Osteoarthritis, gonarthrosis, osteoarthritis are synonymous terms that define the same disease: deformity changes in the cartilage tissue of the knee joint.
The human knee joint is made up of three bones: the thigh, tibia, and patella. At the point of contact with each other, these bones are covered with cartilage tissue, which ensures that the surfaces slide smoothly between themselves.
Over time, these cartilages become thinner and lose their elasticity and resilience. Cartilage is nourished by synovial fluid; The damping properties of the joint depend on the quantity and quality of this fluid.
The first signs and symptoms
- Most commonly seen in people between the ages of 45-50. The disease is typical for both men and women, but the "weaker sex" suffers more often from this disease.
- At the beginning of the disease, the patient has excruciating pain in the knee joint, and over time, severe pain occurs.
- The intensity of pain varies: movement becomes stronger with physical activity, at rest - the pain recedes.
If you do not pay attention to these symptoms of an approaching disease in time, the disease begins to develop and in severe cases leads to disability.
When contacting a doctor, the diagnosis of osteoarthritis is clarified by X-rays. The pictures show that the joint space is narrowing inside or outside the joint. But over time, the pathological process takes over the entire joint. And osteophytes appear along the edges of the joint surface - bone growths.
The main symptoms of osteoarthritis of the knee joint:
- The pain intensifies during the day, the pain decreases at night rest. But if there is venous insufficiency, dull pains continue at night.
- Muscle tension in the joint area
- A crunch is heard in the knee joint while walking
- In severe cases of the disease, deformation and swelling of the affected joint, an increase in volume is observed
- Joint pain on palpation
- The pain increases when trying to move the knee pad
- In the final stages of the disease, the muscles contract and the patient is unable to put his foot in the correct position
- When left untreated, joint mobility is reduced or completely lost
What is patellofemoral arthrosis of the knee?
Too often you hear a doctor diagnose "patellofemoral osteoarthritis" - what is it? Indeed, there is no such osteoarthritis in the international classification of diseases. Few people know that osteoarthritis of the knee joint begins with the development of patellofemoral syndrome.
This syndrome occurs when a part of the body is regularly overused or re-injured. That is, patellofemoral arthrosis is the same as patellofemoral syndrome.
The main causes of the disease are:
- congenital and acquired deformities of the lower extremities;
- various anomalies in the development of the patella;
- regular overload of the knee joint (for example, in athletes).
Patellofemoral arthrosis of the knee joint has the following clinical manifestations: pain significantly increased by physical force on the front of the knee joint (running, jumping, going up and down stairs, various squats). The pain may also increase when the patient sits with his legs bent. The patient may feel tension and stiffness in both the inside and the front of the knee.
Patellofemoral syndrome is diagnosed clinically and usually does not require additional studies.
This disease, as a rule, does not require special treatment. However, the following procedures are needed to reduce pain and develop undesirable consequences (instability of the patella, deformity of the knee joint, accumulation of inflammatory exudate):
- decrease in physical activity. This does not mean that the patient should lead a passive lifestyle, just that the level of activity should not be painful;
- corrects by supporting the patella using a special bandage applied to the knee joint area during exercise or stress;
- With an overt pain syndrome, glucocorticosteroids and anesthetics are injected into the painful areas of the joint with precise injections, which will relieve the pain and help avoid the use of anti-inflammatory drugs in the future.
If patellofemoral osteoarthritis has already caused complications or is accompanied by other degenerative-dystrophic pathologies of the knee joint, therapy is carried out in accordance with the treatment regimen of osteoarthritis of the knee joint.
Reasons
- Occupational disease of athletes experiencing increased stress on the knee joints. Athletes suffer injuries and joint microtraumas, bruises and broken ligaments. After leaving the sport, the muscle frame weakens, which leads to the development of the disease.
- Increased life expectancy and physical activity in middle-aged people
- Increased physical activity in the knee joint in people who spend the working day "on their feet"
- Genetic predisposition
- Congenital diseases of joints and bones
- Collagen deficiency
- Knee injury
- Excess weight that causes more stress on the knee joints
- Acquired joint diseases
- Knee surgery
In order to achieve positive treatment results, it is necessary to conduct a clinical and radiological examination, which reveals several stages of the disease:
- Osteoarthritis of the knee joint 1 degree. . . There is a slight narrowing of the joint space, the edges of the surface are slightly sharpened, there is a slight restriction in movement. During the arthroscopic examination, the doctor checks the softening of the cartilage.
