Once they learn to walk, we begin to perceive this ability as something ordinary. However, diseases of the musculoskeletal system force us to reconsider the attitude to physical activity, and sometimes to make a tremendous effort to restore it. Most often the object of treatment becomes the knee.
How to maintain mobility for years to come and what to do if physical activity has decreased due to osteoarthritis of the knee? Let us understand in order.
Causes of knee joint osteoarthrosis
Osteoarthritis of the knee, or gonarthrosis, — pathology of degenerative nature that affects and distorts all structures of the joint, ultimately leading to the loss of his mobility. Osteoarthritis suffers 15-30% of the world's population, but despite the development of medicine, the statistics are not improving. Knee osteoarthritis is a disease of excess weight, heredity, age and lifestyle. Sick they mostly elderly people, especially obese women over 40 years old. The disease provokes an excessive load on the knees. After 65 years, when the knee cartilage is badly worn, including due to hormonal changes, osteoarthritis in varying degrees is observed in 65-85% of people. Possible birth defects of the knee joint, leading to disease at an early age, for example, failure of intra-articular lubricant. Any traumatic impact to the knee, including surgery, increase the risk of gonarthrosis. The risk group also includes people employed monotonous physical labor, and athletes.
Symptoms of deforming arthrosis of the knee joint
The disease develops slowly and can take a little discomfort over the years. In the beginning, arthritis is not accompanied by painful sensations, but going to a more "Mature" stage, produces increasing pain and limitation of movement in the joint. Sore knee is gradually beginning to change shape, increases in size, the leg can be pulled into an unnatural bend to the left or right.It becomes difficult to perform even basic movements associated with walking, changing body position from vertical to horizontal and back to get in and out. If untreated, knee arthritis leads to disability.
Not to be confused with the arthritis and osteoarthritis are different diseases, although the arthritis may be accompanied by arthritis and even help to identify at an early stage. Arthritis is an inflammation of the joint, as a rule, acute, and osteoarthritis — slow the depletion and destruction of cartilage and bone occurring in the chronic form.
The stage of the disease
There are three degrees of severity of osteoarthritis of the knee. The earlier the disease is detected, the easier it will be to treat.
- 1 degree. The clinical picture of this period rarely causes patients to seek medical attention. They feel a little discomfort in the knee after a long walk, get tired quickly. The pain may occur only after high physical exertion (e.g. after work on the summer cottage) or at the maximum flexion-extension of the knee. However, if an x-ray will show a slight narrowing of the joint space and the first appearance of osteophytes — bony outgrowths within a joint. The problem is usually detected accidentally, when the professional examinations or other examinations, could be fairly quickly resolved using conservative treatment.
- 2 the degree. Appear more pronounced signs of pathology, which are difficult to ignore. Knee pain is felt constantly, particularly in the morning and evening, even at rest, it completely fails. Gait slowing of motion in the knee is difficult and accompanied by a characteristic dull crunch. Possible complication falling of a piece of cartilage or bone fragment in the joint cavity, which increases the pain and inhibit mobility. This is called a "joint mouse". Probing of the knee causes pain, deformity of the joint becomes visible. Can join inflammation, then swelling of the knee. X-ray shows a severely narrowed joint space, overgrowth of osteophytes, deformation and thickening of the bone. Requires complex therapy, sometimes surgical intervention is necessary.
- 3 degree. Advanced stage of the disease, persistent disability. Knee pain is constant, strong, walking, and especially overcoming stairs is excruciating. In all movements of the legs the knee makes a loud crunching sound. The joint is severely deformed and enlarged due to the accumulation of fluid, practically immobilized. On the x-ray shows destruction of the ligaments and menisci, abrasion of cartilage, proliferation of connective tissue. The joint space may partially coalesce. The problem can be solved only by the replacement of the affected artificial joint (endoprosthesis).
Most often, patients seek help at the second degree of osteoarthritis, some closer to the third. This is especially true for elderly people, accustomed to certain ailments, considering the events of the age-cost and apt haphazard people use means.
How to treat arthrosis deformans of the knee joint
Therapy must be comprehensive and consistent, compliance with all recommendations of the doctor. First, any ointment, at the time of relieving the pain, here, in principle, to help not. The treatment regimen selected individually, depending on the clinical picture and the set of methods available in a specific medical facility. It is better if it is a specialized orthopedic clinic, or a modern medical center with experienced orthopedic surgeons.
Methods of conservative treatment of gonarthrosis
Conservative treatment of arthrosis of the knee joint is reduced to two main components: medication and physiotherapy. Be sure to Supplement their diet, physiotherapy and orthopaedic support.
Drugs for the treatment of osteoarthritis of the knee
Medications are used to relieve inflammation, pain and swelling, and normalize the metabolism and activation of regenerative processes. Used non-steroidal anti-inflammatory drugs (NSAIDs) in the form of ointments, pills and injections (diclofenac, piroxicam, nimesulide), injection of corticosteroids, anesthetic blockade of the joint Supplement in pill form. Injections are made directly into the joint.
