Knee articulation arthrosis-This is a degenerative-distribution disease of cartilage, which leads to exposure of bone heads and impaired mobility in the joint.The disease is non -inflammatory in nature and progresses slowly - the transition from the early stage to the deficiency takes from several years to several decades.Knee joint osteoarthritis is included in the 5 most common causes of disability and disability worldwide.
More than 20% of people over 55 are subject to knee arthrosis (gonarthrosis), but the disease is quickly young - increasingly their symptoms manifest at 25.
Over time, the treatment of knee joint arthrosis will help to avoid complications and destruction of the cartilage.
Knee articulation arthrosis signs
The wear of joint cartilage is accompanied by characteristics characteristics, whose intensity depends on the stage of the disease.Most of the time, patients complain:
- morning stiffness and reduction of articulation mobility (it is necessary to wake up);
- Pain and discomfort in the knees, which are improved after physical exertion (long walk, running or standing) and are declining when they rest;
- In the second stage - the initial pains that occur after a long stay in a position;
- increased fatigue, which is often discarded for age -related changes;
- Dry thick crumbling, which is repeated regularly when kneeling and folded;
- edema and other symptoms of inflammation that appear in the second stage of the disease due to the trauma of perioster tissues;
- Metensibility, increased symptoms in the cold season.
When trying to double the knee hit by gonarthrosis, acute pain and a sense of physical obstacle.In later stages, even in the presence of knee joint arthrosis treatment, patients are disturbed in patients (they become enjoying, patients walk in rigid legs), appears the deformation of the lower ends in the form of "O" or "x" letters.
The insidiousness of the disease lies in the fact that it can occur hidden for years, and the first significant symptoms usually appear only in the second stage - when the complete restoration of synovial cartilage is already impossible.
Therefore, it is important to consult a doctor in the first signs of knee discomfort - for example, weak, as if they have pain that occur with insufficient production of synovial fluid.Remember: knee pain is not the norm regardless of age.The examination and treatment timely of the 1st degree knee arthrosis can completely protect it from painful pain in the joints in old age.
What will happen if knee arthrosis does not treat?
In case of self-medication, non-compliance with the doctor's recommendations or the absence of treatment, knee joint osteoarthrosis progresses 3-8 times faster than with complex therapy.If gonarthrosis occurs aggressively, the patient may lose the ability to move normally before retirement age.
Especially important is the effective treatment of knee arthrosis at an exacerbation stage.Role climate, physical or emotional stress, allergies, poisoning, moving to the region with another climate - in one word, any agitation to the body can provoke it.The exacerbation of arthrosis continues with the destruction of a large amount of chondrocytes.In response to this, the body produces enzymes designed to process and remove dead cells.However, if its concentration is too high, healthy areas of cartilage suffering - cell membranes become thinner, erosion foci appear in the synovial seizure of the joint.This process, if not interrupted, treating knee arthrosis with drugs, can flow within a few weeks and with chronic stress, lack of sleep or insufficient diet constantly.
Finally, without treatment, knee osteoarthritis leads to a complete reduction in joint gap lumen due to osteophyte growth.The gap required for normal motion is closed and the patient cannot fold the leg even 30-45 °.Difficulty represents not only climbing the stairs, but also an attempt to get up from the couch or the common movement.This condition is accompanied by pain from which common painkillers do not help.In such cases, an option for the treatment of knee joint arthrosis remains - surgical, with a complete replacement of prosthesis joint architecture and subsequent long -term rehabilitation.But in this case, most patients cannot return to a completely normal life.
Treatment of knee joint osteoarthritis
Depending on the stage of the disease and the condition of joint, conservative or surgical treatment of knee joint arthrosis.
The treatment of arthrosis of the 1st degree knee articulation is always performed by conservative methods -in the case of a successful combination of circumstances and good self -discipline, the patient can be obtained or persistent remission.
The treatment of knee arthrosis of the 2nd degree knee articulation, as a rule, is based on the use of all conservative effects methods, but the doctor may decide on smaller surgical interventions in the joint if the disease develops aggressively or with complications.
The treatment of 3 -degree knee articulation arthrosis almost always implies surgery.
