One of the most common pathologies of the musculoskeletal system is the arthritis of the knee joint (otherwise parental) is a chronic disease, accompanied by dystrophy and destruction of the articular knee structures.
The result of devastating processes is a strong limitation or complete loss of mobility of the joints and therefore - reduction of efficiency, disability.
It is only possible to avoid adverse consequences if you are early diagnosed and treatment in time.
Reasons
With the origin, knee article is primary and secondary.Primary develops as an independent disease, often diagnosed in the elderly and in this case it is due to age -related changes.Secondary goggles becomes the result of other diseases and disorders in the body.
The development of parent contributes to:
- injuries (exacerbations, fractures, meniscus damage);
- Diseases of the musculoskeletal system (congenital leg deformation, knee malformation, coarse, arthritis, osteoporosis).
- Fixed high loads in the joint due to professional activities, professional sports.
- Overweight, obesity.
- Endocrine diseases, including diabetes, hypothyroidism, acromiches.
- Metabolic disorders.
- Genetic predisposition.
Symptoms
Inflammation with the articulation of the knee joint is accompanied by two main clinical manifestations - pain and edema.The intensity and frequency of pain depends on the depth of the lesion in the joint structures.At the initial stage, the pain only feels with load, quickly passes calm.With advanced fertility, pain in pain is constantly present, intensified during movements, with a change in weather.
Other signs of knee joint articulation:
- crunching when moving.
- Joint stiffness, infringement of engine function.
- Knee deformation (with neglected fertility).
Gorgling may be accompanied by a articular (fluid accumulation in the joint cavity) and the subsequent formation of a bakery bladder (elastic formation on the back of the knee).
Articulation
The symptoms of the articulation of the knee joint vary according to the depth of the lesion in the knee structures and therefore the 3 stages of the pathology are distinguished.
- Knee joint arthritis 1 gradeIt manifests from weak pain in the loads (in rest passing at the same time), with slight stiffness after sleep.In the radiographic image, a minor narrowing of the joint gap (less than one -third) is noted, the presence of individual osteophytes is noted.
- Arthritis of the knee joint 2 degreesIt is accompanied by pain and characteristic crisis during movements.The pain remains for some time at rest.There is morning stiffness, limiting the range of movements.Diagnostic procedures reveal a severe stenosis of the common vacuum (more than half) and multiple osteophytes.
- Knee arthritis of 3 degreesIt is accompanied by constant pain, which, during movements and at night, intensifies.Morning stiffness remains greater than one hour with worsening inflammation and at least half an hour - during recession periods.Joint mobility is strongly limited or completely lost.In the radiographic image, multiple large osteophysts, cysts are visible.The common gap is limited by more than two -thirds of the rule.
Depending on the degree of articulation of the knee joint, the patient is prescribed conservative or surgical treatment.
Diagnosis
Diagnosis of knee joint articulation involves visual examination, patient complaints analysis, laboratory tests (urine analysis, general and biochemical blood tests) and methods of organic tests.
The following diagnostic procedures allow you to confirm or refute the diagnosis:
- Radiography?
- Ultrasound (ultrasound);
- MRI (magnetic resonance imaging).
- CT (computed tomography);
- Arthroscopy and scintigraphy (with suspected volume).
Using these methods, it is possible to detect the narrowing of the joint gap, the degree of dilution and deformation of the cartilage, the presence of fluid in the joint cavity, structural changes in the articular membrane, the development of osteophitis, and the osteoporosis.
Conservative treatment
Conservative methods of treatment can reduce pain and inflammation, improve blood circulation and diet of the famous tissues, enhance the muscle.
For this purpose, they are held:
- pharmaceutical treatment;
- exclusion;
- Physiotherapy and manual treatment.
- Medical Physical Education.
An important component of arthritis therapy is to adhere to a therapeutic diet.
Conservative treatment of knee joint articulation will be effective at the initial stage of the disease when small dystrophic cartilage cassettes, inflammation and weakened functions of the articular shell occur.
Drugs
Drug therapy includes appointment:
- Non -Non -Anti -inflammatory drugs (NSAID).
- Coarse Protectors.
- Hyaluronic acid.
NSAID
Non -hypotoidal anti -inflammatory drugs help relieve inflammation, reduce its main symptoms -that and pain.
Fridays are prescribed in the form of solutions (for intramuscular administration) or tablets, capsules (for oral administration).Capsules and tablets from the arthritis of the NSAID knee joint are taken in small lessons, as drugs have a strong irritating effect on the gastric mucosa and can cause the development of peptic ulcer, have many other side effects.
In addition, prescription outer drugs (ointments, gels, creams) based on non -sergeoidal anti -inflammatory ingredients.Local treatment is allowed to take place for a longer period of time.
NSAIDs have a strong anti -inflammatory effect, but with prolonged use contribute to the further destruction of the cartilage.
NSAIDs are a symptomatic treatment.They help eliminate unpleasant symptoms of the disease, but do not affect the condition of the cartilage.In contrast to these products, chondroproteters and hyaluronic acid accelerate the processes of regeneration of cartilage tissue and slow down its destruction.
Protection
Chondrop Protector Medicines contain chondroitin and glycosamine (cartilage building blocks) and help to restore the knee by arthritis of the knee joint.Available in the form of tablets, dust for oral administration, a solution for injection.
