Knee osteoarthritis is a disease of the musculoskeletal system, which consists in the deformation and destruction of cartilage tissue, as a consequence, the structure and functions of cartilage are violated. The disease has several names — osteoarthritis, deforming osteoarthritis. Treatment of knee OA has no clear scheme or a single medicine that could help equally to all who suffer from this problem. Since osteoarthritis is a disease with a progressive nature, occurs more frequently in women suffering from obesity, venous disease, and the elderly. Treatment is manufactured and prescribed individually for each patient.
Knee osteoarthritis can be single or double (depending on whether one or two legs develop the disease). When the first symptoms to seek adequate treatment because ignoring the problem may lead to the final destruction of the cartilage and exposure of bones and, consequently, disability of the person.
There are three stages of disease:
- The initial stage of arthrosis is characterized by a loss of cushioning properties and as a result, cartilage in the movement begin to RUB against each other, causing severe discomfort to the patient. The cartilage becomes rough, deformed, dry, in advanced stages of the disease, even covered with cracks.
- Due to the decrease in depreciation starts the deformation of the bones, which leads to the formation of osteophytes (outgrowths on the surface of the bones) — this is the second stage of the disease. Warping the joint shell and the capsule is also subject to deformation, the knee joint will gradually atrophy due to the constrained movements. There is also a change in the density of joint fluid (it becomes more dense, viscous), poor circulation, deterioration of nutrients in the knee joint. Thinning of the pads of cartilage between joints reduces the distance between the articulated bones.
- The disease progresses rapidly and quickly moves to the third stage, when the patient is almost not able to move because of the constant knee pain. In the cartilage there is a global and irreversible changes, leading to disability of the person.
Most often osteoarthritis or osteoarthritis develops after trauma or injury, the person feels constant severe pain in the knee, which significantly constrains its movement.
The reasons for the development of osteoarthritis
Knee osteoarthritis treatment which takes quite a long time, may occur due to such factors as:
- Genetic predisposition.
- Trauma: sprains, bruises, fractures. In the treatment of the injured knee joint is fixed and some people may not bend and straighten the leg. This leads to poor circulation that often causes the development of post-traumatic gonarthrosis.
- Removal of the meniscus.
- Excessive physical exertion, not corresponding to the age of the person leading to injury or trauma and hypothermia of the joints. For example, not recommended for older people Jogging on the pavement or squats, as these exercises there is a significant pressure on the knee joint, which wears out with age and are not able to carry such loads.
- Excess weight and obesity. This factor leads to damage of meniscus, injuries which may occur during the development of osteoarthritis of the knee.
- Loose ligaments or weak ligaments.
- Arthritis or other acquired diseases of the joints. The inflammatory process can cause the accumulation of synovial fluid in the joint cavity or tumor. This causes a breakdown of cartilage of the knee, leading to osteoarthritis of the knee.
- Violation of metabolism in the human body. Inadequate calcium significantly impairs the condition of the bone and cartilaginous tissues in the human body.
- Flat feet. Incorrect structure of the foot shifts the center of gravity and the stress on the joint becomes more.
- Stress and nervous tension.
The symptoms of osteoarthritis of the knees
The clinical picture of the disease has the following symptoms:
- Pain. The pain occurs suddenly, depending on the physical load on the knee joint. Pain can be of different nature. At the initial stage it is a weak shot that usually the person does not pay much attention. Periodic weak pain can occur for months and sometimes years before the disease does not go into a more aggressive stage.
- Visible deformity of the knee. This symptom manifests itself in the later stages. First, the knee looks swollen or swollen.
- Accumulation of synovial fluid in the joint cavity or cyst Baker. It's a tight formation at the rear of the knee joint.
- The crunch of the joints. Sharp crispy sounds, which are accompanied by pain sensations experienced by patients on the second and third stage of the disease.
- The inflammatory response in the articular synovial membrane, in consequence of which the cartilage swells and increases in volume.
- Reduced mobility of joints. Observed in the later stages. Flexion of the knee becomes almost impossible and is accompanied by severe pain. At the last stage of the knee can be completely immobilized. The movement of the person becomes difficult or even impossible (some patients move on bent legs).
Treatment of osteoarthritis of the knee
Treatment of knee OA should be comprehensive. To date, no medical drug that eliminates this violation. One of the most important conditions of successful treatment is timely diagnosis. The sooner the treatment of osteoarthritis of the knee, the more chances to extend the period of remission and to prevent destruction and deformation of cartilage and bone tissues.
In the treatment before the doctor and the patient has a number of objectives:
- To eliminate or reduce pain;
- To improve the flow of nutrients into the knee joint and, thereby, enhance its regenerative functions;
- To intensify blood circulation in the knee joint;
- To strengthen the muscles around the joint;
- To increase the mobility of joints;
- Seek to increase the distance between the articulated bones.
The treatment of the disease depending on its stage of development can be conservative and operative.
Conservative treatment of osteoarthritis of the knee
Painkillers anti-inflammatory drugs
To relieve or reduce pain, the patient typically is prescribed a course of nonsteroidal anti-inflammatory drugs (NSAIDs). It can be pills, creams and injections. Among the most common pain medications include the following. These medications can be used in two ways — inside or topically.
