Complex treatment of osteoarthritis of the knee

Diseases of the musculoskeletal system lead to severe restrictions on human mobility. In order not to complicate the situation, it is necessary to carry out timely treatment. Osteoarthritis of the knee is the most common form of joint injury in the skeletal bones and the most common cause of disability. But with a timely visit to a doctor, you can get rid of the disease.

GENERAL INFORMATION

Osteoarthritis of the knee joint is the unofficial name for the disease. In medicine, we talk about osteoarthritis. The word is made up of two ancient Greek words - bone and joint. Other synonyms:

• deforming arthritis or AOD in abbreviated form (the first word of the name reflects the main clinical symptom - joint deformity);
• knee osteoarthritis (from a combination of the ancient Greek words "knee" and "joint").

Sometimes the disease is mistakenly called arthritis, although traditionally this term refers to a connective tissue disease that has nothing to do with osteoarthritis.

The essence of osteoarthritis is that the cartilage tissue lining the joint surface is damaged, as a result of which inflammation begins, the work of bone joints is disturbed, and pain appears. Unfortunately, this is a very common pathology, which is mainly diagnosed in the elderly (especially overweight) and in young athletes due to injuries.

For effective treatment, it is necessary to conduct a comprehensive examination of the patient with osteoarthritis, especially to identify the reasons that caused the problem with the musculoskeletal system. Most often, the following factors lead to the disease:

CAUSES AND SYMPTOMS

For effective treatment, it is necessary to conduct a comprehensive examination of the patient with OA, especially to identify the reasons that caused the problem with the musculoskeletal system. Most often, the following factors lead to the disease:

• leg fractures;
• dislocations, cartilage damage, inflammation;
• altered metabolism;
• endocrine diseases;
• weakness of the ligamentous system;
• hereditary predisposition;
• autoimmune diseases and infections that cause damage to joint tissue.

Late access to a doctor threatens with constant pain in the knee area and complete loss of joint mobility.To avoid this, you need to register for a consultation with a specialist if you experience a squealing of the knee when walking and painful sensations that intensify when going down or up the stairs. If treatment is not started at this point, the situation will worsen - the pain will stop passing, movement will become limited, and the knee will be deformed.

The longer you do not see a doctor, the more difficult, time consuming and expensive the treatment of knee osteoarthritis will be.

DEGREE OF ILLNESS

Osteoarthritis is diagnosed by a doctor. It not only identifies the disease, but also determines its degree. There are three:

• First. It is possible to cure the disease at the initial stage, because at this stage there are no morphological disorders of the tissue, the muscles are weakened, but not yet changed, and the joint begins to tolerate the load worse duemalfunctions of the synovial membrane and the biochemical composition of the fluid in the cavity that supplies the cartilage and menisci. Overuse leads to inflammation and pain.

• Second. At this stage, the cartilage and menisci begin to sag, their load leads to pathological growths on the bone tissue, narrowing of the joint space. Due to this, the knee increases in size and appears deformed. Treatment of bilateral knee osteoarthritis of the 2nd degree knee joint is already more difficult compared to the first stage. The pain and inflammation become chronic.
• Third. This degree is already considered severe. At the same time, the bone deformation is clearly expressed, the axis of the limb is changed, so the mechanical load is not properly distributed. The ligaments of the joint are shortened, the natural movements are limited because of this, then the leg can become completely still. Treatment of grade 3 knee osteoarthritis without surgery is impossible because the disease is very advanced.

If the pain seems to be bearable for a long time, people think they only have osteoarthritis in the first stage and put off going to the doctor. But this opinion is not correct. Every day, the load on the main elements of the joint, which is already beginning to collapse, increases, and pathological changes can lead to complete destruction of the joint and severe dysfunction of the limbs.

CLINICAL CURRENT

The progression of the disease is accompanied by characteristic symptoms. The pain occurs in the middle of the night, even if the leg is still. The stiffness is felt in the morning.

Walking becomes difficult when passing a certain distance, then at the beginning of the movement. In severe cases, a person cannot walk 100 meters normally, it becomes painful to stand and sit. You have to move with the help of special equipment.

Slight lameness in the first stage subsequently becomes pronounced. As a result, walking, using public transport, performing work chores, household chores and even self-service can become completely impossible.

TREATMENT METHODS

Folk recipes, pharmaceutical compresses and ointments will not help get rid of the disease, because the approach must be comprehensive.Cure is usually only possible in a hospital, where a doctor will treat osteoarthritis of the knee.What advice to give to the patient, he decides on the basis of the indicated complaints and concomitant pathologies. The following points are generally required:

• reducing the load on the joints;
• respect of the orthopedic regime;
physical therapy
• (exercise therapy);
• in physical therapy.

All of this helps to slow the progression of osteoarthritis and prevent loss of motor function. It should be understood that the methods used will largely depend on the capabilities of the hospital and the availability of one or another physiotherapy equipment. It is better if the patient has the opportunity to go to a spa or a specialized orthopedic clinic, where a modern approach to the choice of drugs, diet, methods, etc. will be proposed.

