Deforming osteoarthrosis of the Knee joints (aka gonartrosis or abbreviated doa) is a degenerative-dystrophic dissease of the Knee joint, which is characterized by a chronic steadily progressive, Damage to All Structural Elements (HyalinCartilage, Periastal Bone Structures, Synovial Shell, the Capsule and a Joint of Joint) and Leads Articular Deformation, Reduation of Movements and Frequently Disability.
The disease begins with changes in joint cartilage, due to which bone joint surfaces occurs.Interruption and loss of elasticity lead to their dystrophy (thinning) and resorption, while bone tissue of joint surfaces is exposed, sliding is disturbed, joint gap is reduced, changing joint biomechanics.The synovial shell by coating the articulation and production of synovial fluid is irritated (which nourishes the cartilage and plays the role of physiological lubrication), which leads to an increase in its quantity in the joint (synovitis).At the bottom of joint gap narrowing, joint volume decreases, synovial fluid highlights the posterior wall of the joint capsule, the Becker cyst is formed (which, reaching large sizes, can cause pain in the popliteal fossa).The thin and delicate fabric of the joint capsule is replaced by a rough connective tissue, the shape of the joint changes.The periopital bone tissue is growing, osteophyte (pathological bone growth) are formed.Blood circulation in periarticular tissues is disturbed and underestimated metabolic products, irritating chemoreceptors, develops persistent pain syndrome.At the bottom of a change in the anatomy of the joint, there is a violation of the work of the surrounding muscles, hypotrophy and spasm appear, a march is disturbed.There is a persistent restriction on the volume of joint movements (contracture), sometimes so pronounced that only balance movements (stiffness) or a complete absence of movements (ankylosis) are possible.
Gonarthrosis is a very common disease: they suffer from 10% of the total population of the planet and, over 60 years old, affects each third person.
The causes of gonarthrosis
- Bone and joint injuries.
- Inflammatory joint diseases (rheumatoid, chlamydia arthritis, gout).
- Violation of mineral metabolism with various endocrinopathies (diabetes mellitus, parathyroid disease, hemochromatosis).
- Muscle and neuropathy diseases (Charcot disease).
In addition to the main reasons, adverse factors from gonarthrosis development are also distinguished, including:
- Overweight (literally exerts pressure on the lower limbs);
- Age (the disease is mainly subject to the elderly);
- female gender (according to statistics in a woman, they are sick more often);
- Increased sports and professional physical effort.
Osteoarthritis symptoms of the knee joints
- The pain that increases when walking and weakening alone.
- Difficulty of family physiological movements in the joints.
- A characteristic "crispness" in the joints.
- The increase of joints in quantity and its visible deformation.
Gonarthrosis stages
Clinical stages of knee articulation arthrosis
The disease goes through various stages.
- In the first stage, a person only feelsA small feeling of discomfortor "severity" in the knee that is bothering for long distance walking or increased physical effort.Radiological examination will be misinformation: it is possible to identify only a small narrowing of the joint gap, there will be no other changes.
- The second stage is characteristicTangible pain, whose gravity is reduced at rest.There is a difficulty in joint joints, when walking, a characteristic "thin" is heard (of the patient you can hear a conventional phrase in everyday life - "the knees ranger").When performing radiography, a clearly distinguishable narrowing of the joint space and unique osteophytes is found.
- When the transition from gonarthrosis to the next, third stage,The pain will constantly disturb the patientIncluding at rest, there is a violation of joint configuration, that is, deformation intensifies due to edema at the time of connecting inflammation.The radiographs determine the narrowing of the joint gap of a moderate degree and multiple osteophytes.In the third stage, many are already running for medical help, because the quality of life suffers significantly due to pain and difficulty in normal walking.
- The fourth internship is accompaniedPain around and tiring.Minimal attempts to move become a difficult test for humans, joint deformation is visually noticeable, walking is extremely difficult.X -ray reveals significant changes: Articular gap in figures is not practically determined, multiple rude osteophytes, “joint mice” (destructive bone fragments that fit the joint cavity) are detected.This stage of gonarthrosis almost always implies disability.
Who treats the articulation of the knee articulation?
The therapist, rheumatologist and general practitioner (family doctor) can provide qualified medical assistance for gonarthrosis (family doctor), but these specialists are treating the knee articulation with uncomplicated arthrosis.When a synovitis or treatment prescribed by the therapist does not give the proper effect, you cannot do without the help of an orthopedist.In situations where surgical care is necessary, the patient is sent to a specialized orthopedic traumatological department.
How and what to treat knee joint arthrosis?
The methods of treatment of knee joint arthrosis, known today, are divided into conservatives, medication and non -Drug surgical.
No -Drug Methods
Many patients are wondering, "How to cure knee joint arthrosis without pills?"Responding to him, with regret, it is necessary to say that gonarthrosis is a chronic disease, it is impossible to eliminate it forever.However, many existing methods today may significantly decrease their progression and improve patient quality, especially when used in the early stages of the disease.
With the opportune search of a doctor and the patient's sufficient motivation for healing, it is sometimes sufficient to eliminate negative factors.For example, it is proven thatoverweight reductionReduces the manifestation of the main symptoms of the disease.
