Reducing osteoarthrosis of the knee joint (aka gonartrosis or impression of prayer) is a degenerative-dystrophic disease of the knee joint, characterized by a progressive course of chronic, damage to all elements of Caps.and often defective.
The disease begins with changes in the articular cartilage, where the surface of the bone occurs.Disruption and loss of elasticity leads to dysfunction (thinning) and absorption, while the articular surface bone tissue is exposed, sliding, narrow joint gaps, joint biomechanical changes.Synovial shells that cover the joints and produce synovial fluid are irritated (which nourish the cartilage and play a role in physiological lubrication), leading to an increase in the number of joints (synovitis).Against the background of the joint gap, the number of joints decreases, the synovial fluid attaches to the posterior wall of the articular capsule, the becker cyst formed (which, achieving a large size, can cause pain in the popliteal fossa).The thin and fine fabric of the articular capsule is replaced by coarse connective tissue, the form of joint change.Periosurpital bone tissue develops, osteophytes (pathological bone growth) are formed.The circulation of blood in the periatic tissue is disrupted, and the low -metabolic product, which irritates chemoreceptors, develops persistent pain syndrome.Against the background of changes in joint anatomy, there is a violation of muscle work -around the surrounding, hypotrophy and cramps appear, gait is disrupted.There are continuous restrictions on the amount of movement in the joint (contraction), sometimes it is said that only the shaking (rigidity) movement, or the absence of complete movement (ankylosis).
Gonarthrosis is a relatively common disease: they have 10% of the population of the planet, and at the age of 60 they affect each third.
The cause of gonarthrosis
- Bone and joint injuries.
- Inflammatory disease (rheumatoid, chlamydia arthritis, gout).
- Violation of mineral metabolism with various endocrinopathy (diabetes mellitus, parathyroid disease, hemochromatosis).
- Muscle and neuropathy (Charcot disease).
In addition to the main causes, poor background factors about gonarthrosis development are also distinguished, including:
- overweight (literally puts pressure on lower limbs);
- age (this disease is mainly subject to parents);
- gender of women (according to statistics in a woman, they are more often sick);
- Improvement of professional sports and physical energy.
Symptoms of osteoarthrosis of the knee joint
- Increased pain when walking and weak only.
- Difficulty in physiological movement in the joints.
- The "crisis" feature in the joints.
- Increased joints in volume and visible deformation.
Stage of gonartrosis
Clinical stage of the knee joint arthrosis
The disease goes through several stages.
- In the first stage, one just feelsFeeling uncomfortableor "severity" in the knees that are disturbing during long walks or increased physical energy.Radiological examinations will be unknown: it is possible to identify only a small narrowing of the joint gap, there will be no other changes.
- The second stage is a featureA real pain, the severity is reduced at rest.There are difficulties in the joints in the joints, while walking, the "Creak" features are heard (from your patients can hear conventional phrases in everyday life - "knee knees").When performing radiography, clear narrowing distinguishes a joint gap and a single osteophytes are found.
- When the transition of gonarthrosis to the third stage,Pain will constantly harass the patientIncluding rest, there is a violation of joint configuration, which is a growing deformation due to edema during the inflammatory connection.Radiography determines the narrowing of the gap along with a moderate level and a variety of osteophytes.In the third stage, many are already seeking medical help, as the quality of life suffers significantly due to the pain and difficulty walking.
- The fourth stage is accompaniedAround, the pain is exhausting.The minimum attempt to move into a difficult test for humans, the deformation of the joints is significant, walking very difficult.X -Ray reveals significant changes: joint gaps in images cannot be determined, a variety of coarse osteophytes, "articular mice" (damaging bone fragments that fall into the joint cavity) are detected.This level of gonarthrosis almost always involves defects.
Who treats knee joint arthrosis?
Therapists, rheumatologists and general practitioners (family doctors) can provide qualified medical treatment for gonarthrosis (family doctor), but these experts treat knee joints with uncomplicated arthrosis.When synovitis occurs or the treatment prescribed by the therapist does not have the right effect, you cannot do without the help of orthopedis.In situations where surgical care is required, the patient is sent to the specialty-traumatology department.
How and what to treat with knee joint arthrosis?
The method of treating knee joint arthrosis, known today, is divided into conservatives, drugs and surgery that are not submerged.
Non -Drug methods
Many patients are wondering: "How to cure knee joint arthrosis without pills?"The answer is that with regret it is important to state that gonartrosis is a chronic disease, it is impossible to eliminate it forever.However, many of the methods available today can slowly slow down their development and improve the quality of the patient, especially when used in the early stages of the disease.
Timely looking for a doctor, and the patient's adequate motivation for healing, sometimes enough to eliminate negative factors.For example, it is proven thatoverweight weight lossReduces manifestations of the main symptoms of the disease.