Complex conservative treatment of knee joint arthrosis involves the removal of pain and inflammation, cartilage restoration and an increase in the volume of joint movements.For this, the patient receives an orthopedic regime of cargo and rest, system and local medicines (anti -hormonal and non -hormonal inflammatory, analgesics, chondroprotectors and others).Innovative biological methods are also spread - injections of medicines for the treatment of knee joint arthrosis directly in the joint bag.At the same time, PRP (blood plasma, enriched with platelets) are used, as well as stem cell injections obtained from the patient's own fatty tissue.At the same time, auxiliary and rehabilitation methods are connected - physiotherapy, massage, manual therapy, therapeutic gymnastics.
Surgical treatment of knee joint osteoarthritis is performed in cases where drugs are powerless.With this pathology, the doctor can prescribe the following interventions:
- Arthroscopy of the knee articulation.The collective name of a minimally invasive operations group designed to remove the broken area of joint or osteophyte tissue, or partial excision of the joint shell.It allows you to delay or exclude prostheses and eliminate discomfort in the early stages of the disease.It is mainly used for the treatment of knee arthrosis in patients under 60 years.
- Osteotomy.The operation to cut part of the bone and correction of the load axle in the painful knee, which allows to reduce degenerative changes.It is usually performed in the treatment of high -degree knee articulation arthrosis.
- Endoprostrate.Partial or complete replacement of knee joint with a titanium implant, which serves for 15 to 20 years.This technique is an extreme measure as it carries certain risks.Recommended for patients over 55 years old.
All of these operations require the recovery period and have several against -indications;Therefore, the best option remains prevention (exercise therapy, chondroprotective) and the treatment of knee joint arthrosis in the early stages.
In addition to the main therapeutic techniques, diet therapy and other methods to decrease body weight are used.To unload the painful joints, bandages and other orthoses are used (walking sticks, orthopedic insoles, etc.).
The treatment of knee arthrosis is prescribed by a rumatologist or orthopedist.In the first reception, he palpates the joint, performs motor tests and then directs the patient to tomography or radiography.
Therapeutic Gymnastics for Knee Arthrosis
Medical Physical Education for lower belt members is considered the most effective method of reducing pain and treatment of knee joint arthrosis.The first results of therapeutic gymnastics occur after 2-4 weeks of continuous classes.Continuity in the treatment of knee joint arthrosis is one of the main factors that affect the effectiveness of exercise with therapy.A complete lesson is held once a day a day, it is also recommended to do at least 3-4 warmths during the day.
Therapeutic gymnastics for knee arthrosis during periods of remissions will help alleviate pain syndrome.
The main task of exercise in the treatment of knee joint osteoarthritis is to strengthen the thigh and leg muscles, maintaining the elasticity of ligaments and tendons, as well as the fight against muscle atrophy, which is characteristic of arthrosis.This allows you to transfer the load from the joint structures to the periarticular - and thus reduce the mechanical abrasion of the cartilage, reduces inflammation.
The exercises for the treatment of the knee of arthrosis are performed for both legs!When acute pain appears, the lesson should be interrupted or continued at a softer pace.
- Home position - Lying on your back.One leg is extended to the floor, the other is increased by 90 ° (the leg is parallel to the floor).We perform movements with the leg up and down as much as the amplitude of the joint movements allow.
- Home position - Lying on your back.We performed the exercise "bicycle".
- Home position - Lying in the stomach.In turn, we shaking our feet, trying to bring the heels closer to the buttocks.
- The starting position is lying sideways, the hand is bent under the head or stretched over the head along a line with the body.The other hand rests on the side.We do balances upside down.We changed the side.
- Home position - Lying on your back.We pulled our legs forward on the floor in front of the heel (of ourselves), the socks look "to ourselves".
- Home position - Lying in the stomach.We do the exercise "boat".If the physical preparation does not allow, we put the palms on both sides of the chest and take our legs back, experiencing stress on the posterior surface of the thigh and leg.
- Home position - Lying on your back.We turn our feet in turn, trying to describe with the socks the most complete circle.
- Starting position - standing against the wall.He crouched slowly and gently, without looking at the back of the wall to distribute the load.When the legs are folded on the knees at 90 °, we start the soft move upwards.
- The starting position is standing.Alternatively, we are swinging our feet forward, back and sideways.
