Arthrosis, gonarthrosis, osteoarthrosis are synonymous terms that define the same disease: deforming changes in the cartilaginous tissue of the knee joint.
The human knee joint is made up of three bones: the femur, the tibia and the patella. At the point of contact with each other, these bones are covered with cartilaginous tissue, which ensures smooth sliding of the surfaces between them.
Over time, these cartilages become thinner, losing flexibility and elasticity. Cartilage is nourished by synovial fluid; the shock absorbing properties of the joint depend on the quantity and quality of this liquid.
First symptoms and signs
- Most often they appear in people aged 45-50 years. This disease is typical for both men and women, but the "weaker sex" suffers from this disease much more often.
- At the beginning of the disease, the patient feels tolerable pain in the area of the knee joint and, over time, intense pain appears.
- The intensity of the pain changes: with movement, physical activity, it gets stronger, at rest - the pain decreases.
If you do not pay attention to these symptoms of a disease that is approaching in time, the disease begins to progress and, in severe cases, leads to disability.
When contacting a doctor, the diagnosis of osteoarthritis is clarified by means of X-rays. The photos show the narrowing of the joint space inside or outside the joint. But over time, the pathological process captures the entire joint. And along the edges of the joint surface, osteophytes are visible - bone growth.
The main signs of osteoarthritis of the knee joint:
- During the day, the pain intensifies, during the night rest, the pain decreases. But, if there is venous insufficiency, the dull pains persist through the night.
- Muscle tension in the joint area
- When walking, a cracking sound is heard in the knee joint
- In severe cases of the disease, deformation and swelling of the affected joint is observed, with an increase in its volume
- Upon palpation, the joint is sore
- When trying to move the knee brace, the pain increases
- In the advanced stage of the disease, muscle shortening occurs and the patient is unable to put the leg in the correct position
- If left untreated, joint mobility decreases or is completely lost
What is patellofemoral arthrosis of the knee?
You can often hear from the doctor the diagnosis "patellofemoral arthrosis" - what is it? In fact, in the international classification of diseases, this arthrosis is absent. Few people know that osteoarthritis of the knee joint begins with the development of patellofemoral syndrome.
This syndrome occurs when a part of the body is subjected to regular overuse or repeated injuries. That is, patellofemoral arthrosis is the same as patellofemoral syndrome.
The main causes of the disease are:
- congenital and acquired deformities of the lower extremities;
- several anomalies in the development of the patella;
- regular overload of the knee joint (for example, in athletes).
Patellofemoral arthrosis of the knee joint has the following clinical manifestations: pain in the frontal region of the knee joint, which increases significantly with physical effort (running, jumping, going up and down stairs, several squats). The pain may also increase when the patient sits with his legs bent under him. The patient may feel a sensation of tension and stiffness in the knee, both inside and from the front.
Patellofemoral syndrome is clinically diagnosed, as a rule, additional studies are not necessary.
This disease, as a rule, does not require special treatment. However, to reduce pain and develop undesirable consequences (instability of the patella, deformation of the knee joint, accumulation of inflammatory exudate), the following procedures are necessary:
- decreased physical activity. This does not mean that the patient will have to lead a passive lifestyle, just the level of activity should not be painful;
- use a special bandage that is used in the knee joint area during exercise or stress, supporting and fixing the patella;
- with a pronounced pain syndrome, glucocorticosteroids and anesthetics are injected into the painful areas of the joint by precise injection, which will relieve the pain and help prevent the use of anti-inflammatories in the future.
If patellofemoral arthrosis has already led to complications or is accompanied by other degenerative-dystrophic pathologies in the knee joint, therapy is performed according to the treatment regime for knee joint arthrosis.
The reasons
- An occupational disease of athletes who experience greater stress on their knee joints. Athletes receive joint injuries and microtrauma, bruising and ligament tears. After retirement from sports, the muscle structure weakens, which leads to the progression of the disease.
- Increased life expectancy and increased physical activity in middle-aged people
- Increased physical activity in the knee joint in people who spend the day working "standing"
- Genetic predisposition
- Congenital diseases of joints and bones
- Lack of collagen
- Knee injury
- Excess weight that puts more pressure on the knee joints
- Diseases acquired in the joints
- Knee surgery
To obtain positive results in treatment, it is necessary to perform a clinical and radiological examination, which reveals several stages of the disease:
- 1 degree knee joint arthrosis. . . There is a slight narrowing of the joint gap, the edges of the surface are slightly sharp, a slight restriction of movement. During the arthroscopic examination, the doctor examines the softening of the cartilage.