- Grade 2 osteoarthritis of the knee jointA significant restriction in the movement of the knee joint is characterized by a strong crisis. The images clearly show osteophytes and 2-3 times narrowing of the joint space. Small cracks are observed on the surface of the joint.
- Knee arthrosis is grade 3- this is already a complete restriction on movement, when joint deformity occurs, deformation and compression, osteophytes and cysts on the joint surface are observed. There were changes in the cartilage tissue along its entire thickness.
- Knee arthrosis rate 4- Arthroscopy shows complete absence of cartilage tissue.
Drug treatment
Drug treatment plays an important role in the complex treatment of osteoarthritis of the knee joint. Combined with physiotherapy procedures, therapeutic exercises and manual therapy, you can achieve very good results until the restoration of limb function.
When osteoarthritis of the knee joint is diagnosed, drug treatment helps relieve pain, normalizes blood circulation in the problem area, improves metabolism and cartilage nutrition, activates recovery processes, and increases joint mobility.
Since it is impossible to apply other therapeutic methods against the background of acute pain, the patient is first prescribed painkillers and anti-inflammatory drugs. However, long-term use of such products is not recommended, because in addition to side effects (which adversely affect the digestive system), it can contribute to dehydration and further destruction of cartilage tissue.
Chondroprotectors are used to restore cartilage nutrition, restore cartilage plaque, and improve synovial fluid quality.. . . Drugs of this group are injected directly into the painful joint and are the safest for the patient. Chondroprotectors that immediately fall on the affected area save the joint from destruction and help restore its function. One of the disadvantages of this method is the long wait for the result - the patient can feel improvement only after a few months. In addition, the use of chondroprotectors is not recommended if the disease is in the third stage and the joint is almost completely destroyed.
Various ointments and creams are used to reduce pain, reduce swelling, and improve joint mobility.Various warming agents are useful to relax the joints and muscles, improve blood circulation and speed up metabolism in the joints. However, it cannot be used in case of inflammation, in which case non-steroidal anti-inflammatory gels and ointments are indicated.
Compresses should not be neglected - they have penetrating properties, improve blood circulation, have anesthetic and anti-inflammatory effect and accelerate metabolic processes in cartilage.
Therefore, for people who suspect a disease or osteoarthritis of the knee joint, you should not delay a visit to the doctor - timely and properly selected drug treatment can help save the joint and prevent surgical intervention.
Medications for the treatment of osteoarthritis of the knee joint
Treatment of knee osteoarthritis can never be completed without the use of medication.
Drug treatment primarily aims to eliminate inflammation and pain, improve local blood circulation and nutrition of articular cartilage, activate metabolic processes and restore joint mobility.
What medications are prescribed for osteoarthritis of the knee joint?
- For successful treatment of the disease, you must first eliminate the pain and eliminate the inflammatory process. Non-steroidal anti-inflammatory drugs are used for this purpose. However, you should not confuse it with this tool - when used for a long time, they tend to hide the true clinical picture of the disease.
- Chondroprotectors are used to restore the cartilage surface of joints, restore structure, nourish cartilage and improve intra-articular fluid production. The effect of these drugs is very slow, so before the patient feels a real improvement, you should undergo 2-3 courses of treatment with chondroprotectors, which will take about a year.
- Gels and ointments can be used in combination with other medications to improve the patient's general condition and relieve pain. If the course of osteoarthritis is accompanied by synovitis, ointments based on non-steroidal anti-inflammatory drugs are preferred.
- Intra-articular injections are used to provide emergency care for osteoarthritis. The most commonly injected corticosteroids or hyaluronic acid.
- Compresses with drugs are prescribed for local treatment - dimethyl sulfoxide, bischofite and medical bile. Dimethyl sulfoxide has the ability to penetrate the skin barriers, ie the effect is directed directly to the site of inflammation. This substance has analgesic, anti-inflammatory, absorbent properties and improves metabolism in the area of application. Bishofite - a derivative of fat - also has an anti-inflammatory effect on the affected joint, gives a warming effect. Medical bile has the same properties as bisophyte and dimethyl sulfoxide, but its use is limited by some contraindications. Medical bile should not be taken by patients with pustular skin diseases, high body temperature and inflammation of the lymph nodes.
