Complex treatment of knee osteoarthritis

Diseases of the musculoskeletal system lead to significant limitations of human mobility. In order not to complicate the situation, it is necessary to carry out timely treatment. Osteoarthritis of the knee joint is the most common form of damage to the bones of the skeleton and the most common cause of disability. But a timely visit to the doctor can get rid of the disease.

GENERAL INFORMATION

Osteoarthritis of the knee joint is the unofficial name of the disease. In medicine it is called osteoarthritis. The word consists 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 “wrist”).

Sometimes the disease is mistakenly called 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 that coats the surface of the joint is damaged, as a result of which inflammation begins, the work of bone joints is disturbed and pain appears. Unfortunately, this is a very common pathology that is mostly diagnosed in older people (especially overweight) and in young athletes due to injuries.

For effective treatment, it is necessary to conduct a comprehensive examination of a patient with osteoarthritis, especially to determine the reasons that caused the problem of 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 a patient with osteoarthritis, especially to determine the reasons that caused the problem of the musculoskeletal system. The following factors most often lead to the disease:

• leg fractures;
• sprains, cartilage injuries, inflammation;
• impaired metabolism;
endocrine diseases;
• weakness of the ligament apparatus;
• hereditary predisposition;
• autoimmune diseases and infections that initiate joint tissue damage.

Late access to a doctor threatens constant pain in the knee area and complete loss of joint mobility.To prevent this, you need to make an appointment for a consultation with a specialist if you experience knee cramps while walking and painful sensations that increase when descending or climbing stairs. If treatment is not started at this stage, the situation will get worse - the pain will stop, the movements will be limited and the knee will be deformed.

The longer you don't see a doctor, the more severe, long-lasting and expensive gonarthrosis will be.

DEGREE OF DISEASE

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

• First. The disease can be cured in the initial phase, since there are no morphological tissue disorders at this time, the muscles are weakened but not yet changed, and the joint begins to withstand the load due to dysfunction of the synovial membrane and biochemical composition of the fluid cavity that feeds cartilage. Excessive use leads to inflammation and pain.

• Other. 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. As a result, the knee increases in size and looks deformed. Treatment of bilateral gonarthrosis of the knee joint of the 2nd degree is already more difficult compared to the first phase. Pain and inflammation become chronic.
• Third. This degree is already considered serious. At the same time, the deformation of the bone is clearly expressed, the axis of the limbs changes, due to which the mechanical load is not properly distributed. The ligaments of the joint are shortened, the natural movements are therefore limited, and then the leg can become completely immobile. Treatment of grade 3 knee osteoarthritis without surgery is impossible because 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 delay going to the doctor. But this opinion is not true. The load on the main elements of the joint increases daily, which is already beginning to deteriorate, and pathological changes can lead to complete destruction of the joint and serious dysfunction of the limbs.

CLINICAL CURRENT

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 is felt in the morning.

Walking becomes difficult when you walk a certain distance and 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.

Light lameness in the first phase subsequently becomes pronounced. As a result, walking, using public transportation, performing professional duties, daily functions, and even self-service can become completely impossible.

TREATMENT METHODS

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

• reduction of load on the joints;
• adherence to orthopedic regimen;
• physical therapy (exercise therapy);
• on physiotherapy.

All of this helps to slow the progression of osteoarthritis 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 the other 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 choosing medications, diet, methods, etc. will be provided.

USING MEDICINES

Inflammatory processes and painful feelings make the treatment of osteoarthritis of the knee impossible without drugs in the form of tablets, creams, ointments and injections. In the first phase, you can use non-steroidal anti-inflammatory drugs - diclofenac, indomethacin, nimesulide, etc. In the second and third you often have to fight inflammation with steroid drugs - triamcinolone, hydrocortisone. The same hormones are used during periods of acute pain.

In addition, you will need intramuscular and intra-articular injections of drugs that improve the condition of cartilage tissue (vasodilators and chondroprotectors).

METHODS OF PHYSIOTHERAPY

Physical therapy can make significant improvements. The following techniques are considered the most effective:

• Shock wave therapy. This method has worked well in the last 20 years. Its essence lies in the action on the affected area with a special device that emits radial acoustic waves that activate the blood supply and stimulate tissue regeneration.
• Myostimulation. This therapy targets the muscles that surround 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. Typical dosage forms are usually absorbed by only 5-7%, but ultrafrequency ultrasonic vibrations heat the tissues and the absorption increases several times. In addition to a good therapeutic effect, this also saves on 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 supplement, and in some cases an alternative to taking hormonal medications.

MEDICAL EXERCISE

Pain during physical exertion on the joint causes a person to try to avoid it. In the long run, this threatens physical inactivity, leading to muscle atrophy and ligament weakness. Of course, in the period of worsening, the load on the joint must be completely eliminated, but after a few days after the relief of inflammation and pain, it is necessary to start physiotherapy exercises.

It is believed that properly and consistently performed exercise therapy exercises can save a patient from the need for surgery. Currently, experienced experts have developed a number of 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 with this type of treatment is regularity.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.

PASSIVE KINESYTHERAPY

Lymphatic drainage, massage, manual therapy are good additions to medications, physiotherapy and physiotherapy exercises. They are necessary for patients who sit and can improve the condition of their muscles, joints and ligaments.

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

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

CHILD COMPLIANCE

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

Another indication for following 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 the affected cartilage tissue by including collagen-rich foods in your diet, which includes jelly and aspic, fish oil, berries and fruits. It is better to refrain from consuming unhealthy foods such as sugar, carbonated and alcoholic beverages.

SURGICAL INTERVENTION

In advanced cases, the quick solution to a problem with the musculoskeletal system is to perform surgery. The following types of surgery are prescribed for osteoarthritis:

• Puncture allows you to get rid of accumulated fluid in the joint cavity. As a result, inflammation is reduced, which restores knee mobility.
• 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 make up the knee joint, which redistributes the load, increases mobility and relieves pain. This intervention is quite traumatic, because the bone must be sawn.
• Endoprosthetics allows the replacement of a diseased joint with a biocompatible structure. At the same time, the previous area of ​​movement 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 sometimes, but on the third it is impossible without it.

PATIENT EXAMINATIONS

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. Only then can you achieve a good result quickly. This is confirmed by patients diagnosed with gonarthrosis.