Deforming osteoarthrosis of the Knee Joints (Aka gonartrosis or abbreviated doa) is a degeneratibic-Dostropic Disease of the County, which is Characterized by a chronicTo All Structural Elements (Hyalin Cartilage, Periastal Bone Structures, A Synovial Shell, A Capsule and A Joint of Joint) and Leads Articular Deformation, Reduction of Movements and Value.
The disease begins with changes in the articular cartilage, which causes the joint surfaces of the bones.The interruption and loss of elasticity lead to its dystrophy (thinning) and absorption, while the bone tissue of the joint surfaces is exposed, the sliding is disturbed, the gap of the joints narrows, the joint biomechanics changes.The synovial sheath lining the joint and produces synovial fluid is irritated (which nourishes the cartilage and plays the role of physiological lubrication), which leads to an increase in its amount in the joint (synovitis).Against the background of narrowing of the joints of the joints, the volume of the joint decreases, the synovial fluid protrudes from the back wall of the joint capsule, the Becker cyst (which, reaching large sizes, can cause pain in the poplial fuss).The thin and delicate tissue of the joint capsule is replaced by rough connective tissue, the shape of the joint changes.The periodsurpine bone tissue develops, osteophytes (pathological bone growths) are formed.The blood circulation in the periarticular tissues is impaired and underestimates metabolic products that irritate chemoreceptors, develops a constant pain syndrome.Against the background of a change in the anatomy of the joint, a violation of the work of the surrounding muscles, hypotrophy and spasm occurs, the gait is disturbed.It is possible to limit the volume of movement in the joint (contracture), sometimes so pronounced that only swinging movements (hardness) or complete absence of movements (ankylosis) are possible.
Gonarthrosis is a very common disease: they suffer from 10% of the total population of the planet, and at the age of 60 this affects every third party.
The causes of gonarthrosis
- Bone and joint injuries.
- Inflammatory joint diseases (rheumatoid, chlamydia arthritis, gout).
- Disruption of mineral metabolism with various endocrinopathies (diabetes mellitus, parathyroid disease, hemochromatosis).
- Muscle and neuropathy diseases (Sharko disease).
In addition to the main causes, adverse backgrounds for the development of gonarthrosis, which include:
- overweight (literally puts pressure on the lower limbs);
- age (the disease is mainly subjected to the elderly);
- female (according to statistics in a woman, they become more ill);
- Increased sports and professional physical efforts.
Symptoms of osteoarthrosis of the knee joints
- The pain that increases when walking and weight loss.
- Difficulty of familiar, physiological movements in the joints.
- Characteristic "crunch" in the joints.
- Increasing the joints in the amount and their visible deformity.
Stages of gonarthrosis
Clinical stages of knee arthrosis joint
The disease goes through several stages.
- In the first stage one feels onlyA little feeling of discomfortor "weight" in the knee, which is worried while walking with long distances or increases physical exertion.The radiological examination will be uninformative: it is possible to identify only a little narrowing of the gap of the joints, there will be no other changes.
- The second stage is characteristicTangible pain, the weight of which is reduced at rest.There is difficulty in the joints in the joints when you walk, there is a characteristic "creaking" (you can hear a conventional phrase in everyday life - "knees creak").When conducting radiography, a clearly distinguished narrowing of the joint gap and single osteophytes is detected.
- When the transition of gonarthrosis to the next, third stage,The pain will bother the patient constantlyIncluding at rest, there is a violation of the joint configuration, ie.The deformity is increased due to edema during the binding of inflammation.Radiographs determine the narrowing of the joint gap with a moderate degree and multiple osteophytes.In the third stage, many are already applying for medical attention, as the quality of life suffers significantly due to pain and difficulty in normal walking.
- The fourth stage is accompanied bySurrounding, exhausting painSThe minimum relocation attempts become a difficult test for people, the deformation of the joints is visually noticeable, walking is extremely difficult.X -ray reveals significant changes: the joint gap of the photos is practically not defined, many coarse osteophytes, "joint mice" (fragments of the destructive bone that fall into the joint cavity) have been found.This stage of gonarthrosis almost always leads to damage.
Who cures knee arthrosis?
The therapist, the rheumatologist and the GP (family doctor) may provide qualified medical assistance for gonarthrosis (family doctor), but these experts treat the knee joint with uncomplicated arthrosis.When the synovitis or the treatment prescribed by the therapist does not give the right effect, you cannot do without the help of an orthopedist.In situations where surgical care is required, the patient is sent to a specialized orthopedic-traumatological department.
How and what to treat knee arthrosis?
The methods for treating arthrosis of the knee joint, known these days, are divided into conservative, medicines that are not conservative and surgical.
Methods without medicine
Many patients wonder: "How to cure knee arthrosis without pills?"In response, it is regrettable to claim that gonarthrosis is a chronic disease, it is impossible to eliminate forever.However, many methods existing today can significantly slow down his progression and improve the quality of the patient, especially when used in the early stages of the disease.
With the timely search for a doctor and sufficient motivation of the patient for healing, it is sometimes sufficient to remove the negative factors.For example, it has been proven thatreduce overweightReduces the manifestation of the main symptoms of the disease.