Before starting any medication for osteoarthritis of the knee joint, it is necessary to consult a doctor, discuss the dose, application characteristics and duration of treatment.
Injections in the knee joint for osteoarthritis
Intraarticular injections are one of the most effective methods of treating osteoarthritis of the knee joint. This very expensive procedure significantly reduces pain and inflammation, and new modern drugs not only improve the overall condition of the patient, but also treat the affected cartilage tissue.
For osteoarthritis, injections in the knee joint are a very difficult procedure, so even if the patient knows what medications to take and how much to inject, you should consult a doctor.
The following medications are most commonly prescribed for intraarticular injections:
- Corticosteroid hormones. These are the most common medications because the effect is achieved within a few minutes after application. However, corticosteroids, which relieve inflammation and pain, have a negative effect on the joint itself - cartilage tissue remains degenerative, in addition, drugs in this group cause narrowing of blood vessels, which destroys joint tissue. Therefore, the use of corticosteroid hormones is justified only in the presence of unbearable pain in the later stages of osteoarthritis. The injection can be repeated no more than once every two weeks.
- Chondroprotectors and enzymes. Unlike hormones, they do not reduce inflammation, so administration is meaningless when there is joint swelling. However, they have a rejuvenating effect, partially restoring cartilage tissue. The use of such drugs is especially effective in the early stages of osteoarthritis. The course of treatment is 5-10 injections.
- Hyaluronic acid. A very effective, but also an expensive drug. Its effectiveness is similar to the natural lubrication of the joint due to the composition of the acid itself. After the introduction of drugs containing hyaluronic acid into the knee, the friction of the affected joint surfaces is reduced and knee mobility improves. Such injections are very effective in the early stages of osteoarthritis, slightly less effective in the second stage, and with osteoarthritis of the third knee joint, such drugs alleviate the patient's condition for a short time. The course of treatment usually includes three to four injections once a year.
Injections into the knee joint for osteoarthritis are completely contraindicated in the following cases:
- skin or subcutaneous tissue infection at the intended injection site;
- sepsis;
- infectious arthritis;
- hemophilia;
- presence of viral infection;
- lack of results from previous injections;
- individual intolerance to the drug.
Intra-articular injections for prophylactic purposes are also unacceptable.
Orthopedic knee pads for osteoarthritis of the knee joint
In the treatment of osteoarthritis of the knee joint, knee pads are used to prevent various injuries, as well as to support damaged tissues and reduce stress on the joint.
An orthopedic knee pad is essentially the same as an elastic bandage. However, compared to the latter, the knee has advantages: it does not need to be wrapped several times a day, it does not slip and slide, a properly installed knee pad does not compress the foot and does not cause swelling and other unpleasant consequences. squeezing for a long time.
Orthopedic knee pads for osteoarthritis of the knee joint perform the following functions:
- reduce inflammation and pain;
- eliminate swelling;
- eliminate stiffness and tension;
- normalize blood circulation;
- facilitate the free movement of the joint.
When choosing an orthopedic knee pad, you should pay attention to the following features:
- The type of knee pad - depending on the severity of the pain. These types of knee pads are:
- closed - used when it is impossible to determine the localization of pain;
- open with adjustable voltage - used during rehabilitation and for minor pain;
- open with a spiral stiffening rib - for pain during the ascent and descent of the stairs, etc. ;
- articular - for different types of pain;
- To support the tendons - is used if the pain is localized under the patella.
- The material from which the knee pad is made is of great importance, because not only the degree of fixation, but also the intensity of the warming effect depends on it. Modern knee pads are made of cotton, lycra, nylon, neoprene, spandex, camel and dog hair.
- The size of the knee pad calculated separately for each patient.
The doctor will help to determine the parameters of the future purchase - not only to choose the size and type of knee pad that is optimal for the patient, but also to advise which material will be most effective.
Orthopedic knee pads for osteoarthritis can be purchased at a pharmacy or a specialty medical equipment store, the price is quite reasonable. You should be wary of such purchases from non-specialized outlets or dubious firms, as you can easily buy a counterfeit, if it does not hurt, it will certainly not help.
Proper nutrition
Nutritionists have been studying the nutritional characteristics of different peoples for many years. Comparing national cuisines, scientists are trying to understand the impact of people's culinary preferences on the development of certain diseases. Such research has been conducted several times in connection with a common disease such as osteoarthritis of the knee joint.
