Osteoarthritis, gonarthrosis, osteoarthritis are synonymous terms that define the same disease: deforming changes in the cartilaginous tissue of the knee joint.
The joint of the human knee is made up of three bones: the femur, the tibia and the patella. At the point of mutual contact, these bones are covered with cartilaginous tissue, which ensures smooth sliding of the surfaces among themselves.
Over time, these cartilages thin out, losing flexibility and elasticity. Cartilage is nourished by synovial fluid; the properties of the shock-absorbing joint depend on the quantity and quality of that fluid.
The first symptoms and signs
- They most often appear in people aged 45-50. 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, severe pain appears.
- The intensity of pain changes: with movements, physical activity, it becomes stronger, at rest - the pain recedes.
If you do not pay attention to these symptoms of the approaching disease in time, the disease begins to progress and in severe cases leads to disability.
When you consult a doctor, the diagnosis of arthrosis is clarified with the help of X-rays. The images show the narrowing of the joint space on the inside or outside of the joint. But over time, the pathological process affects the entire joint. Osteophytes - bone growths - are also visible along the edges of the joint surface.
The main signs of osteoarthritis of the knee joint:
- During the day, the pain intensifies, and during the night rest, the pain subsides. But if venous insufficiency is present, dull pains last at night as well.
- Muscle tension in the joint area
- There is a crunch in the knee joint as you walk
- In severe cases of the disease, deformations and swelling of the affected joint, increase in its volume are noticed
- Palpation of the joint is painful
- When trying to move the knee pad the pain increases
- In the late phase of the disease, the muscles shorten and the patient cannot put his leg in the correct position
- If left untreated, joint mobility is reduced or completely lost
What is patellofemoral osteoarthritis of the knee?
Very often you can hear the diagnosis "patellofemoral arthrosis" from a doctor - what is it? In fact, there is no such arthrosis in the international classification of diseases. 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 exposed 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;
- various anomalies in the development of the patella;
- regular overload of the knee joint (for example, in athletes).
Patelofemoral arthrosis of the knee joint has the following clinical manifestations: pain in the front part of the knee joint, which is significantly increased by physical exertion (running, jumping, climbing and descending stairs, various squats). The pain may also increase when the patient sits with his legs bent below him. The patient may feel tension and stiffness in the knee, both from the inside and from the front.
Patelofemoral syndrome is diagnosed clinically, as a rule no additional studies are required.
This disease, as a rule, does not require special treatment. However, to reduce pain and develop side effects (patella instability, knee joint deformity, accumulation of inflammatory exudate), the following procedures are necessary:
- reduction in physical activity. This does not mean that the patient will have to lead a passive lifestyle, only the level of activity must not be painful;
- the use of a special bandage worn on the knee joint area during exercise or stress, supporting and firming the patella;
- with a pronounced pain syndrome, glucocorticosteroids and anesthetics are injected with precise injection into the painful areas of the joint, which will alleviate the pain and avoid the use of anti-inflammatory drugs in the future.
If patellofemoral arthrosis has already led to complications or is accompanied by other degenerative-dystrophic pathologies in the knee joint, then the therapy is carried out according to the treatment regimen of arthrosis of the knee joint.
Reasons
- Occupational disease of athletes who have increased stress on the knee joints. Athletes get injuries and microtraumas of the joints, bruises and ruptured ligaments. After withdrawing from sports, the muscular framework weakens, which leads to the progression of the disease.
- Increased life expectancy and increased physical activity in middle-aged people
- Increased physical activity on the knee joint in people who spend the working day "on their feet"
- Genetic predisposition
- Congenital diseases of the joints and bones
- Collagen deficiency
- Knee injury
- Excess weight that puts more strain on the knee joints
- Acquired joint disease
- Knee surgery
In order to achieve positive treatment results, it is necessary to conduct a clinical and radiological examination that reveals several stages of the disease:
- Osteoarthritis of the knee joint 1 degree. . . There is a slight narrowing of the joint space, the edges of the surface are slightly sharpened, a slight restriction in movement. During the arthroscopic examination, the doctor examines the softening of the cartilage.
