The deformation of the knee osteoarthrosis (aka gonartrosis or abbreviated DOA) is a degenerative-district disease of the knee joint, which is characterized by a chronic progressive course, a course of contexts of all structural elements (hyaline jumps, periastal bone jumps, a pressure of the pressure and the pressure of the movement,movement. and often disability.
The disease begins with changes in the articular cartilage, due to which the joint bone surfaces occur.The composition and loss of elasticity lead to its dystrophy (thinning) and resorption, while the bone tissue of the articular surfaces is exposed, the slide is disturbed, the joint gap is narrowed, the joint biomechanics changes.Synovial shell that lines the joint and produces synovial fluid is irritated (which nourishes the cartilage and plays the role of physiological lubrication), which leads to an increase in its amount in fusion (synovitis).In contrast to the backdrop of the narrowing of the joint gap, the volume of the joint decreases, the synovial fluid adheres from the posterior wall of the articular capsule, the Becker cyst is formed (which, reaching large sizes, can cause pain in the popliteal).The thin and delicate fabric of the articular capsule is replaced by a rough connective tissue, the shape of the joint changes.Bone tissues are increasing, osteophytes (pathological bone growths) are formed.Blood circulation in periarticular tissue is concerned, and underestimated metabolic products, irritating chemoreceptors, develops continuous pain syndrome.Despite the backdrop of a change in the anatomy of the joint, a violation of the work of the surrounding muscles appears, hypotrophy and spasms appear, a walking is disturbed.There is a continuous restriction of the volume of movements in the union, sometimes so pronounced that only rocking movements (hardness), or a complete lack of movements (ankilosis) are possible.
Gonartrosis is a very common disease: they suffer from 10% of the total population of the planet, and at the age of 60 years of age affecting any third person.
The causes of gonartrosis
- Bone and joint injuries.
- Common inflammatory diseases (rheumatoids, arthritis of chlamydia, gout).
- Violation of mineral metabolism with various endocrinopathies (diabetes mellitus, parathyroid disease, hemochromatosis).
- Diseases of muscle apparatus and neuropathy (Charcot disease).
In addition to the main reasons, there are also adverse factors of gonarthrosis development, which include:
- overweight (literally exerts pressure on the lower limbs);
- age (the disease is mainly under the elderly);
- female gender (according to statistics in a woman, they get sick most often);
- Increased sports and professional physical exercise.
Symptoms of osteoarthrosis of the knee joints
- Pain that grows when walking and weakening only.
- Difficulty of physiological movements known in the joints.
- A characteristic "crisis" in the joints.
- Increased joints in quantity and their visible deformity.
Stages of gonartrosis
The clinical stages of the arthrosis of the knee joint
The disease goes through several stages.
- In the first stage, a person only feelsA little feeling of worryOr "severity" in the knee that disturbs while walking long distance or increased physical exercise.Radiological examination will be unofficial: it is possible to identify only a small narrowing of the common gap, there will be no other changes.
- The second stage is characteristicVulnerability, whose severity decreases at rest.There is a difficulty in the joints in the joints, when walking, a characteristic "wrinkle" is heard (from the patient you can hear a conventional phrase in everyday life - "threat creak").When performing radiographs, there are a clearly distinct narrowing of the common gap and single osteophytes.
- When the passage of gonarthrosis to the next, third stage,The pain will disturb the patient constantlyIncluded in the break, there is a violation of node configuration, ie.Deformation that intensifies due to edema at the time of inflammation.Radiographs determine the narrowing of the common gap of a moderate degree and numerous osteophytes.In the third phase, many are already applying for medical help because the quality of life suffers significantly due to pain and difficulty in normal walking.
- The fourth stage is accompaniedPainful, exhausting.Minimal efforts to move become a difficult test for humans, node deformity is visible visually, walking is extremely difficult.X -Ray reveals important changes: the joint gap in the picture is practically not defined, numerous rude osteophytes, "articular mice" (fragments of destructive bone falling into the joint cavity) are detected.This phase of gonartrosis almost always requires disability.
Who treats the arthrosis of the knee joint?
Therapist, rheumatologist and general doctor (family doctor) can provide qualified medical care for gonartrosis (family doctor), but these experts are treating the knee joint with uncomplicated arthritis.When a synovit or treatment prescribed by the therapist does not give the right effect, you cannot do without the help of an orthopedist.In situations where surgical care is required, the patient is sent to a specialized orthopedic-traumatological department.
How and what to treat the arthrosis of the knee joint?
The methods of treating arthrosis of the knee joint, known nowadays, are divided into non -drug conservatives, medicines and surgical.
Methods No -DRUG
Many patients are wondering, "How to cure knee joint arthrosis without pills?"Responding to him, it is regrettable to say that gonartrosis is a chronic disease, it is impossible to eliminate permanently.However, many existing methods today can slowly slow its progress and improve the patient's quality, especially when used in the early stages of the disease.
With the timely search of a physician and the patient's sufficient motivation for healing, it is sometimes enough to eliminate negative factors.For example, it is proven thatLowering overweightreduces the manifestation of the main symptoms of the disease.