A huge variety of methods reflects the importance of modern medicine for knee joint pathologies and complications of their treatment.
- UHT. The most progressive method of non-invasive treatment of diseases of the musculoskeletal system. Shock wave therapy promotes the resorption of fibrous tissue and removal of salt deposits, reduces inflammation, improves blood flow, increases elasticity of ligaments. The procedure is almost painless, reminiscent of hardware massage lasts for 10-40 minutes. For gonarthrosis necessary course of 4-10 treatments depending on the severity of the disease. The shock-acoustic waves is carried out locally, using a compact emitter.
- Plasma therapy (PRP joint).This is an injection into the joint's own patient's own plasma, rich in platelets. Effectively reduce inflammation, stimulate the regeneration of joint cartilage. The course consists of 4-6 treatments 1-2 times a week.
- Myostimulation. The impact of electric pulses allows to relieve spasms and prevent muscle atrophy around the affected joint. Promotes recovery of motor activity and reduced pain.
- Phonophoresis. Physiotherapy method that uses the properties of ultrasound and medicinal ointments. With osteoarthritis of the knee is performed, for example, hydrocortisone, providing pronounced anti-inflammatory and analgesic effect. Ultrasound contributes to better permeability of the skin and rapid absorption of drugs.
- The ozone therapy. Ozone provides anti-inflammatory and analgesic effect. This kind of therapy usually prescribed for contraindications to the medication.
- Massage (including lymphatic drainage) and manual therapy. Massage course of 5-10 sessions is prescribed in the absence of inflammatory processes. Useful lymphatic drainage that prevents the accumulation of fluid in the joint. Manual therapy combines stroking and rubbing with the movements of the joint. Most effective after a session of physiotherapy.
- Hydrogen sulfide, radon and turpentine baths. Possess analgesic and anti-inflammatory effect, positive impact on musculoskeletal system in General. Hydrogen sulfide and radon baths are part of Spa treatment, coffee can be arranged at home by the doctor.
- Hirudotherapy. Medical leeches are raised around the damaged joint, relieve swelling and has analgesic effects. Their saliva contains bioactive substances that stimulate the regeneration of tissues. The effectiveness of treatment can be assessed after three treatments. Treatment with leeches effectively at the initial stage of osteoarthritis, the effect lasts up to one year.
- LFK. Therapeutic exercise needed to prevent muscle atrophy and immobility in the joint. The first exercise done in the morning, often in bed. Next, you should perform a small set of exercises 3-4 times a day. Useful swimming.
- Acupuncture. If joints are not yet deformed, acupuncture may restore his mobility by relieving swelling and pain.
- Mechanic. Exercises with the use of simulators that allow you to develop joints effectively, but without excessive overload. The most popular form of this therapy — an exercise bike. Recommended during rehabilitation after treatment of the running of osteoarthritis in the prevention of diseases of the joints. Prescribed individually depending on weight, age, medical history.
- Traction of joints. The joint cavity and the joint space can be increased by mechanical stretching. Development of arthrosis after a course of these procedures slows down.
- Dietotherapy. Should be aimed at reducing weight to reduce the load on the knee, improve metabolism, prevent the accumulation of salts, to provide cartilage nutrition.
- Orthopaedic treatment. The use of special insoles for shoes, knee pads and walking sticks allows you to remove unnecessary burden from the patient's joint and to facilitate walking.
Conservative treatment is able to inhibit the development of osteoarthritis of the knee joint for many years, but sometimes still need surgery.
Methods of surgical treatment
Surgical intervention is aimed not so much at the removal of symptoms, but to eliminate its causes. Apply at 2-3 degrees of severity of osteoarthritis.
- Puncture.This pumping of fluid from the joint cavity with a syringe. The result is reduced pressure on the joint, restores mobility, decreases inflammation. The procedure is performed on an outpatient basis. This method applies to minimal intervention.
- Arthroscopy. If you need to clean the joint from the elements of the destroyed cartilage, endoscopic surgery is carried out under control of the micro video camera. Such interference is tolerated better than traditional surgery, and requires prolonged rehabilitation.
- Osteotomy around joints. Method of classical surgery. Deformed knee sawn to give it the correct shape and is fixed with the help of Ilizarov frame or metal plates. Osteotomy requires several months of rehabilitation.
- The endoprosthesis. Replacement of the diseased joint are biologically compatible (usually titanium) design that allows you to return the patient to normal mobility. Rehabilitation may take about a year.
Orthopedic doctors recommend carefully treat knee joints, if you are at risk. After the age of 40 should monitor their weight, avoid physical overload and injuries, wearing comfortable shoes on a small steady heel, to swim.