Complex treatment of knee osteoarthritis

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

GENERAL INFORMATION

Osteoarthritis of the knee joint is the unofficial name of the disease. In medicine, we talk about 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 erroneously referred to as arthritis, although traditionally this term refers to a connective tissue disease that has nothing to do with osteoarthritis.

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 the bone joints is disrupted and pain appears. Unfortunately, this is a very common disease, which is diagnosed mainly in the elderly (especially overweight) and in young athletes due to injuries.

For effective treatment, it is necessary to conduct a comprehensive 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 comprehensive 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:

Osteoarthritis of the knee
  • leg fractures;
  • dislocations, cartilage injuries, inflammation;
  • impaired metabolism;
  • endocrine diseases;
  • weakness of the ligament apparatus;
  • hereditary predisposition;
  • autoimmune diseases and infections that cause damage to joint tissue.

Late access to a doctor threatens with constant pain in the knee area and complete loss of joint mobility.To prevent this from happening, it is necessary to sign up for a consultation with a specialist if you feel a crunch in the knee while walking and painful sensations that intensify when going down or climbing stairs. If the treatment is not started at this stage, the situation will worsen: the pain will cease to pass, the movements will become limited and the knee will be deformed.

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

DEGREE OF DISEASE

Osteoarthritis is diagnosed by a doctor. It 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 worst load due to dysfunctions of the synovial membrane andbiochemical composition of the cavity fluid that feeds the cartilage and enisks. Overuse leads to inflammation and pain.
  • The degree of the disease
  • 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 knee joint osteoarthritis of the 2nd degree is already more difficult than in 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, as a result of which the mechanical load is not distributed correctly. The ligaments of the joint are shortened, natural movements are limited due to this and therefore the leg can become completely immobile. Treatment of grade 3 arthrosis of the knee joint without surgery is impossible, as the disease is very advanced.

If the pain seems bearable for a long time, people think they have osteoarthritis only in the first stage and refer the doctor. But this opinion is incorrect. Every day, the load on the main elements of the joint, which already begins to collapse, increases, and pathological changes can lead to complete destruction of the joint and severe dysfunction of the limbs.

CLINICAL CURRENT

The progression of the disease is accompanied by characteristic symptoms. The pain occurs in the middle of the night, even if the leg is immobile. Stiffness makes itself felt in the morning.

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

CLINICAL CURRENT

A slight lameness in the first stage becomes subsequently pronounced. As a result, walking, using public transport, performing professional duties, daily duties and even self-service can become completely impossible.

TREATMENT METHODS

Folk recipes, pharmaceutical tablets 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 osteoarthritis of the knee.What kind of recommendations to give to the patient, he decides on the basis of the complaints indicated and associated pathologies. The following points are generally required to be compliant:

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

All this helps to slow the progression of osteoarthritis and prevent the 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 the other physiotherapy equipment. It is better 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 drugs, diet, methods, etc. will be provided.

USE OF DRUGS

Inflammatory processes and painful sensations make it impossible to treat osteoarthritis of the knee without drugs in the form of tablets, creams, ointments and injections. In the first stage, you can use non-steroidal anti-inflammatory drugs - Diclofenac, Indomethacin, Nimesulide, etc. These same hormones are used during times of acute pain.

USE OF MEDICINES

In addition, it will be necessary to carry out intramuscular and intraarticular injections of drugs that improve the condition of the cartilage tissue (vasodilators and chondroprotectors).

PHYSIOTHERAPY METHODS

Substantial improvements can be achieved by using physical therapy. The following techniques are considered the most effective:

  • Shock wave therapy. This method has worked well for 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 the blood supply and stimulate tissue repair.
  • Myostimulation. This therapy targets the muscles surrounding the joint. Weak current pulses 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. Typically, such dosage forms are absorbed only by 5-7%, but high-frequency ultrasonic vibrations heat 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 medications.

MEDICAL EXERCISE

PHYSIOTHERAPY

Pain during physical exertion on a joint leads to the person trying to avoid it. In the long run, this threatens physical inactivity, leading to muscle wasting 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 begin physiotherapy exercises.

It is believed that properly and consistently performed physical therapy exercises can save the patient from the need for surgery. At the moment, experienced specialists have developed many special methods of daily training that strengthen the muscles and increase their strength and endurance, inhibit the pathological destruction of tissues, restore joint mobility and freedom of movement.

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 relationship between physical activity and joint rest periods.

PASSIVE KINESITHERAPY

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

Another method of passive kinesitherapy is mechanotherapy. It uses special devices: vibration simulators, weighing materials, mechanical massagers, which improve the effectiveness of the treatment.

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

RESPECT OF A DIET

Since obesity is often the cause of osteoarthritis, patients with such a diagnosis must take care of weight loss. Losing weight will reduce the stress on the joint and facilitate physical therapy. Sometimes the diet is not enough, so bariatric surgery is needed, but such situations are rare.

Another indication for adherence to a certain diet can be any pathology associated with osteoarthritis. 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 your body strengthen affected cartilage tissue by including collagen-rich foods, including jelly and gelatin, fish oil, berries, and fruits, in your diet. It is best to refrain from consuming unhealthy foods such as sugar, carbonated and alcoholic drinks.

SURGICAL INTERVENTION

SURGICAL INTERVENTION

In advanced cases, a quick solution to the problems of the musculoskeletal system is to perform the operations. With osteoarthritis, the following types of surgery are prescribed:

  • The puncture allows you to eliminate the fluid accumulated in the joint cavity. As a result, the inflammation is reduced, due to which the mobility of the knee is restored.
  • Arthroscopy allows you 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, thanks to which the load is redistributed, mobility increases and pain is relieved. This surgery is quite traumatic, as the bone has to be sawn.
  • The endoprosthesis allows to replace 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 needed 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.