Complex treatment of knee arthrosis

Diseases of the musculoskeletal system lead to significant restrictions on human mobility. In order not to bring the situation to complications, it is necessary to carry out treatment in a timely manner. Arthrosis of the knee joint is the most common form of damage to the joints of the bones of the skeleton and the most common cause of disability. But with a timely visit to a doctor, you can get rid of the disease.

GENERAL INFORMATION

Arthrosis of the knee joint is the unofficial name of the disease. In medicine, it is referred to as osteoarthritis. The word is made up of two ancient Greek words - bone and joint. Other synonyms:

• deforming osteoarthritis or DOA in abbreviated form (the first word in the name reflects the main clinical symptom - joint deformity);
• gonarthrosis (from a combination of the ancient Greek words "knee" and "joint").

Sometimes the disease is mistakenly called arthritis, although traditionally this term refers to a connective tissue disease that has nothing to do with arthrosis.

The essence of arthrosis is that the cartilage tissue lining the surface of the joint is damaged, as a result of which inflammation begins, the work of bone joints is disrupted, and pain appears. Unfortunately, this is a very common pathology, which is mainly diagnosed in elderly people (especially overweight) and in young athletes due to injuries.

For effective treatment, it is necessary to conduct a complete examination of the patient with arthrosis, in particular, to identify the reasons that caused the problem with the musculoskeletal system. Most often, the following factors lead to the disease:

CAUSES AND SYMPTOMS

For effective treatment, it is necessary to conduct a complete examination of the patient with arthrosis, in particular, to identify the reasons that caused the problem with the musculoskeletal system. Most often, the following factors lead to the disease:

• leg fractures;
• dislocations, cartilage injuries, inflammation;
• impaired metabolism;
• endocrine diseases;
• ligamentous apparatus weakness;
• hereditary predisposition;
• autoimmune diseases and infections that initiate damage to joint tissue.

Late visit to the doctor threatens with constant pain in the knee area and complete loss of joint mobility.In order to prevent this, you need to make an appointment for a consultation with a specialist if there is a crunch in the knee when walking and painful sensations that increase when descending or climbing stairs. If treatment is not started at this stage, the situation will worsen - the pain will cease to pass, movements will become limited, the knee will be deformed.

The longer you do not see a doctor, the more difficult, time-consuming and expensive treatment of gonarthrosis will be.

DEGREE OF THE DISEASE

Arthrosis is diagnosed by a doctor. He not only identifies the disease, but also determines its degree. There are three of them:

• First. It is possible to cure the disease at the initial stage, since at this time there are no morphological disorders of the tissue, the muscles are weakened, but not yet changed, and the joint begins to tolerate the load worse due to dysfunctions of the synovial membrane and the biochemical composition of the cavity fluid that feeds the cartilage andmenisci. Overuse leads to inflammation and pain.

• Second. At this stage, the cartilage and menisci begin to collapse, the load on them leads to pathological growths on the bone tissue, narrowing of the joint space. Because of this, the knee increases in size and looks deformed. Treatment of bilateral gonarthrosis of the knee joint of the 2nd degree is already more difficult in comparison with the first stage. Pain and inflammation become chronic.
• Third. This degree is already considered severe. At the same time, the bone deformation is clearly expressed, the axis of the limb is changed, due to which the mechanical load is not distributed correctly. The ligaments of the joint are shortened, natural movements are limited because of this, and then the leg can become completely motionless. Treatment of arthrosis of the knee joint of grade 3 without surgery is impossible, since the disease is very advanced.

If pain seems bearable for a long time, people think that they have arthrosis only in the first stage, and postpone going to the doctor. But this opinion is not correct. Every day, the load on the main elements of the joint, already beginning to collapse, increases, and pathological changes can lead to complete destruction of the joint and severe dysfunction of the limbs.

CLINICAL CURRENT

Disease progression is accompanied by characteristic symptoms. The pain occurs in the middle of the night, even if the leg is motionless. Stiffness is felt in the morning.

Walking becomes difficult when passing a certain distance, then at the beginning of the movement. In severe cases, a person cannot walk 100 meters normally, it becomes painful for him to stand and sit. You have to move with the help of special equipment.

Slight lameness at the first stage subsequently becomes pronounced. As a result, walking, using public transport, performing professional duties, household functions, and even self-service may become completely impossible.

METHODS OF TREATMENT

Folk recipes, pharmaceutical compresses and ointments will not help get rid of the disease, as the approach must be comprehensive.Recovery is usually only possible in a hospital, where a doctor will treat arthrosis of the knee.What advice to give to the patient, he decides on the basis of the indicated complaints and concomitant pathologies. The following points are usually mandatory:

• reducing the load on the joints;
• compliance with the orthopedic regime;
• physical therapy (exercise therapy);
• undergoing physical therapy.

All this helps to slow down the progression of arthrosis and prevent loss of motor function. It should be understood that the methods used will largely depend on the capabilities of the hospital and the availability of one or another physiotherapy equipment. It is best if the patient has the opportunity to go to a spa treatment or to a specialized orthopedic clinic, where a modern approach to the choice of medicines, diet, techniques, etc. will be provided.

