Complex treatment of knee arthrosis

Diseases of the musculoskeletal system lead to significant restrictions on human mobility. In order not to bring complications, it is necessary to carry out the treatment in a timely manner. Knee arthrosis is the most common form of damage to skeletal bone joints and the most common cause of disability. But, with a timely visit to the doctor, you can get rid of the disease.

GENERAL INFORMATION

Arthrosis of the knee joint is the unofficial name of the disease. In medicine, it is known as osteoarthritis. The word is made up of two ancient Greek words - bone and joint. Other synonyms:

• deforming osteoarthritis or DOA in abbreviated form (the first word of the name reflects the main clinical symptom - joint deformity);
• gonarthrosis (from a combination of the ancient Greek words "knee" and "joint").

Sometimes the disease is mistakenly called arthritis, although traditionally this term refers to a connective tissue disease that has nothing to do with arthrosis.

The essence of arthrosis is that the cartilage tissue that lines the joint surface is damaged, which causes inflammation, the work of the bone joints is stopped and the pain appears. Unfortunately, this is a very common pathology, which is diagnosed mainly in older people (especially overweight) and in young athletes due to injuries.

For effective treatment, it is necessary to perform a thorough examination of the patient with osteoarthritis, in particular, to identify the reasons that caused the problem of the musculoskeletal system. Most of the time, the following factors lead to the disease:

CAUSES AND SYMPTOMS

For an effective treatment, it is necessary to perform a complete examination of the patient with osteoarthritis, in particular, to identify the reasons that caused the problem of the musculoskeletal system. Most of the time, the following factors lead to the disease:

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

Late access to a doctor threatens with constant pain in the knee area and complete loss of joint mobility.To avoid this, you need to sign up for an appointment with a specialist if you experience knee pain when walking and painful sensations that intensify when going down or up stairs. If treatment is not started at this stage, the situation will worsen - the pain will cease, movements will be limited, the knee will be deformed.

The longer you don't see a doctor, the more difficult, time-consuming and expensive the treatment of gonarthrosis will be.

DEGREE OF DISEASE

Arthrosis is diagnosed by a doctor. It not only identifies the disease, but it also determines its degree. There are three of them:

• First. It is possible to cure the disease in the initial phase, because at this moment there are no morphological disorders of the tissue, the muscles are weakened, but not yet altered, and the joint starts to tolerate the load worse due to dysfunctions of the synovial membrane and the biochemical composition of the fluidcavity that feeds the cartilage and menisci. Overuse leads to inflammation and pain.

• Second. At this stage, the cartilage and meniscus begin to collapse, the load on them leads to pathological growths in the bone tissue, narrowing the joint space. Because of this, the knee increases in size and looks deformed. The treatment of bilateral gonarthrosis of the 2nd degree knee joint is already more difficult compared to the first stage. Pain and inflammation become chronic.
• Third. This grade is already considered serious. At the same time, bone deformation is clearly expressed, the axis of the limb is altered, due to which the mechanical load is not distributed correctly. The ligaments of the joint are shortened, natural movements are limited because of this, and then the leg can be completely immobile. The treatment of grade 3 arthrosis of the knee joint without surgery is impossible, as 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 postpone going to the doctor. But this view is not correct. Every day, the load on the main elements of the joint, already starting to collapse, increases and pathological changes can lead to complete destruction of the joint and severe limb dysfunction.

CLINICAL CHAIN ​​

The progression of the disease is accompanied by characteristic symptoms. The pain occurs in the middle of the night, even if the leg is still. The stiffness is felt in the morning.

Walking becomes difficult when passing a certain distance, right 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.

Mild lameness in the first stage subsequently becomes pronounced. As a result, walking, using public transport, performing professional tasks, housework and even self-service can become completely impossible.

TREATMENT METHODS

Popular recipes, pharmaceutical compresses and ointments will not help to eliminate the disease, as the approach must be comprehensive.Recovery is usually only possible in a hospital where a doctor will treat knee arthrosis.What kind of recommendations to give the patient, he decides based on the indicated complaints and associated pathologies. The following points are generally mandatory:

• reducing the load on the joints;
• adherence to the orthopedic regime;
• physical therapy (exercise therapy);
• in physiotherapy.