Many theories have been put forward, many different hypotheses have been put forward. For example, it was once thought that the use of tomatoes contributed to the development of the disease, and then it was argued that salt was "to blame" for the development of osteoarthritis.
In the twentieth century, the situation with the development of the disease deteriorated sharply.
Proper nutrition is the key to joint health.
To prevent the development of the disease, it is necessary to understand that nutrition plays a key role in osteoarthritis of the knee joint. Consumption of meat products in the fast food segment of the diet should be minimized. These products:
- semi-finished products made from meat waste: sausages, sausages, all kinds of sausages, etc.
- smoked meats sold in stores (in most cases, these products are made chemically, not in smokers).
- ready-to-eat meat - ham, pork (manufacturers do not hesitate to use flavor enhancers and dyes in this case).
- fast food.
Of course, not everyone can give up the above foods. Over the years, many have developed the habit of having fun with smoked sausage sandwiches or boiled sausages in the morning. In this case, we recommend that you buy a piece of meat on the market, bake it in the oven with spices, cut it, and then use it as a base for sandwiches. This type of "fast food" will not harm the body.
So we learned that the best way is to give up semi-finished products, smoked meats and fast food. What if there is meat with a syringe?
Of course, the ideal choice is to buy meat from reliable suppliers, but in urban conditions this recommendation is not practical.
In this regard, it is necessary to use such cooking methods to destroy as much harmful chemicals as possible. Sometimes the use of only this factor has allowed to achieve an excellent effect in the fight against osteoarthritis.
How to properly cook food for osteoarthritis of the knee joint
Remember that for osteoarthritis of the knee joint, the diet should not be saturated with fats.
Therefore, when cooking, it is necessary to cut off the visible fat from the meat and remove the skin from the birds. It is the oil that contains the most harmful substances.
Boiling, brewing, cooking and steaming in foil are the healthiest ways to prepare food.
With osteoarthritis of the knee joint should not eat mixed and mixed meat. There is an opinion from the series "Grandma in the yard said" that these dishes are good for the joints, but this is not the case. A person with osteoarthritis will only get worse from high cholesterol levels.
Meat broths and soups should be consumed as little as possible. Even if you drain the first broth, the second will contain a lot of harmful fat. It is better to teach yourself to vegetable soups, which are very popular in Western countries. Mushroom soups are also useful.
Trying to replace meat for soup with dry broths and cubes will not lead to anything good: these products contain an incredible amount of chemical components.
Unfortunately, fish sold in our markets are diligently dyed and protected, which is why it is harmful for osteoarthritis of the knee joint. Therefore, you should buy as many live fish as possible. It is clear that not everyone has enough money for this. The above methods will help you to cook frozen fish properly.
Prevention of osteoarthritis of the knee joint
It is impossible to allow the deterioration of living conditions due to the disease, so the causes of osteoarthritis should be ruled out. Prevention is easier than expensive and long-term treatment.
- You need to lose weight.
- Joints need constant physical activity: skipping rope, squats, small runs. But everything should be normal. Excessive exercise also causes disease. Alternative joint loads with enough rest.
- Osteoarthritis develops due to knee injuries. Knee pads should be worn when skiing, skating, cycling or skating. There are plenty of options on the market for both stabilized knee pads and sheepskin warmers.
- If the weight is more than your strength, do not neglect the help of another person.
- Eat more vegetables and fruits. It is noted that vegetarians do not suffer from osteoarthritis. Replace mayonnaise with olive or mustard oil. Especially useful cranberries with plums, prunes, apricots, apples, raspberries, honey.
- Strong tea and coffee wash away large amounts of calcium.
- Homemade cottage cheese and cheese will help strengthen bones.
- Walking with a cane will save you from overloading your knee joints.
- Shoes should be comfortable, with small heels.
- Swimming and water aerobics will relieve stress all over the body and fatigue in the knee joints.
- Of the vitamins, vitamin E is especially useful, which prevents the destruction of cartilage tissue.
- Vitamin C is involved in the synthesis of cartilage tissue.
- The disease progresses faster than vitamin D deficiency.
- Calcium helps keep your bones strong. Sesame and celery seeds are high in calcium.
By following these simple rules of a healthy lifestyle, a serious illness can be avoided. In case of disease manifestation, they will slow down the development of pathological processes.