Osteoarthritis of the knee joint.

Osteoarthritis of the knee joint is a disease of the musculoskeletal system, which consists of the deformation and destruction of the cartilaginous tissue of the joint, thereby altering the structure and functions of the cartilage.The disease has several names: gonarthrosis, osteoarthritis deformans.The treatment of osteoarthritis of the knee joint does not have an unequivocal scheme or a single medication that can equally help all people suffering from this problem.Since osteoarthritis is a progressive disease, it is most often seen in overweight women, venous diseases, and elderly people.Treatment is carried out and prescribed individually for each patient.

Osteoarthritis of the knee joint can be unilateral or bilateral (depending on whether the disease develops in one or both legs).At the first symptoms, it is necessary to resort to appropriate treatment, since ignoring this problem can lead to the definitive destruction of the cartilage and exposure of the bone and, as a consequence, human disability.

There are three stages of the disease:

1. The initial stage of knee osteoarthritis is characterized by a loss of shock-absorbing properties and, as a result, the cartilages rub against each other when moving, causing serious discomfort to the patient.The cartilage becomes rough, deformed, dries out and in advanced stages of the disease even becomes covered with cracks.
2. Due to reduced depreciation, bone deformation begins, which leads to the formation of osteophytes (growths on the surface of bones);This is the second stage of the disease.The new joint membrane and capsule are also subject to deformation, the knee joint gradually atrophies due to the rigidity of movement.There is also a change in the density of the joint fluid (it becomes thicker, more viscous), poor circulation and deterioration in the supply of nutrients to the knee joint.The thinning of the lining between cartilaginous joints reduces the distance between the articulating bones.
3. The disease progresses rapidly and quickly goes to the third stage, when the patient practically cannot move due to constant pain in the knee.Global and irreversible changes occur in cartilage tissue that cause human disability.

Most often, osteoarthritis or gonarthrosis develops after an injury or hematoma, while a person feels severe and constant pain in the knee, which significantly hinders his movements.

Reasons for the development of osteoarthritis.

Osteoarthritis of the knee joint, the treatment of which takes a long time, can manifest itself due to the following factors:

1. Genetic predisposition.
2. Injuries: dislocations, bruises, fractures.When treating an injured knee, the joint is fixed and the person cannot bend or straighten the leg for a certain amount of time.This leads to a deterioration in blood circulation, which most often provokes the development of post-traumatic gonarthrosis.
3. Removal of the meniscus.
4. Excessive and inappropriate physical activity for the person's age, which can cause injuries or microtrauma, as well as hypothermia of the joints.For example, running on asphalt or doing squats is not recommended for older people, since during these exercises significant pressure is placed on the knee joint, which wears out with age and is not able to withstand these types of loads.
5. Overweight and obesity.This factor leads to damage to the menisci, injuries to which lead to the development of knee osteoarthritis.
6. Loose ligaments or weak ligaments.
7. Arthritis or other acquired joint diseases.The inflammatory process can cause accumulation of synovial fluid in the joint cavity or swelling.This causes the destruction of the cartilage tissue of the knee, which leads to osteoarthritis of the knee joints.
8. Metabolic disorders in the human body.An insufficient amount of calcium significantly worsens the state of bone and cartilage tissue of the human body.
9. Flat feet.An inadequate foot structure shifts the center of gravity and the load on the joint increases.
10. Stress and nervous tension.

Symptoms of knee osteoarthritis.

The clinical picture of the disease has the following symptoms:

1. Painful sensations.The pain appears suddenly, depending on the physical effort on the knee joint.Painful sensations can be of a different nature.At the initial stage, this is a weak lumbago, to which a person usually does not pay much attention.Periodic mild pain may be seen for months and sometimes years, until the disease progresses to a more aggressive stage.
2. Visible knee deformity.This symptom appears in the later stages.At first, the knee appears swollen or swollen.
3. Accumulation of joint fluid in the joint cavity or Baker's cyst.This is a dense formation on the back wall of the knee joint.
4. Cracking joints.In patients in the second and third stages of the disease, sharp crackling sounds are observed, accompanied by pain.
5. Inflammatory reactions in the articular synovial membrane, as a result of which the cartilage swells and increases in volume.
6. Joint mobility decreases.Observed in later stages.Bending the knee becomes almost impossible and is accompanied by severe pain.In the final stage, the knee may be completely immobilized.A person's movement becomes difficult or completely impossible (some patients move with bent legs).

Treatment of osteoarthritis of the knee joint.

Treatment of osteoarthritis of the knee joint must be comprehensive.To date, there is no medical drug that relieves this disorder.One of the most important conditions for successful treatment is timely diagnosis.The sooner treatment for knee osteoarthritis is started, the greater the chances of prolonging the period of remission and preventing the destruction and deformation of cartilage and bone tissue.

During treatment, the doctor and the patient face several tasks:

1. Eliminate or reduce pain;
2. Establish the supply of nutrients to the knee joint and thus increase its recovery function;
3. Activate blood circulation in the knee joint;
4. Strengthen the muscles around the joint;
5. Increase joint mobility;
6. Strive to increase the distance between the articulating bones.

Treatment of the disease, depending on the stage of its development, can be conservative and surgical.

Conservative treatment of osteoarthritis of the knee joint.

Pain relievers, anti-inflammatory medications.

To relieve or reduce pain, the patient is usually prescribed treatment with nonsteroidal anti-inflammatory drugs (NSAIDs).These can be tablets, ointments and injections.Among the most common pain relievers are the following.These medications can be used in two ways: orally or topically.