All of this helps to slow down the progression of arthrosis and prevent loss of motor function. It should be understood that the methods used will depend a lot on the hospital's capabilities and the availability of one or other physical therapy equipment. It is better that the patient has the opportunity to go to a spa treatment or to a specialized orthopedic clinic, where a modern approach to the choice of drugs, diet, methods, etc. will be provided.

USE OF MEDICINES

Inflammatory processes and painful sensations make treatment of knee osteoarthritis impossible without drugs in the form of pills, creams, ointments and injections. In the first stage, you can use non-steroidal anti-inflammatory drugs - diclofenac, indomethacin, nimesulide, etc. These same hormones are used during periods of acute pain.

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

PHYSIOTHERAPY METHODS

Significant improvements can be achieved with physical therapy. The following methods are considered to be the most effective:

• Shockwave therapy. This method has worked well for the past 20 years. Its essence is in the effect on the affected area with a special device that emits radial acoustic waves that activate the blood supply and stimulate tissue repair.
• Myostimulation. This therapy targets the muscles around the joint. Low current impulses 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. Typically, these dosage forms are absorbed by only 5-7%, but high frequency ultrasound vibrations heat tissues and absorption increases several times. In addition to the good therapeutic effect, it saves 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 complement and, in some cases, an alternative to using hormonal medications.

MEDICAL EXERCISE

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

It is believed that exercise therapy exercises performed correctly and consistently can save the patient from the need for surgical intervention. Currently, experienced specialists have developed many special daily training methods that strengthen muscles and increase their strength and endurance, inhibit pathological tissue destruction, restore joint mobility and range of motion.

The most important thing in this type of treatment is regularity.A good effect is achieved only by patients who understand the need for lifestyle changes and strictly follow the doctor's recommendations on the proportion of physical activity and periods of joint rest.

PASSIVE KINESITERAPY

Lymphatic drainage, massage, manual therapy are a good addition to medication, physiotherapy and exercise therapy. They are indispensable for sedentary patients and can improve the condition of your muscles, joints and ligaments.

Another method of passive kinesiotherapy is mechanotherapy. It uses special devices - vibration simulators, weighing materials, mechanical massagers, which increase the effectiveness of the treatment.

The extension of the joints, in which the space of your cavity increases mechanically, allows you to get rid of the pain and interrupt the destructive processes. Regular use of this therapy will prolong knee health for years.

COMPLIANCE WITH THE DIET

As obesity is often the cause of osteoarthritis, patients with this diagnosis need to take care of weight loss. Weight loss reduces joint stress and facilitates exercise therapy. Sometimes, the diet is not enough, so bariatric surgery is necessary, but these situations are rare.

Another indication for adherence to a certain diet can be any pathology associated with arthrosis. 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 the body strengthen the affected cartilage tissue by including foods rich in collagen in your diet, which include jelly and gelled meat, fish oil, berries and fruits. It is best to avoid consuming unhealthy foods such as sugar, soft drinks and alcohol.

SURGICAL INTERVENTION

In advanced cases, a quick solution to musculoskeletal system problems is to perform operations. In arthrosis, the following types of surgical intervention are prescribed:

• The puncture allows you to get rid of the liquid accumulated in the joint cavity. As a result, inflammation is reduced, due to which knee mobility is restored.
• Arthroscopy makes it possible to clean the joint surface of pieces of destroyed tissue. It is performed with thin and flexible instruments with a video camera, avoiding dissection of the joint cavity.
• Periarticular osteotomy allows you to change the angle of one of the bones that form the knee joint, due to which the load is redistributed, mobility increases and pain is relieved. This intervention is quite traumatic, as the bone has to be sawn.
• The stent makes it possible to replace a diseased joint with a biocompatible structure. At the same time, the previous range of motion is restored, but the operation is quite new and very complicated, after which a long rehabilitation is necessary.

Surgery is rarely necessary in the first stage. In the second, it is necessary only occasionally, but in the third you cannot do without it.

PATIENT EVALUATIONS

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 will be to strictly follow the recommendations of the orthopedist. Only then is it possible to obtain a good result quickly. This is confirmed by patients diagnosed with gonarthrosis.