USE OF MEDICINES

Inflammatory processes and painful sensations make the treatment of osteoarthritis of the knee impossible without drugs in the form of tablets, creams, ointments and injections. At the first stage, you can use nonsteroidal anti-inflammatory drugs - Diclofenac, Indomethacin, Nimesulide, etc. At the second and third, you often have to fight inflammation with steroids - Triamcinolone, Hydrocortisone. These same hormones are used during times of acute pain.

In addition, intramuscular and intra-articular injections of drugs improving the condition of cartilage tissue (vasodilators and chondroprotectors) will be required.

PHYSIOTHERAPY METHODS

Substantial improvements can be made with physical therapy. The following methods are considered the most effective:

• Shock wave therapy. This method has worked well for the past 20 years. Its essence lies in the effect on the affected area with a special device that emits radial acoustic waves that activate the blood supply and stimulate tissue repair.
• Myostimulation. This therapy targets the muscles surrounding the joint. Low current pulses increase leg mobility, relieve pain and increase endurance during physical exertion.
• Phonophoresis. This technique harmoniously combines ultrasound therapy and the use of products in the form of ointments, gels and creams. Usually, these dosage forms are absorbed only 5-7%, but high-frequency ultrasonic vibrations warm the tissues, and the absorption increases several times. In addition to the good therapeutic effect, it avoids the consumption of expensive drugs.
• Ozone therapy. The anti-inflammatory and analgesic effect can be obtained by acting on the joint with active oxygen. It is a good addition and in some cases an alternative to taking hormonal drugs.

MEDICAL EXERCISE

Pain during physical exertion on a joint leads to the person trying to avoid it. In the long run, this threatens physical inactivity, leading to muscle atrophy and ligament weakness. Of course, during the period of exacerbation, the load on the joint should be completely removed, but after a few days after the elimination of inflammation and pain, it is necessary to start physiotherapy exercises.

It is believed that properly and consistently performed exercise therapy exercises can save the patient from the need for surgery. At present, experienced specialists have developed many special methods of daily training that strengthen muscles and increase their strength and endurance, inhibit the pathological destruction of tissues, restore joint mobility and range of motion.

The most important thing in this type of processing is regularity.A good effect is achieved only by patients who understand the need to change their lifestyle and strictly follow the doctor's recommendations on the relationship between physical activity and periods of joint rest.

PASSIVE KINESITHERAPY

Lymphatic drainage, massage, manual therapy are a good adjunct to medication, physiotherapy and exercise therapy. They are essential for sedentary patients and can improve the condition of their muscles, joints and ligaments.

Another method of passive physiotherapy is mechanotherapy. It uses special devices - vibration simulators, weighting agents, mechanical massagers, which improve the effectiveness of treatment.

The extension of the joints, in which the space of their cavity mechanically increases, allows you to get rid of pain and stop destructive processes. Regular use of this therapy prolongs the health of the knee for years.

COMPLIANCE WITH A PLAN

Since obesity is often the cause of osteoarthritis, patients with this diagnosis should take care of weight loss. Losing weight will reduce stress on the joint and make physiotherapy exercises easier. Sometimes diet is not enough, weight loss surgery is necessary, but such situations are rare.

Another indication of adherence to a certain diet may be any conditions associated with osteoarthritis. If there is no obesity or other diseases, accompanied by the need to change eating habits, it is not necessary to follow a special diet. However, you can help the body strengthen the affected cartilage tissue by including foods rich in collagen in your diet, including jelly and jelly meat, fish oil, berries, and fruits. It is best to refrain from consuming unhealthy foods like sugar, carbonated drinks and alcohol.

SURGICAL INTERVENTION

In advanced cases, a quick solution to problems with the musculoskeletal system is to perform operations. With osteoarthritis, the following types of surgical intervention are prescribed:

• Puncture allows you to get rid of the fluid that has accumulated in the joint cavity. As a result, inflammation is reduced, due to which mobility of the knee is restored.
• Arthroscopy cleans the surface of the joint from destroyed pieces of tissue. It is performed using thin flexible instruments using a video camera, thus avoiding dissection of the joint cavity.
• Periarticular osteotomy allows you to change the angle of one of the bones that form the knee joint, due to which the load is redistributed, mobility increases and pain is relieved. This intervention is quite traumatic, because the bone must be sawn.
• Endoprostheses are used to replace a diseased joint with a biocompatible structure. At the same time, the previous range of motion is restored, but the operation is quite new and very complicated, after which a long rehabilitation is required.

Surgery is rarely necessary in the first stage. On the second, it is necessary only occasionally, but on the third one cannot do without.

PATIENT ADVICE

Which of the many treatments that will be applied in each case depends on the doctor. The specialist will choose the best method, and the patient's task is to strictly follow the recommendations of the orthopedist. This is the only way to get a good result quickly. This is confirmed by patients who have been diagnosed with knee osteoarthritis.