The exception of the physical work of the pathology and vice versa,Therapeutic gymnastics classesBy using rational physical programs, they reduce the intensity of pain.It has been proven that exercises to strengthen the strength of the four hip muscles that can be compared to anti -anti -medication.
If we treat knee joint arthrosis, then we must tryproper nutrition: To improve the properties of elastic articular cartilage will help products containing large amounts of animal collagen (type of diet and diet) and chondroitin (shrimp, crab, crab), collagen saturation and antioxidants, and fresh fruits, dishes instead, infringement of metabolic processes in the body and excess weight gain.
The complex treatment of the knee joint arthrosis also involves very effective appointment even with a sophisticated form of diseasePhysots -Prosed Procedure.With widespread use in various categories of patients suffering from the disease, it has proven its effectivenessMagnetotherapy: After several procedures, the intensity of the pain decreases, due to increased blood circulation, reducing edema and eliminating muscle cramps increases joint mobility.The effects of magnetotherapy are very clear during the development of active inflammation in the joints: the severity of edema is significantly reduced, the phenomenon of regress synovitis.Not so popular, but not less effective in treating knee joints with arthrosis is a physiotherapy method such asLaser and cryotherapy therapy(Cold exposure), has a clear effect of painkillers.
Drug
In an effective treatment scheme for knee joint arthrosis, the medication below is used.
Anti -anti -ssteroid drugsProduced in the form of external (various gels, ointments) and systemic use (tablets, candles, solutions), has long been proving its effectiveness in the treatment of osteoarthrosis and is widely prescribed by a doctor.Blocking inflammation at enzimatic levels, they eliminate joint pain and swelling, slow down the development of the disease.Keep in mind that prolonged systemic techniques can cause the development and hunting of ulcerative processes in the gastrointestinal tract, and also negatively affect kidney and liver function.Therefore, the patient, taking medication for a long time, should also prescribe medications that protect the gastric mucosa and regularly monitor the internal organ work.
Glucocorticosteroids (GKS)- Hormone medication with a clear anti -inflammatory effect.As a strong anti -inflammatory agent, GC has certain contraindications, as they can call some significant side effects.In the form of a system for gonarthrosis, they are practically not prescribed.As a rule, effective treatment of arthrosis involves GC injection into the disease point of the peri -human, which increases the intensity of the struggle against inflammation and minimizes the risk of unwanted side effects.With one GCS introduction, the effect of its use lasts up to 1 month.In line with the national proposal for the treatment of osteoarthritis, you cannot do more than three drug injections annually in the same joint.
With osteoarthritis "ignored", when a person suffers from an unbearable pain that is not resting at rest, breaking normal sleep, prescription may beOpioid painkillers.These drugs are only used according to the prescription of the doctor, which consider the possibility of their appointment in each case.
Chondroprotectors(With a literal translation - "protect the cartilage").The name is understood as a variety of drugs consolidated by one property - the effect of structural modification, the ability to slow down degenerative changes in cartilage and narrowing of joint gaps.They are produced in both forms for oral administration (glucosamine, chondroitin sulfate, piaastaline), and for introduction to the joint cavity (hyaluronates).Of course, these medicines do not do wonders and do not "grow" new cartilage, but they can suspend their destruction.To achieve a continuous effect, they must be used for a long time, regular courses several times a year.
Surgical treatment of knee joint arthrosis
The most popular type of surgical care for gonarthrosis isEndoprosthetics, that is, eliminating your own joints with simultaneous installation of metalloprosthesis replacing it, the same design as the anatomy of one's knee joint.At the same time, the prerequisites for this type of surgical treatment are: the absence of rough deformation of the charter, forming "false joints", muscle contraction and spoken muscle atrophy.With severe osteoporosis (a significant decrease in bone mineral density), endoprosthetics also does not indicate: "sugar" bones will not withstand the introduction of metal pins, and at the installation area, quick renewal (resorption) of bone tissue will begin, pathological fractures may occur.Therefore, timely solutions to the issue of the need to install endoprosthesis are very important - it should be accepted when the age and general state of the human body still allow you to perform surgery.
Despite the widespread endoprosthetics of the knee joint, such operations are often unsatisfactory, and the percentage of complications is high.This is due to the features of endoprostheses design and the complexity of the surgical intervention (replacing the hip joint easier in technical terms).
Artromedullary shunting- The connection of the femur bone marrow with the knee joint cavity using a shunt - a hollow metal tube.As a result, the fat bone marrow from the third lower than the knee joint, nourishing cartilage and lubricant, which achieved a significant decrease in pain.
In conclusion above, I would like to note that gonarthrosis treatment is a complex social task.And although today the medicine cannot offer the remedy that eliminates it, or other ways to cure the disease, a healthy lifestyle, seek timely medical help and the implementation of a doctor's recommendation can suspend its development.