Arthrosis, gonarthrosis, osteoarthritis are synonymous terms that define the same disease: deforming changes in the cartilage tissue of the knee joint.
The human knee joint is formed by 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 surfaces among themselves.
Over time, these cartilage becomes thinner, losing flexibility and elasticity. The cartilage is nourished by the synovial fluid; the shock-absorbing properties of the joint depend on the quantity and quality of this fluid.
First symptoms and signs
- Most often appear in people aged 45-50 years. This disease is typical for both men and women, but the "weaker sex" suffers from this ailment much more often.
- At the onset of the disease, the patient experiences tolerable pain in the knee joint area, and over time, severe pain appears.
- The intensity of the pain changes: with movement, physical activity, it becomes stronger, at rest - the pain recedes.
If you do not pay attention to these symptoms of an approaching disease in time, then the disease begins to progress and in severe cases leads to disability.
When contacting a doctor, the diagnosis of arthrosis is clarified using X-rays. The pictures show a narrowing of the joint space from the inside or outside of the joint. But over time, the pathological process captures the entire joint. And along the edges of the articular surface, osteophytes are visible - bone growths.
The main signs of arthrosis of the knee joint:
- During the day, the pain intensifies; during the night's rest, the pain subsides. But if venous insufficiency is present, then dull pains persist at night.
- Muscle tension in the joint area
- When walking, a crunch is heard in the knee joint
- In a severe course of the disease, deformation and swelling of the affected joint is observed, an increase in its volume
- On palpation, the joint is painful
- When trying to move the knee pad, the pain increases
- In the late stage of the disease, muscle shortening occurs, and the patient cannot put the leg in the correct position
- If untreated, joint mobility decreases or is completely lost
What is patellofemoral arthrosis of the knee?
Very often from the doctor you can hear the diagnosis "patellofemoral arthrosis" - what is it? Indeed, in the international classification of diseases, such arthrosis is absent. Few people know that arthrosis 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;
- various 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 area of the front side of the knee joint, which significantly increases with physical exertion (running, jumping, going up and down stairs, various squats). The pain can also increase when the patient sits with his legs bent under him. The patient may experience a sensation of tension and stiffness in the knee, both on the inside and on the front of it.
Patellofemoral syndrome is diagnosed clinically, as a rule, additional studies are not required.
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:
- decrease in 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;
- using a special bandage that is worn on the knee joint area during exercise or stress, thereby supporting and fixing the patella;
- with a pronounced pain syndrome, glucocorticosteroids and anesthetics are injected into painful areas of the joint by precise injection, which will relieve pain and help 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 therapy is carried out according to the treatment regimen for arthrosis of the knee joint.
The reasons
- An occupational disease of athletes who experience increased stress on the knee joints. Athletes receive injuries and microtraumas of the joints, bruises and ligament ruptures. After retiring from sports, the muscle 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 their working day "on their feet"
- Genetic predisposition
- Congenital diseases of joints and bones
- Lack of collagen
- Knee injury
- Excess weight that puts more stress on the knee joints
- Acquired joint diseases
- Knee surgery
To achieve positive treatment results, it is necessary to conduct a clinical and radiological examination, which reveals several stages of the disease:
- Arthrosis of the knee joint 1 degree. . . There is a slight narrowing of the joint gap, the edges of the surface are slightly sharpened, a slight restriction in movement. During arthroscopic examination, the doctor probes the softening of the cartilage.
- Arthrosis of the knee joint of the 2nd degreecharacterized by significant limitation in the movement of the knee joint, strong crunch. The images clearly show osteophytes and a 2-3-fold narrowing of the joint space. Small cracks are observed on the surface of the joint.
- Knee arthrosis grade 3- this is already a complete restriction in movement, when a deformation of the joint has occurred, deformation and compaction, osteophytes and cysts are observed on the surface of the joint. There have been changes in the cartilaginous tissue throughout its entire thickness.
- Knee arthrosis grade 4- arthroscopy shows the complete absence of cartilage tissue.
Drug treatment
In the complex treatment of arthrosis of the knee joint, drug therapy occupies an important place. Combining it with physiotherapeutic procedures, therapeutic exercises and manual therapy, you can achieve very good results, up to the restoration of limb function.
When diagnosed with arthrosis of the knee joint, drug treatment helps to eliminate pain, normalizes blood circulation in the problem area, improves metabolism and cartilage nutrition, activates recovery processes, and increases joint mobility.