Exclusion of pathological physical exercise and on the contrary,The therapeutic gymnastics classWith the use of rational physical programs, they reduce the intensity of the pain.It is proven that exercises to strengthen the strength of the four -headed hip muscle are comparable in effect with anti -inflammatory drugs.
If we treat the arthrosis of the knee joint, then we should try toProper food: To improve the elastic properties of the articular cartilage will help products containing a large amount of animal collagen (dietary varieties of meat and fish) and chrimrines (shrimp, crab, crill), saturated with collagen and antioxidants, sweet and fresh dishes, sweet plates and pools,Sweet, sweet pools and sweet pools and sweet pools, sweet pools and sweet pools and sweet pools and sweet pools and sweet pools, sweet pools and pools, sweet pools and pools, sweet pools, pools.On the contrary, a violation of the metabolic processes in the body and the accumulation of excess weight to overweight are empowered.
Complex treatment of knee joint arthrosis also includes the appointment of many effective even with advanced forms of the diseasePhysiot -procedure.Widespread in different categories of patients suffering from this disease, has proven its effectivenessMagnetotherapy: After some procedures, the intensity of the pain decreases, as a result of improving blood circulation, decreasing edema and eliminating muscle spasm increases joint mobility.The effect of magnetotherapy is particularly vibrant during the development of active inflammation in the joint: the severity of the edema is significantly reduced, the phenomena of synovitis regression.Not so popular, but no less effective in treating the knee joint with arthrosis are such methods of physiotherapy asLaser therapy and cryotherapy(Cold exposure), having a pronounced effect of painkillers.
Treatment
In the effective treatment schemes of the knee joint arthrosis, the medication below is used.
Non -inflammatory drugs non -inflammatoryProduced in forms for external (different gels, ointments) and systemic use (tablets, candles, solutions), have long proven their effectiveness in the treatment of osteoarthrosis and are widely prescribed by doctors.By blocking inflammation at an enzymatic level, they eliminate joint pain and swelling, slow down the progression of the disease.It should be remembered that a prolonged systemic technique can cause the development and deterioration of ulcerative processes in the gastrointestinal tract, and also adversely affect kidney and liver functions.Therefore, patients, taking the medicine for a long time, should also prescribe medicines that protect the gastric mucosa and monitor the labs of the internal organs regularly.
Glucocorticosteroids (GKS)- Hormonal medication with a pronounced anti -inflammatory effect.Being a powerful anti -inflammatory agent, GCs have some contraindications because they are able to call a number of important side effects.In the forms of the system for gonartrosis, they are practically not described.As a rule, effective treatment of arthritis includes GC injections at peri -inhuman pain points, which increases the intensity of the fight against inflammation and minimizes the risk of undesirable side effects of the drug.With a single presentation of GCS, the effect of its use lasts up to 1 month.In accordance with national recommendations for the treatment of osteoarthritis, you should not perform more than three drug injections per year in the same union.
With osteoarthritis "neglected" when a person experiences unbearable pain that does not even go down at rest, violating normal sleep, recipe is possibleopenterer.These medicines are used only according to the doctor's prescription, which takes into account the feasibility of their appointment in each case.
Chondroprotectors(with a genuine translation - "cartilage protection").This name is understood as different medicines joined by a property - a structural modifier effect, ie the ability to slow down degenerative changes in cartilage and narrowing of the common gap.They are produced in forms such as for oral administration (glucosamine, chondroitin sulfate, pastaline), and for entry into the common cavity (hyaluronates).Of course, these medicines do not perform a miracle and do not "grow" a new cartilage, but they can suspend its destruction.To achieve a continuous effect, they must be used for a long time, and regular several times a year.
Surgical treatment of knee joint arthrosis
The most popular type of surgical care for gonarthrosis isEndoprosthetics, D.M .. At the same time, a prerequisite for this type of surgical treatment is: the lack of gross deformation of the statute, formed "false joints", muscle contractions and pronounced muscle atrophy.With severe osteoporosis (a significant decrease in bone mineral density), the endoprosthetics also do not indicate: "sugar" bone will not resist the presentation of metal pins, and at the installation site, the rapid renovation of bone tissue will begin, pathological fractures may begin.Therefore, a timely solution to the issue of the need to install an endoprostese is so important - it must be accepted when age and overall condition of the human body still allow you to perform surgeries.
Despite the widespread spread of knee endoprosthetics, the results of such operations are often unsatisfactory, and the percentage of complications is high.This is due to the design features of the endoprostese and the complexity of the surgical intervention itself (replacement of the hip node is much easier in technical terms).
Shunting arthromedullary- Connecting the femur bone marrow to the knee joint cavity using a shunt - a hollow metal tube.Because of this, the bone marrow of the fat from the lower third of the femur enters the knee joint, feeding the cartilage and lubricating it, which reaches a significant drop in pain.
Summing up the above, I would like to note that treating gonarthrosis is a complex social task.And, although today medicine is unable to provide a drug that eliminates it permanently, or other ways to fully cure this disease, a healthy lifestyle, seeking in time medical help, and the implementation of the doctor's recommendations can suspend its progress.