Deforming Osteoarthrosis of the Knee Joints (aka gonartrosis or abbreviated doa) is a degenerative-dystrophic disease of the knee joint, which is characterized by a chronic steadily progressive course, damage to all structural elements (hyaline cartoShell, A Capsule and a joint of joint) and leads articular deformation, reduction of movements and often disability.
The disease begins with changes in the articular cartilage to which the joint surfaces of the bones occur.Disorder and loss of elasticity lead to its dystrophy (thinning) and absorption, while the bone tissue of the articular surfaces is exposed, the gliding is disturbed, the joint column narrows, the joint biomechanics changes.The synovial bowl that lines the joint and produces the synovial fluid is irritated (which feeds the cartilage and plays the role of physiological lubrication), which leads to an increase in its amount in the joint (synovitis).Against the background of the narrowing of the joint column, the volume of the joint decreases, the synovial fluid embroider the rear wall of the joint capsule, the Beck cyst (which can reach large sizes, can cause pain in the popliteal fossa).The thin and sensitive fabric of the joint capsule is replaced by a rough connective tissue, the shape of the joint changes.The periosurpital pital bone tissue grows, osteophytes (pathological bone growth) are formed.The blood circulation in the periartic tissues is disturbed, and underestimated metabolic products, irritating chemoreceptors, develops a persistent pain syndrome.Against the background of a change in the anatomy of the joint, the work of the surrounding muscles, hypotrophy and cramp occurs, a gear is disturbed.There is a persistent restriction of the movement volume in the connection (contract regulation), sometimes so pronounced that only swing movements (rigidity) or a complete lack of movements (ankyloses) are possible.
Gonarthrosis is a fairly frequent disease: they suffer from 10% of the total population of the planet and affect every third person at the age of 60.
The causes of gonarthrosis
- Injuries to bones and joints.
- Inflammatory joint diseases (rheumatoids, chlamydia arthritis, gout).
- Violation of mineral metabolism with various endocrinopathies (diabetes mellitus, parathyroid disease, hemochromatosis).
- Diseases of muscle devices and neuropathy (Charcot disease).
In addition to the main reasons, undesirable background factors for the development of gonarthrosis are also differentiated, including:
- Obesity (literally exerts pressure on the lower limbs);
- Age (the disease is mainly subject to older people);
- Female gender (according to the statistics of a woman they become sick more often);
- Increased sports and professional physical exertion.
Symptoms of osteoarthritis of the knee joints
- The pain that increases alone when walking and weakness.
- Difficulty of the familiar, physiological movements in the joints.
- A characteristic "crunch" in the joints.
- The increase in the joints in the quantity and their visible deformation.
Stadiums of gonar rose
Clinical stages of the arthrosis of the knee joint
The disease goes through several stages.
- In the first stage one person only feelsA little feeling of discomfortOr "heavy" in the knee, which is bothered by long walking or increased physical exertion.The radiological examination will not be informative: it is possible to identify only a small narrowing of the common gap, there will be no other changes.
- The second stage is characteristicTangible painwhose severity is reduced in peace.There is a difficulty in the joints in the joints, when walking you can hear a characteristic "creak" (you can hear a conventional sentence from the patient in everyday life - "the knee chest").When carrying out radiography, a clearly distinguishable narrowing of the common gap and the individual osteophytes are found.
- If the transition of gonarthrosis to the next, third stage,Pain constantly disturb the patientIncluding in peace there is a violation of the configuration of the joints, i.e.H. The deformation intensifies by edema at the time of the connection of the inflammation.The X -ray images determine the narrowing of the common gap of moderate degrees and several osteophytes.In the third stage, many already apply for medical help, since the quality of life suffers significantly due to pain and difficulties in normal walking.
- The fourth stage is accompaniedEnvironment, strenuous pain.The minimal attempts to move are a difficult test for humans.The deformation of the joints is visually striking, walking is extremely difficult.X -Ray shows significant changes: The common gap in the pictures is practically not determined, multiple rude osteophytes, "joint mice" (fragments of the destructive bone that fall into the joint cavity).This level of gonarthrosis almost always includes a disability.
Who treats osteoarthritis of the knee joint?
The therapist, rheumatologist and general practitioner (family doctor) can offer qualified medical care for gonar rose (family doctor), these experts treat the knee joint with uncomplicated osteoarthritis.If synovitis occurs or the treatment prescribed by the therapist does not have the right effect, you cannot do without the help of an orthopedic surgeon.In situations in which surgical care is required, the patient is sent to a specialized orthopedic department.
How and what treats osteoarthritis of the knee joint?
The methods for the treatment of osteoarthritis of the knee joint, which are currently known, are divided into non -angry conservative, medication and surgical.
Not -drug methods
Many patients wonder: "How can you heal the arthrosis of the knee joint without pills?"If you react to him, it no longer has to indicate that gonar rose is a chronic disease.It is impossible to eliminate it forever.However, many who are present today can slow down the progress and improve the quality of the patient, especially if they are used in the early stages of the disease.
When looking for a doctor in good time and the patient's adequate motivation to heal, it is sometimes sufficient to eliminate negative factors.For example, it is proven that thatReduction of overweightreduces the manifestation of the main symptoms of the disease.