Note: Therapeutic gymnastics after the board operations have its own details and changes, depending on how many days have passed since surgery.It is prescribed by a surgeon or rehabilitologist.
Knee arthrosis massage
Therapeutic massage for knee arthrosis is performed on both legs.At first, at least 10 to 12 sessions are required for a rehabilitologist or equipment for whirlpool equipment, but a general massage of general strengthening can be performed at home.Includes the following types of movements:
- caressing and superficial friction (up and down, software and anti -overseas direction);
- Investigate and lengthen with the ends of the deeper fabric fabrics;
- Tighten and touching the skin.
Knee arthrosis massage should be done by a specialist who will not harm the sick joint.
Self -massage can be combined with the treatment of knee joint arthrosis with medicines: it will not be superfluous to apply a heated ointment or balm before or during the session.You can also take a hot shower before the procedure.
IMPORTANT: Massage is against -Indicated to patients with symptoms of inflammation (osteoarthritis or exacerbation of arthrosis).In this case, therapy is required for the acute phase.
Diatotherapy for arthrosis
The standard energy protocol in the treatment of knee joint arthrosis requires:
- Limit products and dishes rich in simple carbohydrates (white bread, confectionery, snacks, sweets, potatoes, sugar);
- Delete processed (ready for use) and rich - fast food dishes, semi -agreed products, sausages;
- Refuse alcohol, decoded coffee and greasy meat.
Instead, you should include in the menu:
- grain and whole grain dishes;
- Fat fish of northern seas and dietary meat of birds;
- Cartilage (ears, nyushki, legs and other parts rich in collagen), cold men and jam;
- Vegetables and fruits rich in vitamins and antioxidants (in particular, vitamins A, B12, C, E);
- Nuts and other sources of fat omega acids and valuable minerals.
The knee joint arthrosis diet provides a balanced diet, which helps restore cartilage tissue.
The treatment of knee joint arthrosis with drugs - Vitamin Mineral Complexes (2 courses annually) is also recommended.
Physiotherapy for the treatment of knee osteoarthritis
The following physiotherapeutic procedures are used for the effective treatment of knee arthrosis and to improve the action of medicines:
- Magnetotherapy;
- laser therapy;
- UHF;
- Ultrasound therapy;
- amplipult;
- electrophoresis (including medicine);
- Ozoiory and paraffin applications;
- thermotherapy (cryotherapy, inductothermia);
- phonophoresis;
- Balneological therapy (hydrogen sulfuric sulfuric baths).
Acupuncture in the treatment of knee joint arthrosis 2 degrees, as a rule, is not used.
Before visiting the procedures, you need to consult a doctor - many types of physiotherapy are against -indication in the exacerbation of the disease.
Drugs for the treatment of knee joint arthrosis
The treatment of knee joint arthrosis with drugs is performed symptoms and taking into account the individual reaction of the patient to selected medications.DRIVERY THEORE - Injections, Ointments or Compresses for the Treatment of Knee Articulation Arthrosis - Courses are usually prescribed or as needed.
To choose the right drug for the treatment of knee articulation arthrosis, consult a doctor who, after the study, will select the necessary medicines.
In the treatment of knee articulation arthrosis, there are several directions: relief of the patient's life, improving cartilage nutrition, cartilage regeneration and maintaining the standard of the muscular liner.
Anti -non -inflammatory drugs -esteroids
To relieve NSAID exacerbations in tablets or capsules, they take courses (about 12 days) or, if necessary, depending on the intensity of pain syndrome.Non -controlled NSAID reception with impaired doctor instructions or recommendations is full of stomach or bowel ulcer.They should be very careful to take them in combination with glucocosteroids and drugs that affect blood clotting.Additional Risk Factors - Age over 65 years, tobacco, alcohol intake during the course.In such cases, doctors often recommend administration of medications injection by ignoring the gastrointestinal tract.Together with NSAIDs, it is advisable to take gastroprotectors.
The maximum effect can be achieved with a combination of systemic (for internal administration) and external NSAIDs - in the form of ointments, creams or gels.The second option provides a point effect on the affected joint and at the same time affects digestion.
Corticosteroids (steroid drugs for the treatment of knee joint arthrosis)
Hormonal drugs (Civil Code) are usually used to block knee steroids in cases where AINE is not enough to calm pain and inflammation.
