets), as well as injection of stem cells obtained from the patient's fat tissue are used.Parallel, additional and recovery methods are connected - physiotherapy, massage, manual therapy, therapeutic gymnastics.
Surgical treatment of osteoarthrosis of the knee joint is performed in cases where the drugs are powerless.With this pathology, the doctor may prescribe the following interventions:
- Arthroscopy of the knee joint.The collective name for a minimum group of invasive operations aimed at eliminating articular or osteophyte fractures, or partial shell isolation.It allows you to slow down or exclude prosthetic, as well as eliminate discomfort in the early stages of the disease.It is used primarily for the treatment of knee arthrosis in patients under 60 years.
- Osteotomy.Operation to cut part of the bone and the axial correction of the weight of the knee, which allows you to slow down the degenerative change.It is usually performed in the treatment of knee joint arthrosis at the 2nd level.
- Endoprosthetics.Partial or complete replacement of the knee joint with titanium implants, which works 15-20 years.This technique is an extreme measure, as it poses a certain risk.It is recommended for patients over 55 years old.
All of these operations require a period of recovery and have several contraindications, so the best choice of prevention (training therapy, chondroprotectors) and the treatment of knee joint arthrosis in the early stages.
In addition to major therapeutic techniques, diet therapy and other methods for losing weight are used.To unload joint pain, bandages and other orthoses are used (walking sticks, orthopedic insoles, etc.).
Knee arthrosis treatment is prescribed by a rhumatologist or orthopedic.At the first reception, he penetrated the joints, performed a motor test, and then directed the patient to tomography or radiography.
Therapeutic gymnastics for knee arthrosis
Medical Physical Education for lower belt members is considered the most effective method for reducing the pain and treatment of knee joint arthrosis in the first stage.The first result of therapeutic gymnastics occurs after 2-4 weeks of continuous class.Continuity in the treatment of knee joint arthrosis is one of the major factors that affect the effectiveness of exercise therapy.Full lessons are done once a day, it is also recommended to do at least 3-4 heating during the day.
Therapeutic gymnastics for knee arthrosis during the remission period will help relieve the pain syndrome.
The main task of physical exercise in the treatment of osteoarthrosis of the knee joint is to strengthen the thighs and lower leg muscles, maintain the elasticity of the ligaments and tendons, as well as combat muscle atrophy, which is a characteristic of arthrosis.This allows you to move the load from the joint to the periarticular structure - and, thus, slow the mechanical abrasion of the cartilage, reduces inflammation.
Training for the treatment of arthrosis is done for both feet!When sharp pain arises, the lesson should be stopped or continued at a softer rate.
- Position starts - lie on your back.One foot extended on the floor, the other was raised by 90 ° (lower leg in parallel to the floor).We move with the lower leg up and down, as the amplitude of the movement in the joint allows.
- Position starts - lie on your back.We do "bike" exercises.
- Position starts - lying on the stomach.Instead, we stretched our feet, trying to bring the heel as close to the back as possible.
- The starting position is lying next to the hand, the hands are bent under the head or stretch the head along a line with the body.The other part is located next to.We made upside down.We changed the sides.
- Position starts - lie on your back.We pull the foot forward on the floor in front of the heel (from ourselves), the socks appear "to ourselves".
- Position starts - lying on the stomach.We do "boat" exercises.If physical preparation is not allowed, we place our palms on both chests and take turns -take our feet back, under pressure on the posterior surface of the thighs and lower legs.
- Position starts - lie on your back.We turned to the foot in turn, trying to describe the most complete circle socks.
- Position begins - standing against the wall.Slowly and smoothly, without looking with your back from the wall to distribute the load.When the foot is bent on the knee by 90 °, we start to move smoothly.
- The starting position stands.Often, we swing our feet forward, back and forth.
Please note: Therapeutic gymnastics after surgery on the joints have specific and its own changes depend on how many days have passed since surgery.It is prescribed by a surgeon or recovery.