- 2nd degree knee joint arthrosischaracterized by a significant limitation in the movement of the knee joint, a strong crunch. The images clearly show osteophytes and a narrowing of the joint space 2-3 times. Small cracks are observed on the surface of the joint.
- Grade 3 knee arthrosis- it is already a complete restriction of movement, when there is a deformation of the joint, deformations and compaction, osteophytes and cysts are observed on the surface of the joint. There were changes in the cartilaginous tissue in all its thickness.
- Grade 4 knee arthrosis- arthroscopy shows the complete absence of cartilaginous tissue.
Drug treatment
In the complex treatment of osteoarthritis of the knee joint, drug therapy plays an important role. Combining this with physical therapy procedures, therapeutic exercises and manual therapy, you can get very good results, even the restoration of limb function.
When diagnosed with osteoarthritis of the knee joint, drug treatment helps eliminate pain, normalizes blood circulation in the problem area, improves cartilage metabolism and nutrition, activates recovery processes and increases joint mobility.
As it is impossible to apply other therapeutic methods in the context of strong pain sensations, first, analgesics and anti-inflammatory drugs are prescribed to the patient. However, it is not recommended to use these funds for a long time, because, in addition to the side effects (most of the time it is a negative effect on the digestive system), they can contribute to dehydration and subsequent destruction of cartilage tissue.
Chondroprotectors are used to restore cartilage nutrition, regenerate cartilage plaque and improve the quality of synovial fluid.. . . The drugs in this group are injected directly into the painful joint and are the safest for the patient. Immediately falling into the affected area, chondroprotectors save the joint from destruction and help restore its function. One of the disadvantages of this method is the long wait for the result - the patient can see an improvement only after a few months. In addition, it is not advisable to take chondroprotectants if the disease is in the third stage and the joint is almost completely destroyed.
Various ointments and creams are used to reduce pain, relieve swelling and slightly improve joint mobility.Various warming agents are good for relaxing ligaments and muscles, improving blood circulation and speeding up metabolism in the joint. But they cannot be used in the presence of inflammation, in which case the use of non-steroidal anti-inflammatory gels and ointments is demonstrated.
The compresses should not be neglected - they are capable of penetration, improve blood circulation, have anesthetic and anti-inflammatory effects and accelerate the metabolic processes in the cartilage.
Therefore, you should not delay a visit to the doctor by people who are suspicious of the presence of an illness or arthrosis of the knee joint is found - drug treatment, initiated in a timely manner and correctly selected, can save the joint and help prevent interventionsurgical.
Medicines for the treatment of osteoarthritis of the knee joint
The treatment of knee arthrosis is never complete without the use of medications.
Drug therapy has the main objective of eliminating inflammation and pain, improving local blood circulation and nutrition of articular cartilage, activating metabolic processes and restoring joint mobility.
What medications are prescribed for osteoarthritis of the knee joint?
- For the treatment of the disease to be successful, the pain must first be relieved and the inflammatory process eliminated. For this, non-steroidal anti-inflammatory drugs are used. However, these features should not be thrilled - with prolonged use, they tend to mask the true clinical picture of the disease.
- Chondroprotective agents are used to restore the cartilaginous surface of the joints, restore their structure, nourish the cartilage and improve the production of intra-articular fluid. The action of these drugs is very slow, therefore, before the patient realizes a real improvement, you will have to undergo 2-3 cycles of treatment with chondroprotectors, which will take about a year.
- To improve the patient's general condition and relieve pain, in combination with other drugs, gels and ointments can be used. If the course of arthrosis is accompanied by synovitis, then ointments based on non-steroidal anti-inflammatory substances will be given preference.
- Intra-articular injections are used to provide emergency care for osteoarthritis. The most commonly injected corticosteroids or hyaluronic acid.
- For local treatment, compresses with medications are prescribed - dimethyl sulfoxide, bischofite and medical bile. Dimethylsulfoxide has the ability to penetrate the skin's barriers, that is, its action is directed directly at the site of inflammation. This substance has analgesic, anti-inflammatory, absorbent properties and improves metabolism in the area of its application. Bischofite - a derivative of the oil - also has an anti-inflammatory effect on the affected joint, gives a warming effect. Medicinal bile has the same properties as dimethyl sulfoxide with bischophyte, but its use is limited by some contraindications. Medicinal bile should not be taken by patients with pustular skin diseases, elevated body temperature and inflammation of the lymph nodes.