- Osteoarthritis of the knee joint II degreecharacterized by a significant limitation in the movement of the knee joint, strong creaking. The images clearly show osteophytes and narrowing of the joint space by 2-3 times. Small cracks can be seen on the joint surface.
- Knee osteoarthritis grade 3- this is already a complete restriction in movement, when the deformation of the joint has occurred, deformations and compaction, osteophytes and cysts can be noticed on the surface of the joint. There were changes in the cartilage tissue throughout its thickness.
- Knee osteoarthritis grade 4- Arthroscopy shows complete absence of cartilage tissue.
Drug treatment
In the complex treatment of osteoarthritis of the knee, drug therapy occupies an important place. By combining it with physiotherapy procedures, therapeutic exercises and manual therapy, you can achieve very good results, all the way to restoring limb function.
When osteoarthritis of the knee joint is diagnosed, drug treatment helps relieve pain, normalizes blood circulation in the problem area, improves cartilage metabolism and nutrition, activates recovery processes, and increases joint mobility.
Since it is impossible to apply other therapeutic methods in the background of sharp feelings of pain, then, first of all, the patient is prescribed painkillers and anti-inflammatory drugs. However, long-term use of such agents is not recommended, because in addition to side effects (most often it is a negative effect on the digestive system), they can contribute to dehydration and further destruction of cartilage tissue.
Chondroprotectors are used to restore cartilage, regenerate cartilage and improve the quality of synovial fluid.. . . Drugs of 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 functions. One of the disadvantages of this method is the long wait for the result - the patient may notice an improvement only after a few months. In addition, it is not desirable to take chondroprotectors if the disease is in the third phase, and the joint is almost completely destroyed.
Various ointments and creams are used to reduce pain, relieve swelling and to some extent 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 they have been shown to use nonsteroidal anti-inflammatory gels and ointments.
Coatings should not be neglected - they have penetrating abilities, improve blood circulation, have anesthetic and anti-inflammatory effects and accelerate metabolic processes in cartilage.
Therefore, you should not delay a visit to the doctor to persons suspected of having the disease or found osteoarthritis of the knee joint - drug treatment, started on time and properly selected, can save the joint and help avoid surgery.
Drugs for the treatment of osteoarthritis of the knee joint
Treatment of knee osteoarthritis is never complete without the use of medication.
Drug therapy is primarily aimed at eliminating inflammation and pain, improving local blood circulation and nutrition of the articular cartilage, activating metabolic processes and restoring joint mobility.
What medications are prescribed for osteoarthritis of the knee?
- To successfully treat the disease, you should initially relieve the pain and eliminate the inflammatory process. Nonsteroidal anti-inflammatory drugs are used for this. However, you should not get carried away by these means - with prolonged use, they tend to obscure the true clinical picture of the disease.
- Chondroprotectors are used to regenerate the cartilaginous surface of the joints, renew its structure, nourish the cartilage and improve the production of intra-articular fluid. The effect of these drugs is very slow, therefore, before the patient notices real improvement, you will have to undergo 2-3 courses of treatment with chondroprotectors, which will last about a year.
- Gels and ointments can be used in combination with other medications to improve the patient's general condition and relieve pain. If the course of osteoarthritis is accompanied by synovitis, ointments based on nonsteroidal anti-inflammatory substances are preferred.
- Intra-articular injections are used to provide first aid for osteoarthritis. The most commonly injected are corticosteroids or hyaluronic acid.
- For local treatment are prescribed dressings with drugs - dimethyl sulfoxide, bishofite and medical bile. Dimethyl sulfoxide has the ability to penetrate skin barriers, ie its action is directed directly to the site of inflammation. This substance has analgesic, anti-inflammatory, absorbent properties and improves metabolism in the area of application. Bischofite - an oil derivative - also has an anti-inflammatory effect on the affected joint, giving a warming effect. Medicinal bile has the same properties as dimethyl sulfoxide with bishofite, but its use is limited by some contraindications. Medicinal bile should not be taken by patients with pustular skin diseases, fever and lymph node inflammation.
Before starting any medication for osteoarthritis of the knee joint, it is necessary to consult a doctor, discuss the dosage, features of application and duration of treatment.
