Deformation of osteoarthrosis of the knee joints (also known as gonarthrosis or abbreviated DOA) is a degenerative-dynist disease of the knee joint, which is characterized by chronic, constantly progressive pathways, damage to all structural elements (hyaline poria, periastal bone structures, synovial shell, one wrist and lead).
The disease begins with changes in articular cartilage, which causes the bone joint surfaces.The interruption and loss of elasticity leads to dystrophy (thinning) and resorption, while the bone tissue of the joint surfaces is exposed, the slippage is disturbed, the joint gap narrows, and the joint biomechanics changes.Synovial shell of the production of the joints and synovial fluid is irritated (which nourishes cartilage and the role of physiological lubrication) leading to an increase in the amount of joints (synovitis).In the background of narrowing of the joint gap, the volume of the joint is reduced, and the synovial fluid pulls out the back wall of the joint capsule.The thin and fine tissue of the joint capsule is replaced by a coarse connective tissue, the shape of joint changes.The periosurpital bone tissue increases and osteophytes (growth of pathological bones) are formed.In the periarticular tissues, blood circulation is disturbed and underestimated metabolism products, irritating chemoreceptors, and persistent pain syndrome.Changes in the anatomy of the joint damage the work of the surrounding muscles, the appearance of hypotrophy and cramps, and the disturbance of walking.There is a lasting restriction of joint movements (contracture), sometimes so pronounced that only rocking movements (stiffness) or complete lack of movements (ankylosis) are possible.
Gonarthrosis is a fairly common disease: they suffer from 10% of the planet's total population and affect every third person in the age of 60.
The causes of gonarthosis
- Injuries of bones and joints.
- Inflammatory arthritis (rheumatoid, chlamydia arthritis, gout).
- Violation of mineral metabolism with various endocrinopaths (diabetes mellitus, parathyroid disease, hemochromatosis).
- Disease of muscle device and neuropathy (CSRIGOT).
In addition to the main reasons, the harmful background factors of gonarthrosis are distinguished, including the following:
- overweight (literally put pressure on the lower limbs);
- age (the disease is primarily exposed to elderly);
- female gender (a woman's statistics say they will be patients more often);
- Increased sports and professional physical effort.
Symptoms of osteoarthrosis of the knee joints
- The pain that increases when it walks alone and weakens.
- Difficulty in the familiar, physiological movements of the joints.
- Typical "crunch" in the joints.
- Growth of the joints in the amount and their visible deformation.
Sections of gonarthrosis
Clinical stages of arthrosis of the knee joint
The disease goes through several stages.
- In the first stage, only one person feelsA feeling of a little discomfortor "severity" in the knee that interferes or enhances physical efforts during long -term walking.Radiological examination will not be information: only a small narrowing of the joint can be identified, there is no other change.
- The second stage is characteristicTangible pain, whose severity decreases at rest.The joints have difficulty in the joints, and when walking, they hear a characteristic "squeak" (you hear a traditional sentence from the patient in everyday life - "kneeling of the knee").When the radiography is performed, there is a clearly distinctive narrowing of the joint gap and a single osteophytes.
- When the transition of gonarthrosis to the next third stage,Pain constantly disturbs the patientIncluding tranquility, they violate the configuration of the joints, that is, the deformation increases the edema when the inflammation is connected.X -rays determine the narrowing of the medium and multiple osteophytes.In the third phase, many are already seeking medical help because the quality of life suffers significantly due to the pain and the difficulties of normal walking.
- Is accompanied by the fourth stageSurrounding, exhaustive pain- Minimum attempt to move is a difficult test for people, the deformation of the joints is visually noticeable, and the walk is extremely difficult.X -Ray finds significant changes: the joint gap of images cannot be defined, more rough osteophytes, "joint mice" (fragments of the devastating bone falling into the joint cavity).This stage of gonarthrosis is almost always a disability.
Who treats the artrose of the knee joint?
The therapist, the rheumatologist and the general practitioner (family doctor) can provide qualified medical attention to gonarthrosis, but these experts treat the knee joint with non -complicated arthrosis.If synovitis occurs or the treatment prescribed by the therapist does not give the right effect, it will not be able to do so without orthopedics.In situations where surgical care is required, the patient is sent to a special orthopedic traumatology department.
How and what should be treated with joint treatment of the knee joint?
The methods of treating arthrosis of the knee joint, now known, non -drog conservative, medication and surgical.
No -drog methods
Many patients wonder: "How to cure the knee joint artrosis without tablets?"In response, it must be regretted that gonarthrosis is a chronic disease, it is impossible to eliminate forever.However, today's existing methods can significantly slow down its progress and improve the quality of the patient, especially when used in the early stages of the disease.
The timely search for a doctor and the patient's motivation to heal is sometimes sufficient to eliminate negative factors.For exampleTo reduce overweightReduces the manifestation of the main symptoms of the disease.