Before starting any medication for osteoarthritis of the knee joint, it is necessary to consult a doctor, discuss the dosage, the characteristics of administration and the duration of treatment.
Injections in the knee joint for osteoarthritis
Intra-articular injections are one of the highly effective methods of treating osteoarthritis of the knee joint. This very expensive procedure significantly reduces pain and inflammation, and new modern drugs not only improve the patient's general condition, but also treat the affected cartilage tissue.
Injections in the knee joint for osteoarthritis is a very difficult procedure, so you should see a doctor, even if the patient knows which drugs to inject and how much.
For intra-articular injections, the following medications are most often prescribed:
- Corticosteroid hormones. These are the most common remedies, as the effect after its introduction is achieved in a matter of minutes. However, by relieving inflammation and pain, corticosteroids negatively affect the joint itself - the cartilage tissue remains degenerative, in addition, drugs in this group cause narrowing of blood vessels, which also destroys joint tissues. Therefore, the use of corticosteroid hormones is only justified in case of unbearable pain in the last stages of arthrosis. The injection cannot be repeated more than once every two weeks.
- Chondroprotectors and enzymes. Unlike hormones, they do not reduce inflammation, so administration does not make sense in the presence of joint swelling. But they have a regenerative effect, partially restoring the cartilage tissue. The use of such drugs is especially effective in the early stages of osteoarthritis. The course of treatment is 5 to 10 injections.
- Hyaluronic acid. A very effective drug, but at the same time expensive. Its effectiveness lies in the fact that the acid itself is similar in composition to the natural lubrication of the joint. After the introduction of drugs with hyaluronic acid in the knee, the friction of the affected joint surfaces decreases and the mobility of the knee improves. These injections are very effective in the initial stage of arthrosis, a slightly lesser effect is seen in the second stage and, with arthrosis of the third knee joint, such drugs briefly relieve the patient's condition. The course of treatment usually includes three to four injections once a year.
Injections in the knee joint for osteoarthritis are strictly contraindicated in the following cases:
- infection of the skin or subcutaneous tissue in the area intended for injection;
- sepsis;
- infectious arthritis;
- hemophilia;
- the presence of a viral infection;
- lack of results from previous injections;
- individual drug intolerance.
It is also unacceptable to make intra-articular injections for prophylactic purposes.
Orthopedic knee pads for osteoarthritis of the knee joint
During the treatment of osteoarthritis of the knee joint, to prevent various injuries, as well as to support damaged tissues and relieve joint stress, knee pads are used.
An orthopedic knee brace is essentially the same as an elastic bandage. However, compared to the latter, the knee brace has its advantages: it does not need to be bandaged several times a day, it will not slip or wobble, a well-adjusted knee brace will not compress the leg and cause swelling and other unpleasant consequences of prolonged compression.
Orthopedic knee pads for osteoarthritis of the knee joint perform the following functions:
- reduce inflammation and pain;
- relieve swelling;
- relieve stiffness and tension;
- normalize blood circulation;
- facilitate free movement of the joint.
When choosing an orthopedic knee brace, you should pay attention to the following features:
- Type of knee brace - is selected according to the intensity of the pain. There are these types of knee pads:
- closed - used when it is not possible to determine the location of the pain;
- open with adjustable tension - used during rehabilitation and for mild pain;
- open with spiral reinforcements - for pain when climbing and descending stairs, etc. ;
- articulated - for different types of pain;
- to support tendons - used if the pain is located under the patella.
- The material of which the knee brace is made is of great importance, as it depends not only on the degree of fixation, but also on the intensity of the heating effect. Modern knee pads are made of cotton, lycra, nylon, neoprene, spandex, camel and dog hair.
- The size of the knee brace, which is calculated individually for each patient.
The doctor will help determine the parameters of future purchase - he will not only select the ideal size and type of knee brace for the patient, but will also advise which material will be most effective.
Orthopedic knee pads for osteoarthritis can be purchased at the pharmacy or specialized medical equipment store, their price is quite acceptable. Care should be taken with such purchases at unspecialized outlets or questionable firms, as you can easily buy a fake, which, if not harmful, will certainly not help.
Proper nutrition
Nutritionists have been studying the nutritional characteristics of various peoples for many years. Comparing national cuisines, scientists are trying to understand the influence of people's culinary preferences on the occurrence of certain diseases. This type of research has already been carried out many times in relation to a disease as common as arthrosis of the knee joint.