Excluding pathological physical activity and on the contrary,Classes of therapeutic gymnasticsWith the use of rational physical programs, they reduce the intensity of pain.Exercises have been shown to strengthen the strength of the quadrilateral muscle of the hip joint are comparable to anti -inflammatory drugs.
If we treat arthrosis of the knee joint then we must strive forProper nutrition: to Improve the Elastic Properties of Articular Cartilage Will Help Products Containing A LARGE AMOUNT OF ANIMAL Collagen (DIETARY VERIETIES OF MEAT and FISH) and Chondroitin (SHRIMP, CRABCollagen and Antioxidants, Fresh Vegetables and Fruits, and Passion for Smoked Meenas, Conservatives, Sweet and Perechen Dishes, Sweet and PaVed Dishes, Sight and Pave DishesObesity is potentiated.
The complex treatment of knee arthrosis also involves the appointment of very effective even in advanced forms of the diseaseProcessSWith widespread use in different categories of patients suffering from this disease, it has proven its effectivenessMagnetotherapy: After several procedures, the intensity of pain decreases as a result of improving blood circulation, reducing swelling and eliminating muscle spasm increases the mobility of the joint.The effect of magnetotherapy is particularly bright during the development of active inflammation in the joint: the severity of the edema is significantly reduced, the phenomena of the regression of synovitis.Not so popular but less effective in treating knee joint with arthrosis are such methods of physiotherapy asLaser therapy and cryotherapy(Cold exposure) having a pronounced painkiller effect.
Medication
In the effective treatment of arthrosis of the knee joint, the drugs are used below.
Non -steroidal anti -inflammatory drugsMade in the forms for external (different gels, ointments) and systemic use (tablets, candles, solutions), have long proven their effectiveness in the treatment of osteoarthrosis and are widely prescribed by doctors.By blocking inflammation at the enzyme level, they eliminate joint pain and swelling, slow down the progression of the disease.It should be remembered that prolonged systemic technique can cause the development and exacerbation of ulcer processes in the gastrointestinal tract, and also adversely affects the functions of the kidneys and liver.Therefore, patients taking the drug for a long time should also prescribe medicines that protect the gastric mucosa and regularly monitor the laboratory indicators for the functioning of the internal organs.
Glucocorticosteroids (GK)- Hormonal drugs with a pronounced anti -inflammatory effect.As a powerful anti -inflammatory agent, GC has certain contraindications as they are able to call a number of significant side effects.In the systemic forms of gonarthrosis, they are practically not prescribed.As a rule, the effective treatment of arthrosis involves GC injections into perhaven pain points, which increases the intensity of the fight against inflammation and minimizes the risk of unwanted side effects of the drug.With one introduction of the GCS, the effect of its use lasts up to 1 month.In accordance with national recommendations for the treatment of osteoarthritis, you should not perform more than three injections of the medicine a year in the same joint.
With distant osteoarthritis, when a person experiences intolerable pains that do not even go away at rest, disturbing normal sleep, the recipe is possibleopioid painkillersSThese medicines are used only as prescribed by the doctor, who considers the feasibility of their appointment in any case.
Chondroprotectors(With literal translation - "cartilage protection").This name is understood as different drugs united by one property - a structural -modifying effect, ie.The ability to slow down degenerative changes in cartilage and narrow the gap of joints.They are produced in forms both for oral administration (glucosamine, chondroitin sulfate, piastalin), and for introduction into the joint cavity (hyalurons).Of course, these drugs do not do a miracle and do not "grow" a new cartilage, but they can stop its destruction.In order to have a constant effect, they must be used for a long time, regular courses several times a year.
Surgical treatment of knee arthrosis joint
The most popular type of surgical care for gonarthrosis isEndoprothetics, ieRemoving your own joint by simultaneously installing the metaloprosthesis that replaces it, the design of which is similar to the anatomy of the knee joint of a person.At the same time, a prerequisite for this type of surgical treatment is: the lack of rough deformities of the charter, forms "false joints", muscle contracts and pronounced muscular atrophy.In severe osteoporosis (a significant reduction in bone mineral density), endoprothetics also do not show: "sugar" bone will not withstand the introduction of metal pins and a rapid tissue may occur at the site of installation, the bone may occur, the rapid renewal (resorption) may occur.Therefore, the timely solution to the question of the need to install an endoprosthesis is so significant - it should be accepted when the age and general condition of the human body still allow you to perform surgery.
Despite the widespread spread of knee joint endoprothetics, the results of such operations are often unsatisfactory and the percentage of complications is high.This is due to the design characteristics of the endoprosthesis and the complexity of the surgical intervention itself (the replacement of the hip joint is much easier technically).
Arthromedulary maneuver- bone canal bone marrow of the femur to the cavity of the knee joint with the help of a shunt - a hollow metal tube.Therefore, the fat bone marrow from the lower third of the femur enters the knee joint, nourishing the cartilage and lubricates it, which achieves a significant reduction in pain.
Summarizing the above, I would like to point out that the treatment of gonarthrosis is a complex social task.And although medicine is not able to offer a medicine today that eliminates it forever or other ways to completely cure this disease, a healthy lifestyle, timely seeking medical attention and the implementation of the doctor's recommendations can stop its development.