Since it is impossible to apply other therapeutic methods against the background of sharp pain sensations, then, first of all, the patient is prescribed pain relievers and anti-inflammatory drugs. However, it is not recommended to use such funds for a long time, because, in addition to side effects (most often this 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 nutrition, regenerate the cartilage plate and improve the quality of synovial fluid.. . . The drugs of this group are injected directly into the diseased 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 advisable to take chondroprotectors 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 somewhat improve joint mobility.Various warming agents are good for relaxing ligaments and muscles, improving blood circulation, and speeding up the metabolism in the joint. But they cannot be used in the presence of inflammation, in which case it is shown to use non-steroidal anti-inflammatory gels and ointments.
Compresses should not be neglected - they have penetrating abilities, improve blood circulation, have anesthetic and anti-inflammatory effects, and accelerate metabolic processes in the cartilage.
Therefore, you should not delay a visit to the doctor for people who have suspicions of the presence of a disease or arthrosis of the knee joint is found - drug treatment, started in a timely manner and correctly selected, can save the joint and help avoid surgical intervention.
Medicines for the treatment of arthrosis of the knee joint
Treatment of arthrosis of the knee is never complete without the use of drugs.
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 arthrosis of the knee joint?
- For the successful treatment of the disease, you should initially relieve pain and eliminate the inflammatory process. For this, non-steroidal anti-inflammatory drugs are used. However, you should not get carried away with these funds - with prolonged use, they tend to mask the true clinical picture of the disease.
- To restore the cartilaginous surface of the joints, restore its structure, nourish the cartilage and improve the production of intra-articular fluid, chondroprotectors are used. The action of these drugs is very slow, therefore, before the patient notices a real improvement, you will have to undergo 2-3 courses of treatment with chondroprotectors, which will take about a year.
- To improve the general condition of the patient and relieve pain, in combination with other drugs, gels and ointments can be used. If the course of arthrosis is accompanied by synovitis, then preference is given to ointments based on non-steroidal anti-inflammatory substances.
- Intra-articular injections are used to provide emergency care for arthrosis. The most commonly injected corticosteroids or hyaluronic acid.
- For local treatment, compresses with drugs are prescribed - dimethyl sulfoxide, bischofite and medical bile. Dimethyl sulfoxide has the ability to penetrate the skin 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 oil - also has an anti-inflammatory effect on the affected joint, gives a warming effect. Medical bile has the same properties as dimethyl sulfoxide with bischofite, but its use is limited by some contraindications. Medical 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 arthrosis of the knee joint, it is necessary to consult with a doctor, discuss the dosage, features of administration and the duration of the course of treatment.
Injections in the knee joint for arthrosis
Intra-articular injections are one of the highly effective methods of treating arthrosis 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 in the knee joint for arthrosis is a rather difficult procedure, therefore, you should consult a doctor, even if the patient knows what medications need to be injected and in what quantity.
For intra-articular injections, the following medications are most often prescribed:
- Corticosteroid hormones. These are the most common remedies, since the effect after their introduction is achieved in a matter of minutes. However, relieving inflammation and pain, corticosteroids negatively affect the joint itself - the cartilage tissue remains degenerative, in addition, drugs in this group cause narrowing of the blood vessels, which additionally destroys the joint tissues. Therefore, the use of corticosteroid hormones is justified only in case of unbearable pain in the last stages of arthrosis. The injection can be repeated no more than once every two weeks.
- Chondroprotectors and enzymes. Unlike hormones, they do not reduce inflammation, so administration is meaningless in the presence of joint swelling. But they have a regenerative effect, partially restore cartilage tissue. The use of such drugs is especially effective in the initial stages of arthrosis. The course of treatment is 5-10 injections.
- Hyaluronic acid. A very effective, but at the same time expensive drug. 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 into the knee, the friction of the affected articular surfaces decreases, and the knee mobility improves. Such injections are very effective in the initial stage of arthrosis, a slightly lesser effect is observed in the second stage, and with 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 in the knee joint for arthrosis are strictly contraindicated in the following cases:
- infection of the skin or subcutaneous tissue in the intended area of the injection;
- sepsis;
- infectious arthritis;
- hemophilia;
- the presence of a viral infection;
- lack of result from previous injections;
- individual intolerance to the drug.
It is also unacceptable to make intra-articular injections for prophylactic purposes.
Orthopedic knee pads for arthrosis of the knee joint
During the treatment of arthrosis of the knee joint, to prevent various injuries, as well as to support damaged tissues and relieve stress from the joint, knee pads are used.
An orthopedic knee pad 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 dangle, a properly fitted knee pad will not squeeze the leg and provoke swelling and other unpleasant consequences of prolonged squeezing.
Orthopedic knee pads for arthrosis of the knee joint perform the following functions:
- reduce inflammation and pain;
- relieve puffiness;
- relieve stiffness and tension;
- normalize blood circulation;
- facilitate free movement of the joint.