Injections into the knee joint due to arthrosis
Intra-articular injections are one of the highly effective methods of treating osteoarthritis of the knee joint. This rather expensive procedure significantly reduces pain and inflammation, and new modern drugs not only improve the general condition of the patient, but also treat the affected cartilage tissue.
Injections into the knee joint due to osteoarthritis are quite a difficult procedure, so you should consult a doctor, even if the patient knows which medications to inject and in what amount.
The following medications are most commonly prescribed for intra-articular injections:
- Corticosteroid hormones. These are the most common drugs, because the effect is achieved in a few minutes after their introduction. However, by relieving inflammation and pain, corticosteroids negatively affect the joint itself - cartilage tissue remains degenerative, in addition, drugs from this group cause narrowing of blood vessels, which further destroys joint tissue. Therefore, the use of corticosteroid hormones is justified only in the case of unbearable pain in the last stages of arthrosis. The injection can be repeated at most once every two weeks.
- Chondroprotectors and enzymes. Unlike hormones, they do not reduce inflammation, so the application is meaningless in the presence of swelling of the joints. But they have a regenerative effect, partially regenerating cartilage tissue. The use of such drugs is especially effective in the initial stages of osteoarthritis. The course of treatment is 5-10 injections.
- Hyaluronic acid. Very effective, but at the same time expensive medicine. Its effectiveness lies in the fact that the acid itself is similar in its composition to the natural lubrication of the joint. After the introduction of hyaluronic acid drugs into the knee, the friction of the affected joint surfaces is reduced and the mobility of the knee is improved. Such injections are very effective in the initial stage of arthrosis, a slightly smaller effect is observed in the second stage, and in arthrosis of the third knee joint such drugs only briefly alleviate the patient's condition. The course of treatment usually includes three to four injections once a year.
Injections into the knee joint due to osteoarthritis are strictly contraindicated in the following cases:
- infection of the skin or subcutaneous tissue in the intended area of injection;
- sepsis;
- infectious arthritis;
- hemophilia;
- the presence of a viral infection;
- lack of results of previous injections;
- individual drug intolerance.
It is also unacceptable to give intra-articular injections for prophylactic purposes.
Orthopedic pads for osteoarthritis of the knee joint
During the treatment of osteoarthritis of the knee joint, knee pads are used to prevent various injuries, as well as to support damaged tissues and relieve stress from the joint.
An orthopedic knee pillow is basically 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 roll, a properly placed knee pad will not squeeze the leg and cause swelling and other unpleasant consequences of prolonged squeezing.
Orthopedic pads for osteoarthritis of the knee perform the following functions:
- reduce inflammation and pain;
- relieve swelling;
- relieve stiffness and tension;
- normalize blood circulation;
- facilitate the free movement of the joint.
When choosing an orthopedic knee pad, pay attention to the following features:
- Knee type - selected depending on the severity of the pain. There are these types of knee pads:
- closed - used when it is impossible to determine the location of pain;
- open with adjustable tension - used during rehabilitation and for minor pain;
- open with spiral ribs for stiffening - for pain during ascent and descent of stairs, etc. ;
- joint - for different types of pain;
- for tendon support - used if the pain is localized below the patella.
- The material from which the knee pad is made is of great importance, because it depends not only on the degree of fixation, but also the intensity of the warming effect. Modern knee pads are made of cotton, lycra, nylon, neoprene, spandex, camel and dog hair.
- Knee pillow size calculated individually for each patient.
The doctor will help you determine the parameters of the future purchase - not only will he choose the size and type of knee pillow that is optimal for the patient, but he will also advise which material will be most effective.
Orthopedic knee pads for osteoarthritis can be bought at a pharmacy or a specialized store of medical equipment, the price of which is quite acceptable. You should beware of such purchases in non-specialized outlets or from dubious companies, because you can easily buy a fake, which if it does not hurt, it will certainly not help.
Proper nutrition
Nutritionists have been studying the nutritional characteristics of different 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 been conducted many times in connection with such a common disease as osteoarthritis of the knee joint.