Patients usually prefer local treatment in the form of gels, ointments and hot patches.The effect of these pain relievers does not occur immediately, but after a few days (approximately 3-4 days).The maximum effect is achieved after a week of regular use of the drug.Such medications do not treat the disease as such, they only relieve pain, since it is impossible to start pain treatment.

Pain relievers should be taken strictly as prescribed by the doctor;They should only be used for severe pain, as prolonged and frequent use can cause side effects and even accelerate the destruction of articular cartilage.In addition, with prolonged use of these drugs, the risk of adverse reactions increases, including stomach ulcers, duodenal ulcers, disturbances in the normal functioning of the liver, kidneys, and allergic manifestations in the form of dermatitis are also possible.

hormones

Sometimes, in the treatment of osteoarthritis of the knee joint, treatment with hormonal drugs is prescribed.They are prescribed if NSAIDs are no longer effective and the disease begins to progress.Most often, hormonal drugs for the treatment of this disease are used in the form of injections.

The course of treatment with hormonal drugs is usually short-lived and is prescribed during a period of severe exacerbation, when inflammatory fluid accumulates in the joint.The hormone is injected into the joint about once every ten days.

Chondroprotectors

To restore and nourish cartilage tissue in the initial stages of the disease, a course of glucosamine and chondroitite sulfate, the so-called chondroprotectors, is prescribed.This is by far the most effective treatment for osteoarthritis.They have almost no contraindications and in rare cases side effects occur.

Vasodilators

To relieve spasms of small vessels, improve blood circulation and supply the knee joint with nutrients, as well as eliminate vascular pain, vasodilators are prescribed.They are crushed together with chondroprotectors.If knee osteoarthritis is not accompanied by fluid accumulation, it is also recommended to use ointments, gels and warm liquids.

therapeutic exercise

A course of exercise therapy can be very useful and give good results only when prescribed by a doctor and carried out under supervision, following the recommendations of a specialist or trainer.Self-medication is dangerous for health.Exercise therapy is used to further prevent the destruction of cartilage tissue, slow the development of stiffness, and relax muscle spasms that cause pain.During periods of exacerbation, exercise treatment is contraindicated.A competent specialist in this field must develop a course of special individual exercises, which take into account not only the stage of the disease and the state in which the cartilage is, but also the age of the patient.

Physiotherapy

Physiotherapy is used as one of the methods of conservative therapy: electrophoresis, laser therapy, acupuncture, diadynamic currents, UHF.A local massage course also gives positive results.Physiotherapeutic methods act in several directions: they relieve pain, reduce inflammation, normalize metabolism within the joint and restore its usual functions.The method and duration of physiotherapy treatment are determined by the patient's medical history and are prescribed only after a thorough diagnosis and study of the condition of the joints.

Physical therapy for pain relief includes:

1. Medium wave ultraviolet irradiation (SUV irradiation).The contact of ultraviolet light with the skin of the knee continues until slight redness appears.Substances are formed in the tissues that dull the sensitivity of the nerve fibers, which is why the analgesic effect is achieved.The duration of treatment is prescribed by the doctor depending on the symptoms, frequency and severity of the pain.On average, the course of treatment is approximately 7-8 sessions.
2. Local magnetotherapy aimed at the comprehensive recovery of the patient's body.This procedure relieves inflammation, eliminates pain and neutralizes muscle spasms.It is effectively used for osteoarthritis of the knee joint in the initial stages.The course of treatment is usually limited to 20-25 procedures, each of which lasts about half an hour.
3. Infrared laser therapy, low-intensity UHF therapy, centimeter therapy (SMV therapy).
4. Ultrasound, darsonvalization, therapeutic baths, interference therapy, which is prescribed to improve blood circulation in the joint.

Health treatment in a spa is of no small importance.This treatment is prescribed for deforming and dystrophic osteoarthritis.This treatment, like those listed above, has its contraindications, so the treating doctor carefully examines the patient's medical history before recommending the health resort method.

Surgical treatment of osteoarthritis of the knee joint.

This is a radical method of treating osteoarthritis of the knee joint, which partially or completely restores the functioning of the joint.Methods and forms of surgical intervention depend on the degree of joint damage, as well as the patient's medical history.

Late osteoarthritis of the knee joint can only be treated surgically: the knee joint is completely or partially replaced with an endoprosthesis.Surgical treatment allows not only to improve well-being, but also to restore the patient's working capacity in the later stages of knee osteoarthritis.The long recovery period with the use of physiotherapy, mechanotherapy and other means is considered by many to be a significant disadvantage of the operation.

There are several types of surgical intervention for osteoarthritis of the knee joint:

Prevention of knee arthritis.

To avoid this disease, people at risk (athletes, elderly people, overweight people, company workers) must follow certain instructions:

1. Proper nutrition and the fight against excess weight.It is necessary to exclude unhealthy foods from your diet: fatty, fried foods, alcohol, and it is better to consult a nutritionist who will help you individually choose a suitable diet.
2. When playing sports, monitor the load on your joints and reduce it if necessary.
3. Monitor your health and treat infectious diseases in a timely manner, preventing them from becoming chronic.
4. Timely and adequate treatment of spinal diseases, if any, development of correct posture.
5. Sports activities (cycling, swimming, walking, special gymnastic exercises for the joints).
6. No self-medication!At the first symptoms of knee arthritis, go to the clinic.
7. Avoid stress, sleep well.
8. Systematically increase your immunity (toughen up or at least take a vitamin treatment 2-3 times a year).
9. Avoid hypothermia of the body, especially the lower extremities.

A healthy lifestyle and timely treatment are the best ways to prevent knee arthritis.