Many theories have been put forward, many different assumptions have been made. For example, at one time it was thought that the use of tomatoes contributed to the development of the disease, so it was suggested that table salt was "the culprit" for the onset of arthrosis.
In the 20th century, the situation with the development of the disease worsened dramatically.
Proper nutrition is the key to joint health.
To prevent the development of the disease, it is necessary to understand that nutrition plays a fundamental role in osteoarthritis of the knee joint. From the diet, the consumption of meat products belonging to the fast food segment should be minimized. These products are:
- semi-finished products made from waste from meat production: sausages, sausages, all types of sausages, etc.
- smoked meats sold in stores (most of the time this type of product is prepared with chemicals, not smoked).
- ready-to-eat meat - ham, bacon (manufacturers, in this case, do not hesitate to use flavor enhancers and dyes).
- fast food.
Of course, not all people are able to give up on the above food products. Many years they developed the habit of enjoying smoked sausage sandwiches or cooked sausage in the morning. In this case, we advise you to buy a piece of meat at the market, bake it with spices, cut it and then use it as a base for sandwiches. This type of "fast food" does not harm the body.
Thus, we found that it is better to refuse semi-finished products, smoked meats and fast food. But what about meat if it is injected?
The ideal option, of course, is to buy meat from reliable suppliers, but in urban conditions this advice is impractical.
In this regard, it is necessary to use such cooking methods so that as many harmful chemical compounds are destroyed as possible. Sometimes, using only this factor would have an excellent effect in combating osteoarthritis.
How to properly cook food for knee joint arthrosis
It should be remembered that nutrition for osteoarthritis of the knee joint should not be saturated with fats.
Therefore, when preparing food, it is necessary to cut the visible fat from the meat and remove the skin of the birds. It is the fat that concentrates the greatest amount of harmful substances.
Boiling, stewing, baking in foil and steaming are the healthiest ways to prepare food.
In arthrosis of the knee joint, you should not eat gelatinous and gelatinous meats. There is an opinion from the series "the backyard grandmother said" that these dishes are good for joints, but it is not so. A person with osteoarthritis only gets worse with high cholesterol.
Meat broths and soups should be consumed as little as possible. Even if you drain the first broth, there will still be a lot of unhealthy fats in the second. Better get used to vegetable soups, which are so popular in Western countries. Mushroom soups are also useful.
An attempt to replace meat with soup with dried broths and cubes will not do you any good: these products contain an incredible amount of chemical components.
Unfortunately, the fish sold in our markets is also painstakingly injected with dyes and preservatives and is therefore harmful to knee joint arthrosis. Therefore, you should buy live fish whenever possible. Of course, not everyone has enough money for this. The above methods will help to cook frozen fish properly.
Prevention of knee joint arthrosis
It is impossible to allow the state of life to worsen due to the disease, therefore, the causes that lead to arthrosis must be excluded. Preventing the disease is much easier than dealing with expensive, long-term treatments.
- You need to lose weight.
- The joints need constant physical activity: skipping rope, squats, small runs. But everything should be in moderation. Excessive exercise also leads to illness. Alternate loads on joints with adequate rest.
- Due to knee injuries, osteoarthritis develops. When skiing, skating, cycling or rollerblading, padded knee pads should be worn. On sale there is a sufficient selection of knitting for fixing and heating sheep's wool.
- Do not ignore someone else's help if the weight is beyond your strength.
- Eat more vegetables and fruits. It is noted that vegetarians practically do not suffer from arthrosis. Replace mayonnaise with olive oil or mustard oil. Especially useful are plums, dried apricots, apricots, apples, raspberries, cranberries with honey.
- Strong tea and coffee eliminate calcium in large quantities.
- Cottage cheese and homemade cheese help to strengthen bones.
- Walking with a cane will save you from straining your knee joints.
- Shoes should be comfortable, with small heels.
- Swimming and water aerobics relieve stress from the whole body and fatigue in the knee joints.
- Of the vitamins, vitamin E is especially useful, which prevents the destruction of cartilage tissue.
- Vitamin C is involved in the synthesis of cartilage tissue.
- The disease progresses more quickly due to lack of vitamin D.
- Calcium helps to keep bones strong. High calcium content in sesame and celery seeds.
By observing these simple rules for a healthy lifestyle, you can avoid serious illness. And in the event of a manifestation of the disease, they will delay the development of pathological processes.