Many theories have been put forward, many different assumptions have been made. For example, at one time the use of tomatoes was thought to contribute to the development of the disease, then it was suggested that table salt was "to blame" for the onset of osteoarthritis.
In the twentieth century, the situation with the development of the disease deteriorated sharply.
Proper nutrition is the key to joint health.
To prevent the development of the disease, it is necessary to understand that diet plays a key role in osteoarthritis of the knee joint. From the diet, the consumption of meat products belonging to the fast food segment should be reduced. These products are:
- semi-finished products from meat production waste: sausages, sausages, all types of sausages, etc.
- smoked meat sold in stores (most often this type of product is prepared chemically, not in smokehouses).
- ready-to-eat meat - ham, bacon (producers in this case do not hesitate to use flavor enhancers and colors).
- fast food.
Of course, not every person is able to give up the above food products. Over the years, many have become accustomed to enjoying sandwiches with smoked sausage or cooked sausages in the morning. In this case, we advise you to buy a piece of meat at the market, bake it in the oven with spices, cut it and then use it as a base for sandwiches. This kind of "fast food" will not harm the body.
So, we found that it is best to refuse semi-finished products, smoked meat and fast food. But what about meat if it is sprayed?
The ideal option is, of course, to buy meat from reliable suppliers, but in urban conditions this advice is unfeasible.
In this regard, it is necessary to use such cooking methods in order to destroy as many harmful chemical compounds as possible. Sometimes the use of only this factor made it possible to achieve an excellent effect in the fight against arthrosis.
How to properly cook food for osteoarthritis of the knee
It should be borne in mind that the diet for osteoarthritis of the knee joint should not be saturated with fat.
Therefore, when preparing food, it is necessary to cut off the visible fat from the meat and remove the skin of the poultry. It is in the fat that the largest amount of harmful substances is concentrated.
Cooking, stewing, baking in foil and steaming are the healthiest ways to prepare food.
In osteoarthritis of the knee, jelly and jelly meat should not be eaten. There is an opinion from the series "Grandma in the yard said" that these dishes are good for the joints, but that is not the case. A person with osteoarthritis will only get worse from high cholesterol levels.
Meat stews and soups should be consumed as little as possible. Even if you squeeze the first soup, there will still be a lot of unhealthy fats in the second. Get used to vegetable soups, which are so popular in Western countries. Mushroom soups are also useful.
Trying to replace meat for soup with dry broth and cubes will not lead to anything good: these products contain an incredible amount of chemical components.
Alas, the fish sold in our markets is also diligently injected into dyes and preservatives and therefore harms the arthrosis of the knee joint. Therefore, you should buy live fish whenever possible. It is clear that not everyone has enough money for this. The above methods will help in proper cooking of frozen fish.
Prevention of osteoarthritis of the knee joint
It is impossible to allow the deterioration of life due to the disease, so the causes that lead to osteoarthritis must be ruled out. It is much easier to prevent the disease than to deal with expensive and long-term treatment.
- You need to lose weight.
- The joints need constant physical activity: skipping ropes, squats, small races. But everything should be in moderation. Excessive exercise also leads to disease. Alternate joint loads with appropriate rest.
- Osteoarthritis develops due to knee injuries. Padded knee pads should be worn when skiing, skating, cycling or rollerblading. For sale, there is a sufficient choice of fastening knee pads and heating from sheep wool.
- Do not neglect the help of another person if the weight exceeds your strength.
- Eat more vegetables and fruits. It is noticed that vegetarians practically do not suffer from arthrosis. Replace mayonnaise with olive or mustard oil. Especially useful are plums, dried apricots, apricots, apples, raspberries, cranberries with honey.
- Strong tea and coffee wash away calcium in large quantities.
- Homemade cottage cheese and cheese will help strengthen bones.
- A walk with a cane will save you from overloading your knee joints.
- Shoes should be comfortable, with small heels.
- Swimming and water aerobics will relieve whole body stress and knee joint fatigue.
- 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 faster due to vitamin D deficiency.
- Calcium helps keep your bones strong. High calcium content in sesame and celery seeds.
By following these simple rules of a healthy lifestyle, you can avoid a serious illness. And in case of manifestation of the disease will slow down the development of pathological processes.