The minimum course of tablets and dust is 3 months.After a break, the course is repeated 2-3 times.The course of treatment with a solution includes 12-15 injections, repeated 2-3 times a year.
The first positive effects of treatment with chondroprostates are remarkable only a few months after the start of treatment.
Hyaluronic acid
Hyaluronic acid introduced injected into the affected joint.The treatment for articulation of the knee joint performs the role of lubrication - surrounds the articular surfaces, thereby reducing friction between them.
Hyaluronic acid treatment medications help increase the elasticity of cartilage tissue, prevents the further destruction of articular structures, which improves the motility of the joint, reduce the symptoms of inflammation.Medicines are well tolerated, they do not cause side effects.Their only disadvantage is the high cost.
The course of treatment with hyaluronic acid usually includes 3-4 injections, which are performed with breaks of 10-14 days.
Exclusion
If with non -hypotheoid anti -inflammatory drugs, knee pain cannot be relieved by arthritis, an exclusion is performed -a method of treatment in which the drugs are directly injected into the affected tissues to relieve pain and inflammation.In the treatment of articulation, articular (injections in the articular cavity) and marginal (peripheral cavity) are used.
The main advantage of the method is an immediate deliberate action, since with such an introduction the maximum concentration of the active substance is created precisely in the inflammation zone.In addition, medicines do not fall into the systemic blood circulation, which significantly reduces the risk of unwanted actions.
In the later stages of the genotization, the synovial gap Narrows, the osteophytes grow, the joint surfaces are deformed, so only blockage is allowed.
The blocking of the knee joint for arthritis can be performed using anesthetics and corticosteroids.
Anestics are usually inserted in combination with steroid hormones to reduce process pain.
Hyaluronic acid and chondroprostates can also be inserted directly into the joint.But in this case, we are not talking about exclusion, but about endotomy injection, as these drugs do not prevent pain impulses, but activate the processes of regeneration of cartilage tissue.
Physiotherapy and manual treatment
The main methods of physiotherapeutic effects used in the treatment of articulation include:
- laser treatment;
- Ultrasound treatment.
- cryotherapy
- Paraffin and Ozkerite treatment.
- Mud.
The main task of all physiotherapeutic processes is to stimulate blood circulation in the nearby tissues, the improvement of cartilage diet.
Exercise treatment
Pain syndrome forces a patient with parenting to limit motor activity, as a result of which close ligaments and muscles atrophy.This condition negatively affects their joints, as during movement the nutrients penetrate the synovial fluid to cartilage.If the joint is constantly at rest, the dystrophic processes worsen.
That is why physiotherapy exercises are an integral component of conservative treatment.Moderate physical activity allows you to enhance the muscle device, enhance the strength of articular structures, eliminate rigidity and improve the function of the motor motor system.
Therapeutic exercises are developed by the doctor individually for each patient, taking into account the depth of the lesion and the functional condition of the articular structures.
General recommendations for the treatment of exercise treatment for arthritis of the knee joint:
- Starting classes only after stopping signs of acute inflammation.
- Perform all exercises smoothly without sudden movements.
- The load is gradually increased.
- Eliminate high loads in the joint (enhanced bending/knee extension).
- If pain or discomfort occurs, stop training.
Diet
With the parent, the products they contain: contain:
- amino acids (dairy products, low varieties of meat).
- collagen (gelatin dishes)?
- irreplaceable fatty acids (vegetable oils, fish).
- Divine and selenium (legumes, cereals, cabbage and apples, beef, chicken, eggs).
It is also important:
- Eliminate the use of smoked meat, pickles, marinade.
- Limit the salt consumption.
- They adhere to a 5 -time diet.
- Observe the alcohol consumption function.
Excessive body weight is one of the main factors that cause the development of knee joint articulation.Therefore, the task of patients with overweight is to reduce body weight.In this case, you can only achieve the result with the help of a diet, as intensive sports are harmful to the inflammatory joint.
To reduce body weight, it is recommended to be blocked by the menu:
- oily varieties of meat and fish.
- Cream, homemade sour cream and other dairy products with a high fat content.
- Margarine, mayonnaise, various sauces.
- confectionery;
- fast food;
- Sweet drinks.
Surgical treatment
The arthritis of the 3rd degree knee joint is not susceptible to conservative treatment, so the function is the only way out for the patient.
There are two options for surgery:
- Corrective osteotomy- It is held at the initial stage of development of the 3rd stage of the parent, if the cartilage is partially destroyed, the osteophysts can be removed.
- Endoprothic- The replacement of the joint or its destroyed parts is performed by the complete destruction of the cartilage.
Forecast
Pathological changes in joint structures are progressive, irreversible.However, with early diagnosis and proper treatment, you can completely stop inflammation and stop dystrophic changes in cartilage tissue - 1 degree knee joint articulation is well offered to conservative treatment.
With the 2nd degree article, which is accompanied by cartilage destruction and the formation of osteophytes, the conservative methods allow you to slow down or suspend cartilage deformation, stop inflammation and improve kinetic activity.However, doctors are often forced to resort to exclusion, arthroscopy.
It is impossible to cure the articulation of the knee joint of 3 degrees in a conservative manner.The only way to restore knee mobility is surgery.