Exclusion of pathological physical exertion and on the contrary,Classes of therapeutic gymnasticsWith the use of rational physical programs, you reduce the intensity of the pain.It has been proven that exercises to strengthen the strength of the four -headed hip muscle in force are comparable to anti -inflammatory drugs.
If we treat the arthrosis of the knee joint, we have to strive for itreal nutrition: to improve the elastic Properties of Articular Cartilage Will Help Products Containing A Large Amount of Animal Collagen (Dietary Varieties of Meat and Fish) and Chondroitin (Shrimp, Crabs, Kril), Sataturated With Vegetable Collagen and Antioxidants, Fresh Vegetables andFruits, and Passion for Smoked Meenas, Conservatives, Sweet and Perechen Dishes, Sweet and Paved Dishes, Sweet and Paved Dishes on the In contrast, a violation of the metabolic processes in the body and the accumulation of overweight against fatty are potentially potentially.
The complex treatment of osteoarthritis of the knee joint also includes the appointment of very effective, even with advanced forms of the diseasePhysiot -Procedure.With the widespread use in different categories of patients suffering from this disease, its effectiveness has provenMagnetotherapy: After several interventions, the pain intensity decreases, since the blood circulation, the reduction of the edema and the elimination of the muscle cramp increases the mobility of the joint.The effect of magnetotherapy is particularly alive during the development of active inflammation in the joint: the severity of the edema is significantly reduced, the phenomena of synovitis are back.Not as popular, but no less effective in the treatment of knee joint with osteoarthritis are such methods of physiotherapy asLaser therapy and cryotherapy(Cold exposure) with a pronounced pain reliever effect.
Drug treatment
The following medication are used in the schemes of the effective treatment of the osteoarthritis of the knee joint.
Non -steroidal anti -inflammatory medicationIn the forms for the external (various gels, ointments) and systemic use (tablets, candles, solutions), they have long demonstrated their effectiveness in the treatment of osteoarthrosis and are widespread by doctors.They block inflammation on an enzymatic level and eliminate joint pain and swelling and slow down the progression of the disease.It must be remembered that an extended systemic technology cause the development and worsening of ulcerative processes in the gastrointestinal tract and also negatively influences the functions of the kidneys and liver.Therefore, patients who take the drug for a long time should also prescribe medication that protect the gastric mucosa and regularly monitor the laboratory indicators of the work of the internal organs.
Glucocorticosteroids (GKS)- Hormonal medication with a pronounced anti -inflammatory effect.Since the GCS are a powerful anti -inflammatory means, they have certain contraindications because they are able to call up a number of significant side effects.They are practically not prescribed in system forms for gonarthrosis.As a rule, an effective treatment of osteoarthritis of GCS in Peri -Humanian pain points includes the intensity of the struggle against inflammation and the risk of undesirable side effects of the drug is minimized.With a single introduction of the GCS, the effect of its use takes up to 1 month.In accordance with national recommendations for the treatment of osteoarthritis, you should not carry out more than three injections of the drug per year in the same joint.
With the FAR -GO, "neglected" osteoarthritis when a person has unbearable pain that does not even leave in peace, violation is possible against normal sleepOpioid pain.These drugs are only used in accordance with the prescription of the doctor, which in any case looks at the feasibility of their appointment.
Chondroprotectors(with a literal translation - "shooters from cartilage").This name is understood as various drugs that are combined by a property - a structural modifying effect, i.e.H. the ability to slow down degenerative changes in cartilage and the narrowing of the common gap.They are produced for oral administration (glucosamine, chondroitin sulfate, pastalin) as well as for oral administration and for the introduction to the joint cavity (hyaluronates).Of course, these drugs are no wonder and do not “grow” a new cartilage, but they can suspend its destruction.In order to achieve a persistent effect, they have to be used regularly several times a year for a long time.
Surgical treatment of knee cararthrosis
The most popular type of surgical care for gonarthrosis isEndoprosthetics, d.H. Remove your own joint with a simultaneous installation of a metalloprosthesis that replaces you, the design of which is similar to the anatomy of the knee steering of a person.At the same time, a prerequisite for this type of surgical treatment is: the lack of gross formations of the charter, formed "false joints", muscle contractures and pronounced muscle atrophy.In the case of severe osteoporosis (a significant decrease in the mineral density of bones), the endoprosthetics do not show: the "sugar" leg tier does not withstand the introduction of metal pencils, and the rapid renewal (absorption) of the bone tissue can begin, pathological fractures.Therefore, a timely solution to the problem of installing an endoprosthesis is significant - it should be accepted if the age and general condition of the human body can still perform an operation.
Despite the widespread prevalence of the endoprosthetics of the knee joint, the results of such operations are often unsatisfactory, and the percentage of the complications is high.This is due to the construction features of endoprostheses and the complexity of the surgical intervention itself (the replacement of the hip joint is much easier in technical terms).
Artromedullary Shunting- Connection of the bone marrow canal of the femur to the cave of the knee joint with a shunt - a hollow metal tube.For this reason, the fat bone marrow comes into the knee joint from the lower third of the thigh, nutritious cartilage and smears, which achieves significant pain.
If I would like to summarize the above, I would like to find that the treatment of gonarthrosis is a complex social task.And although medicine cannot offer a medication today that eliminates it forever, or other ways to completely heal this disease, a healthy lifestyle, a timely search for medical help and the implementation of the doctor's recommendations can suspend its progress.