When choosing an orthopedic knee pad, you should pay attention to the following features:
- Knee pad type - is selected depending on the severity of pain. There are these types of knee pads:
- closed - used when it is impossible to determine the localization of pain;
- open with adjustable tension - used during rehabilitation and for minor pain;
- open with spiral stiffening ribs - for pain during the ascent and descent of the stairs, etc. ;
- articulated - for different types of pain;
- to support the tendons - used if the pain is localized under the kneecap.
- The material from which the knee pad is made is of great importance, since not only the degree of fixation, but also the intensity of the warming effect depends on it. Modern knee pads are made from cotton, lycra, nylon, neoprene, spandex, camel and dog hair.
- The size of the knee pad, which is calculated individually for each patient.
The doctor will help to determine the parameters of the future purchase - he will not only select the size and type of knee pad that is optimal for the patient, but will also advise which material will be the most effective.
Orthopedic knee pads for arthrosis can be bought at a pharmacy or a specialized medical equipment store, its price is quite acceptable. You should beware of such purchases at non-specialized outlets or from dubious firms, since you can easily purchase a fake, which, if it does not harm, it certainly will 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 kind of research has been carried out many times in relation to such a common disease as arthrosis of the knee joint.
Many theories have been put forward, a lot of different assumptions have been made. For example, at one time it was thought that the use of tomatoes contributes to the development of the disease, then it was suggested that table salt was "to blame" for the appearance of arthrosis.
In the twentieth century, the situation with the development of the disease has deteriorated sharply.
Proper nutrition is the key to joint health.
To prevent the development of the disease, it is necessary to understand that nutrition in arthrosis of the knee joint plays a key role. 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 meat production waste: sausages, sausages, all kinds of sausages, etc.
- smoked meats sold in stores (most often this kind of products are prepared using chemistry, and not in smokehouses).
- ready-to-eat meat - ham, bacon (manufacturers in this case do not hesitate to use flavor enhancers and dyes).
- fast food.
Of course, not every person is able to give up the above food products. Many over the years have developed the habit of indulging themselves with smoked sausage sandwiches or boiled sausages in the morning. In this case, we advise you to buy a piece of meat on 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 out that it is best to refuse semi-finished products, smoked meats and fast food. But what about meat if it is syringed?
The ideal option, of course, is to purchase meat from trusted suppliers, but in urban conditions this advice is impracticable.
In this regard, it is necessary to use such methods of cooking so that as many harmful chemical compounds are destroyed 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 arthrosis of the knee joint
It should be remembered that food for arthrosis of the knee joint should not be saturated with fats.
Therefore, when preparing food, it is necessary to cut off the visible fat from the meat, and remove the skin from the poultry. It is in fat that the largest amount of harmful substances is concentrated.
Boiling, stewing, baking in foil, and steaming are the healthiest ways to prepare food.
With arthrosis of the knee joint, jellied and jellied meat should not be eaten. There is an opinion from the series "grandmother in the yard said" that these dishes are good for joints, but this is not so. A person with arthrosis will only get worse from high cholesterol levels.
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 one. Better to accustom yourself to vegetable soups, which are so popular in Western countries. Mushroom soups are also helpful.
An attempt to replace meat for soup with dry broths 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 with dyes and preservatives and therefore is harmful for 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 to properly cook frozen fish.
Prevention of arthrosis of the knee joint
It is impossible to allow the condition of life to worsen due to the disease, therefore, the causes that lead to arthrosis must be excluded. 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: jumping rope, squats, small runs. But everything should be in moderation. Excessive exercise also leads to illness. Alternate joint loads with adequate rest.
- Due to knee injuries, arthrosis develops. When skiing, skating, cycling or rollerblading, padded knee pads should be worn. On sale there is a sufficient selection of both fixing knee pads and warming from sheep wool.
- Do not ignore the help of another person 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 or mustard oil. Especially useful are plums, dried apricots, apricots, apples, raspberries, cranberries with honey.
- Strong tea and coffee wash out calcium in large quantities.
- Homemade cottage cheese and cheese will help strengthen bones.
- Walking with a cane will save you from overloading the knee joints.
- Shoes should be comfortable, with small heels.
- Swimming and water aerobics will relieve stress from the whole body and fatigue from 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 faster from a lack of vitamin D.
- Calcium helps keep your bones strong. High calcium content in sesame and celery seeds.
By observing these simple rules of a healthy lifestyle, you can avoid a serious illness. And in the event of a manifestation of the disease, they will slow down the development of pathological processes.