Usually patients prefer local treatment in the form of gels, ointments, warming patches. The effect of these anesthetic drugs does not occur immediately, but after a few days (about 3-4 days). The maximum effect is achieved after a week of regular use of the drug. These medicines do not treat the disease as such, but only relieve pain, since to start treating when the pain is impossible.
The pain medicine should be strictly according to the doctor, use them only in severe pain, because prolonged and frequent use can lead to side effects and even to reproach the destruction of cartilage tissue. In addition, chronic administration of these drugs increases the risk of adverse reactions, including stomach ulcers, duodenal ulcers, disruption of normal functioning of liver, kidneys, possible allergic manifestations in the form of dermatitis.
Sometimes in the treatment of knee arthritis are prescribed a course of hormonal therapy. They are prescribed if NSAIDs have become effective, and the disease starts to progress. The most common hormonal drugs for the treatment of this disease are applied in the form of injections.
The course of treatment hormonal therapy is usually short and is assigned during severe exacerbations, when the joint is accumulated inflammatory fluid. The hormone is injected into the joint about once every ten days.
To restore and nourish cartilage in the early stages of the disease is assigned a course of treatment with glucosamine and chondroitinsulfate — the so-called chondroprotectors. This is by far the most effective treatment of osteoarthritis. They have almost no contraindications, and the side-effects manifest themselves in rare cases.
To relieve spasm of small vessels, improve blood circulation and delivery of nutrients to the area of the knee joint, and vascular pain vasodilators drugs. They crush together with chondroprotectors. If knee arthritis is not accompanied by accumulation of fluid, it is also recommended to use warming ointment, gels, liquids.
A course of physical therapy can be very useful and bring good results only in the case when prescribed by a physician and held under observation, according to the recommendations of the expert or coach. Self-medication is dangerous for health. Physical therapy is used as a further prevention of destruction of cartilage, slowing the development of stiffness, relaxation of muscle spasm causing pain. In the period of acute therapy is contraindicated. A course of special individual exercises, which take into account not only the stage of the disease and the condition in which the cartilage, and the patient's age, should develop the expertise in this area.
As one of methods of conservative therapy used physiotherapy, electrophoresis, laser therapy, acupuncture, diadynamic currents, UHF. Positive results are obtained and the rate of the local massage. Physiotherapy act in several ways — relieve pain, reduce inflammation, normalize the metabolism within the joint, regain its usual function. Method and duration of treatment physical therapy due to a history of the patient and is appointed only after a thorough diagnosis and study of the condition of joints.
To pain physical therapy include:
- Medium-wave ultraviolet irradiation (UV-irradiation). Contact of ultraviolet radiation with the skin of the knee is continued until a slight reddening. The fabrics are formed of substances that dull the sensitivity of nerve fibers, whereby analgesic effect. The duration of the course of treatment prescribed by the doctor depending on the symptoms, the frequency and severity of pain. The average course of treatment is approximately 7-8 sessions.
- Local magnetic therapy, aimed at the total recovery of the patient. This procedure reduces inflammation, eliminates pain and neutralizes muscle spasms. Effectively used for osteoarthritis of the knee joint in the initial stages. Treatment is usually limited to 20-25 procedures, each of which lasts about half an hour.
- Infrared laser therapy, low-intensity UHF-therapy, therapy centimeter (SMV-therapy).
- Ultrasound, darsonvalization, medicinal baths, the interference-therapy, which is appointed with the purpose of improving blood circulation in the joint.
Equally important is the sanitary-resort treatment. Assigned to this treatment in deformans and degenerative osteoarthritis. Such treatment as previously listed, has its contraindications, so the doctor carefully examines the history of the patient before suggesting him the sanitary-resort method.
Surgical treatment of osteoarthritis of the knee
This is a radical method of treatment of osteoarthritis of the knee, which partially or fully restores the functioning of the joint. Methods and forms of surgical intervention depends on the degree of joint disease, and the medical history of the patient.
Late osteoarthritis of the knee treated only by surgery — the knee joint is completely or partially replaced by the prosthesis. Surgical treatment can not only improve health, but also to return a disabled patient in the last stages of osteoarthritis of the knee. A significant drawback of the operation, many think of a lengthy recovery period with the use of exercise therapy, mechanotherapy, and other tools.
There are several types of surgical intervention for osteoarthritis of the knee:
Prevention of arthritis of the knee joint
In order to avoid this disease people at risk (athletes, the elderly, people who are overweight, employees of enterprises) must comply with certain regulations:
- Proper nutrition and fight obesity. You must eliminate from your diet harmful foods — fatty, fried and alcohol, and better to consult with a dietitian, who will individually help you choose the right diet.
- In sports to monitor the loads on the joints, if necessary, to reduce it.
- To monitor their health and treat infectious diseases, preventing their transition to the stage of chronic.
- Timely and adequate treatment of diseases of the spine, if any, development of a proper posture.
- Sports (Cycling, swimming, walking, special gymnastic exercises for the joints).
- No self-medication! When the first symptoms of arthritis of the knee joint to contact the clinic.
- To avoid stress, have proper sleep.
- Systematically increase your immunity (to harden or at least to take a course of vitamin 2-3 times a year).
- To avoid hypothermia, especially of the lower extremities.
Healthy lifestyle and timely treatment are the best prevention of arthritis of the knee.