Massage with knee arthrosis
Therapeutic massage for knee arthrosis is performed on both feet.Initially, at least 10-12 sessions were required for rehabilitology or equipment for hydromassa equipment, but general reinforcement massage could be easily done at home.It includes the following types of movements:
- shallow and scrubbing (up and down, software and clockwise);
- research and stretch with deeper tips of cloth;
- Tighten and knock the skin.
Massage with knee arthrosis should be done by a specialist who will not harm the diseased joints.
Self can be combined with the treatment of knee joint arthrosis with medication: it will not be excessive to apply heating ointment or balm before or during session.You can also take a warm bath before the procedure.
Important: Massage is contraindicated to patients with inflammatory symptoms (osteoarthritis or enlargement of arthrosis).In this case, therapy for acute phase is required.
Dietotherapy for arthrosis
Standard power protocol in the treatment of knee joint arthrosis requires:
- Limit products and dishes rich in carbohydrates (white bread, sugar -gula, snacks, sugar -gula, potatoes, sugar);
- to exclude processed dishes (ready for use) and rich dishes - fast food, half -finished products, sausages;
- Reject alcohol, certified coffee and fatty meat.
Instead, you should enter in the menu:
- growing dishes and cereals;
- Northern sea fat and chicken diet;
- cartilage (ear, nyushki, feet and other collagen -rich parts), cold men and jelly;
- Vegetables and fruits rich in vitamins and antioxidants (in particular, vitamins A, B12, C, E);
- Peanuts and sources of omega fatty acids and valuable minerals.
Diet with knee joint arthrosis provides a balanced diet, which helps restore cartilage tissue.
Treatment of knee joint arthrosis with medication -Vitamin -mineral complex (2 courses per year) is also recommended.
Physiotherapy for the treatment of knee osteoarthrosis
The following physiotherapeutic procedures are used for effective treatment of knee arthrosis and improves drug action:
- magnetotherapy;
- laser therapy;
- Uhf;
- ultrasound therapy;
- amplipulse;
- electrophoresis (including medicine);
- Ozokerite and paraffin applications;
- Thermotherapy (cryotherapy, inductermia);
- Phonophoresis;
- Balneological therapy (sulfuric, hydrogen sulfide bath).
Acupuncture in the treatment of 2 -degree knee arthrosis, as a rule, is not used.
Before visiting the procedure, it is necessary to consult a doctor - many types of physiotherapy are contraindicated in further aggravating the disease.
Medicines for the treatment of knee joint arthrosis
Treatment of knee joint arthrosis with medication is symptomatic and takes into account the individual reaction to the selected medication.Drug therapy - injection, ointment or tablet for the treatment of knee joint arthrosis - is usually prescribed or required.
To choose the right remedy for the treatment of knee joint arthrosis, consult a doctor who, after the study, will choose the necessary medications.
In the treatment of knee joint arthrosis, there are several directions: a reduction of patients' life, improving cartilage nutrition, cartilage regeneration, and maintaining muscle-liner apparatus norms.
Anti -anti -ssteroid drugs
To relieve NSAID tension in tablets or capsules, they take courses (about 12 days) or if necessary, depending on the intensity of the pain syndrome.Uncontrolled NSAID acceptance with the instructions or recommendations of a doctor who is full of abdominal or intestinal ulcers.They should be careful to bring them in combination with glucocorticosteroids and medicines that affect blood clotting.Additional risk factors - over 65 years old, smoking, alcohol consumption during the course.In this case, doctors usually recommend administration of drug injection by extending the gastrointestinal tract.Together with NSAIDs, it is advisable to take gastroprotectors.
The maximum effect can be achieved by a combination of systemic NSAIDs (for internal administration) and external - in the form of ointments, creams or gels.The second option gives a point effect on the affected joints and at the same time minimally affects digestion.
Corticosteroids (steroid drugs for the treatment of knee joint arthrosis)
Hormone medications (civil code) are commonly used for knee steroid restrictions in cases where NSAIDs are not sufficient to soothe pain and inflammation.