Exclusion of pathological physical effort and on the contrary,Therapeutic gymnastics classesWith the use of rational physical programs, they reduce the intensity of pain.It is proven that the exercises to strengthen the strength of the four postponement hip muscle are comparable in force with anti -inflammatory drugs.
If we treat the arthrosis of the knee articulation, we must fight forproper nutrition: To Improve the Elastic Properties of Articular Cartilage Will Help Products Containing A Large Amount of Animal Collagen (Dietary Varies of Meat and Fish) and Chondoitin (SHRIMP, Crabs, Kril), Satuated with Vegetable Collagen and Antioxidants, Fresh Vegetables and Fruits, and Frucs, andPassion for Smoked Meenas, Conservatives, Sweet and Perechen Dishes, Sweet and Paved Dishes, Sweet and Paved Dishes On The In contrast, a violation of metabolic processes in the body and the accumulation of overweight to obesity are potentiated.
The complex treatment of knee joint arthrosis also involves the appointment of very effective, even with advanced forms of the diseasePhysiot -Procement.With widespread use in different categories of patients suffering from this disease, it proved its effectivenessMagnetotherapy: After several procedures, pain intensity decreases as a result of improving blood circulation, reducing edema and eliminating muscle spasm increases joint mobility.The effect of magnetotherapy is especially vivid during the development of active joint inflammation: edema severity is significantly reduced, the phenomena of synovitis regression.It is not so popular, but no less effective in the treatment of knee articulation with arthrosis, they are physiotherapy methods asLaser therapy and cryotherapy(Cold exposure), having a pronounced analgesic effect.
Drug treatment
In the schemes of the effective treatment of knee joint arthrosis, the medicines below are used.
Anti -non -inflammatory drugs -esteroidsProduced in the forms for external use (various gels, ointments) and systemic (tablets, candles, solutions), have long proved their effectiveness in the treatment of osteoarthritis and are widely prescribed by doctors.Blocking inflammation on an enzyme level, they eliminate joint pain and swelling, reducing disease progression.It should be remembered that a prolonged systemic technique can cause the development and exacerbation of ulcerative processes in the gastrointestinal tract and also negatively affect the functions of the kidneys and liver.Therefore, patients, taking the medicine for a long time, should also prescribe medications that protect the gastric mucosa and regularly monitor laboratory indicators of the work of internal organs.
Glicocochosteroids (GKS)- Hormonal medicines with a pronounced anti -inflammatory effect.Being a powerful anti -inflammatory agent, GCs have certain against -indications because they are able to call various significant side effects.In system forms for gonarthrosis, they are hardly prescribed.As a rule, effective arthrosis treatment involves injections of GCs at peri -Human problem points, which increases the intensity of the fight against inflammation and minimizes the risk of undesirable drugs of the drug.With a single GCS introduction, the effect of its use lasts up to 1 month.According to national recommendations for the treatment of osteoarthritis, you should not perform more than three injections of the drug per year in the same joint.
With distant "neglected" osteoarthritis, when a person experiences unbearable pains that do not even diminish at rest, violating normal sleep, prescription is possibleopioid analgesics.These medications are used only according to the prescription of the doctor, who considers the viability of his appointment in each case.
Chondoprotectors(with a literal translation - “Cartilage Protection”).This name is understood as several medicines united by a property - a structural modifier effect, that is, the ability to reduce degenerative changes in cartilage and the narrowing of the joint gap.They are produced in shapes for oral administration (glucosamine, chondroitin sulfate, pelastaline) and for introduction to joint cavity (hyaluronates).Obviously, these medicines do not perform a miracle and do not "grow" a new cartilage, but may suspend their destruction.To achieve a persistent effect, they must be used for a long time, regular courses several times a year.
Surgical treatment of knee articulation arthrosis
The most popular type of surgical care for gonartrosis isEndoprostratethat is, to remove your own joint with a simultaneous installation of a metaloptesis that replaces it, whose design is similar to the anatomy of a person's knee joint.At the same time, a prerequisite for this type of surgical treatment is: the absence of serious deformations of the letter formed “false joints”, muscle contractures and pronounced muscle atrophy.With severe osteoporosis (a significant decrease in bone mineral density), the endoprothetic does not show either: the "sugar" bone will not support the introduction of metal pins and, at the installation site, the rapid renewal (resorption) of bone tissue will begin, pathological fractures may occur.Therefore, a timely solution to the question of the need to install an endoprosthesis is so significant - it should be accepted when the age and general condition of the human body still allow you to perform surgery.
Despite the widespread prevalence of knee joint endoprothetic, the results of such operations are usually unsatisfactory and the percentage of complications is high.This is due to the design resources of endoprostheses and the complexity of the surgical intervention itself (the replacement of the hip board is much easier in technical terms).
Artromedular deviation- Femur bone marrow channel connection to the knee joint cavity using a derivation - a hollow metal tube.Because of this, the fat bone marrow of the lower third of the femur enters the knee joint, nourishing the cartilage and lubricating -a, which reaches a significant decrease in pain.
In short, I would like to observe that gonarthrosis treatment is a complex social task.And although today medicine cannot offer a medicine that eliminates it forever, or other ways to completely cure this disease, a healthy lifestyle, seeking timely medical help and the implementation of the doctor's recommendations may suspend their progression.