USE OF MEDICINES

Inflammatory processes and painful sensations make the treatment of osteoarthritis of the knee impossible without medications in the form of tablets, creams, ointments and injections. At the first stage, you can use non-steroidal anti-inflammatory drugs - Diclofenac, Indomethacin, Nimesulide, etc. At the second and third, you often have to fight inflammation with steroid drugs - Triamcinolone, Hydrocortisone. These same hormones are used during periods of acute pain.

In addition, intramuscular and intraarticular injections of drugs that improve the condition of cartilage tissue (vasodilators and chondroprotectors) will be required.

PHYSIOTHERAPY METHODS

Substantial improvements can be made using physical therapy. The following methods are considered the most effective:

• Shockwave therapy. This method has worked well over the past 20 years. Its essence lies in the effect on the affected area with a special apparatus that emits radial acoustic waves that activate blood supply and stimulate tissue repair.
• Myostimulation. This therapy targets the muscles surrounding the joint. Low current impulses increase leg mobility, relieve pain, and increase endurance during physical exertion.
• Phonophoresis. This technique harmoniously combines ultrasound therapy and the use of products in the form of ointments, gels and creams. Usually, such dosage forms are absorbed by only 5-7%, but high-frequency ultrasound vibrations heats up the tissues, and the absorption increases several times. In addition to the good therapeutic effect, this saves the consumption of expensive drugs.
• Ozone therapy. The anti-inflammatory and analgesic effect can be achieved by acting on the joint with active oxygen. This is a good addition, and in some cases an alternative to taking hormonal drugs.

MEDICAL EXERCISE

Pain during physical exertion on a joint leads to the fact that the person tries to avoid it. In the long term, this threatens physical inactivity, leading to muscle atrophy and ligament weakness. Of course, during the period of exacerbation, the load on the joint must be completely eliminated, but after a few days after the inflammation and pain are relieved, it is necessary to start physiotherapy exercises.

It is believed that correctly and consistently performed exercise therapy exercises can save the patient from the need for surgical intervention. At present, experienced specialists have developed many special methods of daily training that strengthen muscles and increase their strength and endurance, inhibit pathological tissue destruction, restore joint mobility and range of motion.

The most important thing about this type of treatment is regularity.A good effect is achieved only by those patients who understand the need for lifestyle changes and strictly follow the doctor's recommendations on the ratio of physical activity and joint rest periods.

PASSIVE KINESITERAPY

Lymphatic drainage, massage, manual therapy are a good addition to medication, physiotherapy and exercise therapy. They are indispensable for sedentary patients and can improve the condition of their muscles, joints and ligaments.

Another passive kinesitherapy method is mechanotherapy. It uses special devices - vibration simulators, weighting materials, mechanical massagers, which enhance the effectiveness of treatment.

Extension of the joints, in which the space of their cavity increases mechanically, allows you to get rid of pain and stop destructive processes. Regular use of this therapy prolongs knee health for years.

COMPLIANCE WITH A DIET

Since obesity is often the cause of arthrosis, patients with this diagnosis need to take care of weight loss. Losing weight will reduce the stress on the joint and facilitate exercise therapy. Sometimes diet is not enough, then bariatric surgery is required, but such situations are rare.

Another indication for adherence to a certain diet may be any pathology associated with arthrosis. If there is no obesity or other diseases, accompanied by the need to change eating habits, there is no need for a special diet. However, you can help the body to strengthen the damaged cartilage tissue by including in your diet foods rich in collagen, which include jelly and aspic, fish oil, berries and fruits. It is better to refrain from consuming unhealthy foods such as sugar, carbonated and alcoholic drinks.

SURGICAL INTERVENTION

In advanced cases, a quick solution to problems with the musculoskeletal system is to perform operations. With arthrosis, the following types of surgical intervention are prescribed:

• Puncture allows you to get rid of the accumulated fluid in the joint cavity. As a result, inflammation is reduced, due to which knee mobility is restored.
• Arthroscopy makes it possible to clean the surface of the joint from pieces of destroyed tissue. It is performed using thin flexible instruments using a video camera, thus avoiding dissection of the joint cavity.
• Periarticular osteotomy allows you to change the angle of one of the bones that form the knee joint, due to which the load is redistributed, mobility increases, and pain is relieved. This intervention is quite traumatic, since the bone has to be sawed.
• Endoprosthetics allows replacing a diseased joint with a biocompatible structure. At the same time, the previous range of motion is restored, but the operation is quite new and very complicated, after which a long rehabilitation is required.

Surgery is rarely required in the first stage. On the second, it is necessary only occasionally, but on the third one cannot do without it.

PATIENT REVIEWS

Which of the many treatments will be applied in each case depends on the doctor. The specialist will choose the best method, and the patient's task is to strictly follow the recommendations of the orthopedist. This is the only way to get a good result quickly. This is confirmed by patients who have been diagnosed with gonarthrosis.