Glycocorticoid injections are considered an extreme measure in the treatment of knee joint arthrosis with medicines.They provide relief 20 minutes after administration, but hormonal disorders and cartilage tissue damage, violating administration rules.Due to side effects, many orthopedists prefer a knee operation of prolonged CC therapy.
Condropoprotectors in the treatment of knee joint arthrosis
CondoProtective agents based on nuclei extracts and cattle cartilage, marine fish and mollusks contribute to the restoration of synovial cartilage and, therefore, are irreplaceable for the effective treatment of knee arthrosis.Condroprotectors contain a large number of glycosaminoglycans - natural polymers, from which cartilage is built.Therefore, they make chondrocytes (cartilaginous cells) more stable, contribute to their growth, enrich the synovial fluid.
Unlike anti -inflammatory drugs, chondoprotectors are hardly against -indications.They provide a cumulative and prolonged effect-first improvements occur after 1-3 months of admission, and the course duration is 3-6 months.
Skin scattering agents
External preparations for the treatment of knee arthrosis with a growth effect locally improve blood circulation and joint nutrition and also distract the patient from pain.For this purpose, ointments, gels, creams, and we are used based on natural ingredients - bee or snake poison, burning pepper extract.
In the presence of an allergic reaction (persistent redness and skin pain, rash), during pregnancy and lactation, as well as in the presence of other against -indications, it is best to avoid heating ointments for the treatment of knee joint arthrosis and limit to hot baths, applications and anti -inflammatory drugs.
Synovial fluid prostheses
If the synovial liquid in the joint is too small, the sliding of the joint surfaces will be disturbed.And most importantly, the hunger of the cartilage begins, because the joint liquid, which only drinks it like a sponge, usually provides nutrients for the growth and maintenance of cartilage tissue.To prevent cell destruction and mechanical abrasion of knee cartilage, the doctor may prescribe high molecular molecular weight derivatives injections.The injections of the drug in the treatment of knee joint arthrosis (Viscostering) are made directly in the joint scholarship, which leads to fast relief, which lasts 3 to 12 months at the end of the course.However, with the introduction of prostheses, there is a risk of necrotic changes or joint infections.
Antispasmodic, painkillers, muscle relaxants
In cases where spasms and muscle tension prevent the patient from falling asleep, creating pain during movement, the doctor prescribes antispasmodic and muscle relaxing.
Simple analgesics in the treatment of knee joint arthrosis are not used, as they mask the pain, but do not relieve inflammation.You can use them or accessible NSAIDs without a prescription for up to 10 days, after which an exam is required.
The form of release of medicines for the treatment of knee joint arthrosis
For the convenience of patients, drugs for the treatment of knee joint arthrosis are released in various ways.Is there a difference between them and which one to choose?
Preparations for the treatment of knee arthrosis have various forms of release: sasha, injections, ointments, tablets.Choose what is best suited for you.
Capsules, sasha and tablets for the treatment of knee joint arthrosis
Non -steroid, corticosteroid, chondoprotectors and muscle relaxing drugs are produced in oral administration forms.In this case, they are easy to dose, the reception is possible without the participation of a medical worker, it is easy to control which part of the course has already been approved.When you take chondroprotectors and NSAIDs in, they have reasonably high bioavailability (especially in the form of sasha).Upon taking a chondroprotective in the periarticular region, more than 95% of the beneficial substances of the drug are obtained.
Injection Solutions
In the form of injections, you can pick up the NSAIDs already mentioned, Civil Code, CondoProtectors and muscle relaxants, as well as synovial liquid prostheses.This method of treatment of knee joint arthrosis demonstrates maximum bioavailability.
This method of treatment of knee arthrosis is safe for digestion, but it is desirable that injections (intravenous, intramuscularly in the joint or intraarticular) place a qualified medical team.Intramuscular injections in the buttock or thigh can be made independently.
External use
Local, anti -inflammatory and chondroprotector growth ointments are used externally to treat knee joint arthrosis.The advantage of such a medicine is to direct effects on the affected tissue.But on the way to active substances, a skin barrier increases - unfortunately, usually only 5% of active ingredients reach the desired tissue layers.
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