To exclude abnormal physical effort and, on the contrary,Classes of therapeutic gymnasticsThe use of rational physical programs reduces the intensity of pain.The exercises to strengthen the four -headed hip muscle have been proven to be comparable to anti -inflammatory drugs.
If the joint treatment of the knee joint is treatedproper nutrition: To improve the elastic properties of the articular cartilage, it promotes large amounts of animal collagen (dietary types of meat and fish) and chondroitin (shrimp, crabs, crilies), saturated vegetable collateral and antioxidants, fresh vegetables and fruits, and smoked foods.The Paveds Paveds.Unlike the violation of metabolic processes in the body and the accumulation of excessive weight until obesity.
Complex treatment of arthrosis of the knee joint also includes a very effective appointment with advanced forms of diseasePhysiot- has proven its efficiency with wide use in different categories of patients with diseaseMagnetic therapy: After many procedures, pain intensity reduces blood circulation, reducing edema and elimination of muscle cramps increases joint mobility.The effect of magnetic therapy is particularly vivid in the joints of the joint: the severity of edema is significantly reduced and the phenomena of the regression of synovitis.Not as popular, but no less effective in treating the knee joint with arthrosis.Laser therapy and cryotherapy(Cold exposure), pronounced analgesic effect.
Drug treatment
The following drugs are used in the schemes for effective treatment of the arthrosis of the knee joint.
No -steroid anti -inflammatory drugsIn the forms of external (various gels, ointments) and systemic use (tablets, candles, solutions), they have long proven their effectiveness in the treatment of osteoarthrosis and are widely prescribed.Blocking inflammation at the enzymatic level, eliminating joint pain and swelling, and slows down the progress of the disease.It should be remembered that prolonged systemic techniques can cause the development and aggravation of ulcerative processes in the stomach system and can negatively affect the functions of the kidneys and liver.Therefore, patients who take the medicine for a long time should also prescribe drugs that protect the stomach mucosa and regularly monitor laboratory indicators of internal organs.
Glucocorticosteroids (Gks)- Hormonal drugs have a pronounced anti -inflammatory effect.Because they serve as a powerful anti -inflammatory agent, GCs have some contraindications because they can draw many significant side effects.It is virtually not prescribed in the form of the gonarthrosis system.As a general rule, effective treatment of arthrosis involves the injection of GCs to Perihuman pain points, which increases the intensity of the inflammation and minimizes the risk of the drug's undesirable side effects.The use of GC with a single introduction lasts for 1 month.In line with the national recommendations for the treatment of osteoarthritis, the drug can perform more than three injections a year in the same joint.
Far -Go, with the "neglected" osteoarthritis, when a person experiences unbearable pains that are not even lost even in rest, a normal sleep violation, recipe is possibleopioid painkillers- These drugs are used only according to the doctor's prescription, who always examines the feasibility of their appointment.
Chondropotectors(With literal translation - "protection of cartilage").This name is understood as various drugs, which are combined with a trait - a structural - modification effect, that is, the ability to slow down the degenerative changes of the cartilage and the narrowing of the joint.These are produced in the form of oral administration (glucosamine, chondroitin sulfate, piastaline) and in the form of an introduction to the joint cavity (hyaluronates).Of course, these drugs are not surprised and do not "grow" a new cartilage, but they can suspend its destruction.To achieve a lasting effect, these should be used for a long time, regular courses several times a year.
Knee joint surgery
The most popular type of surgical care of gonarthrosisEndoprostics, ie removing your own joint by simultaneously installation of a metalloprothesis that replaces the one that is similar to the anatomy of the person's knee joint.At the same time, this type of surgical treatment is a prerequisite: lack of gross deformation of charter, "fake joints", muscle controphy and pronounced muscle atrophy.In the case of severe osteoporosis (a significant decrease in the mineral density of bones), endoprostany is also not indicated: the "sugar" bone does not resist the introduction of metal taps, and at the site of installation, rapid renewal (resorption) of bone tissue begins and pathological fractures may occur.Therefore, the timely solution of the need to install endoprothesis is so significant - it should be accepted if the age and general condition of the human body continue to allow surgery.
Although widespread the endoprostany of the knee joint, the results of such operations are often unsatisfactory and the percentage of complications is high.The reason for this is the design features of endoprotheses and the complexity of surgical intervention itself (replacing the hip joint is much easier from a technical point of view).
Artomromedullary flood- Connecting the femoral bone marrow to the knee joint cavity - a hollow metal tube.As a result, the oily bone marrow from the lower third of the femur enters the knee joint, nutritious cartilage and lubrication, resulting in a significant reduction in pain.
With the above, I would like to note that treatment of gonarthrosis is a complex social task.And while today's medicine is not able to offer a medicine that forever eliminates or other methods to complete the disease, a healthy lifestyle, medical attention in time, and the doctor's recommendations can suspend its progress.