Glucocorticoids injection are considered an extreme measure in the treatment of knee joint arthrosis with medication.They provide assistance 20 minutes after administration, but hormone disruption and damage to cartilage tissue that violate administrative rules can cause.Due to side effects, many orthopedists prefer the surgery on the knee of prolonged CC therapy.
Chondroprotectors in the treatment of knee joint arthrosis
Chondroprotective agents based on extracts from core and cartilage, seafood and mollusks contribute to the recovery of synovial cartilage, and therefore cannot be converted for effective treatment of knee arthrosis.Chondroprotectors contain a large number of glycosaminoglycans - a natural polymer, from which cartilage is built.Therefore, they make condo (cartilagin cells) more stable, contributing to their growth, enriching synovial fluid.
Unlike anti -inflammatory drugs, chondroprotectors have no contraindications.They provide a cumulative and prolonged effect-the first improvement occurs after 1-3 months of admission, and the course duration is 3-6 months.
Agents
External preparations for the treatment of knee arthrosis with increasing effects locally increased blood circulation and joint nutrition, and also diverted the patient's attention from pain.For this purpose, ointments, gels, creams and balms based on natural ingredients are used - bees or snakes, burning pepper extract.
With the presence of allergic reactions (redness and skin pain, rash), during pregnancy and breastfeeding, as well as in the presence of other contraindications, it is best to prevent ointment heating for the treatment of knee joint arthrosis and limiting yourself to the external bath, application and anti -Flammatory.
Synovial liquid prosthesis
If the synovial fluid in the joints is too small, the articular surface sliding is interrupted.And most importantly, cartilage starvation begins, as the articular fluid, which only drinks it like a sponge, usually provides nutrients for growth and maintains cartilage tissue.To prevent the destruction of cells and mechanical abrasion of knee cartilage, doctors may prescribe hyaluron high molecular heavy derivative injections.Injection of drugs in the treatment of knee joint arthrosis (viscostering) is made directly into the articular bag, leading to rapid release, which lasts from 3 to 12 months at the end of the course.However, with the introduction of prosthesis, there is a risk of necrotic changes or joint infections.
Antispasmodic, analgesic, relaxant muscle
In cases where cramps and muscle tension prevent the patient from sleeping, making pain during movement, doctors prescribe antispasmodic and muscle relaxants.
Simple analgesics in the treatment of knee joint arthrosis are not used, as they cover the pain, but do not relieve inflammation.You can use it or NSAID affordable without a doctor's prescription for up to 10 days, after which the examination is required.
A form of release of drugs for the treatment of knee joint arthrosis
For the convenience of the patient, medicines for the treatment of knee joint arthrosis are released in many forms.Is there a difference between them and which to choose?
Preparations for the treatment of knee arthrosis have several forms of release: sasha, injection, ointment, tablet.Choose what works best for you.
Capsules, sasha and tablets for the treatment of knee joint arthrosis
Nonsteroidal anti -inflammation, corticosteroids, chondroprotectors and muscle relaxants are produced in the form of oral administration.In this case, they are easy for doses, acceptance is possible without the participation of a medical worker, easy to control which part of the course has been approved.When taking chondroprotectors and NSAIDs inside, they have relatively high bioavailability (especially in the form of Sasha).When taking chondroprotector in the periarticular region, more than 95% of beneficial ingredients from the drug are obtained.
The injection solution
In the form of injections, you can take the mentioned NSAID, civil code, chondroprotectors and muscle relaxants, as well as synovial fluid prostheses.The method of treating knee joint arthrosis shows maximum bioavailability.
The method of treating knee arthrosis is safe for digestion, but it is advisable that injection (intravenous, intramuscular or intraarticular) injection puts qualified medical staff.Intramuscular injection in the back or thighs can be done independently.
External use
Anti -chondroprotective and chondroprotective ointment locally, used externally to treat knee joint arthrosis.The advantage of such a drug is to direct the effect on the affected tissue.But on the active ingredient, the skin barrier is increasing - unfortunately, often only 5% of the active ingredient reaches the desired layer of tissue.
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