Osteoarthritis, 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 made up of three bones: the femur, the tibia and the kneecap. At the point of contact with each other, these bones are covered with cartilage tissue, which ensures a smooth sliding of the surfaces between them.
Over time, these cartilages become thinner, losing their flexibility and elasticity. The cartilage is nourished by the synovial fluid; the damping properties of the joint depend on the quantity and quality of this fluid.
First symptoms and signs
- Most often appear in people between the ages of 45 and 50. This disease is typical for both men and women, but the "weaker sex" suffers from it much more often.
- At the onset of the disease, the patient feels tolerable pain in the area of the knee joint, and over time severe pain appears.
- The intensity of the pain changes: with movement, physical activity it becomes stronger, at rest - the pain disappears.
If you do not pay attention to these symptoms of an impending illness in time, the disease begins to progress, and in severe cases leads to disability.
When contacting a doctor, the diagnosis of osteoarthritis is clarified with the help of x-rays. The images show the narrowing of the joint space from the inside or the 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 - bony growths.
The main signs of osteoarthritis of the knee joint:
- During the day, the pain intensifies; during nighttime rest, the pain subsides. But in case of venous insufficiency, dull pains persist at night.
- Muscle tension in the joint area
- When walking, a crunch is heard in the knee joint
- In severe cases of the disease, deformation and swelling of the affected joint is observed, an increase in its volume
- On palpation, the joint is painful
- When you try to move the knee brace, the pain increases
- In the advanced stage of the disease, muscle shortening occurs and the patient cannot put the leg in the correct position
- If left untreated, joint mobility decreases or is completely lost
What is patellofemoral osteoarthritis of the knee?
Very often at the doctor you can hear the diagnosis "patellofemoral osteoarthritis" - what is it? Indeed, in the international classification of diseases such arthritis is absent. Not many 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 subjected to regular overuse or repeated injury. In other words, patellofemoral osteoarthritis is the same as patellofemoral syndrome.
The main causes of the disease are:
- congenital and acquired deformities of the lower limbs;
- various anomalies in the development of the patella;
- regular overload of the knee joint (for example, in athletes).
Patellofemoral osteoarthritis of the knee joint presents the following clinical manifestations: pain in the area of the front face of the knee joint, which increases considerably with physical exertion (running, jumping, climbing and descendingstairs, various squats). The pain may also increase when the patient is seated with the legs bent under them. The patient may feel a feeling of tension and stiffness in the knee, both inside and in front of it.
Patellofemoral syndrome is diagnosed clinically, as a rule, additional studies are not necessary.
This disease, as a rule, does not require special treatment. However, to reduce pain and develop unwanted consequences (instability of the patella, deformation of the knee joint, accumulation of inflammatory exudate), the following procedures are necessary:
- decreased physical activity. This does not mean that the patient will have to lead a passive life, just the level of activity should not be painful;
- using a special bandage that is worn over the area of the knee joint during exercise or stress, thereby supporting and fixing the kneecap;
- with a pronounced pain syndrome, glucocorticosteroids and anesthetics are injected into the painful areas of the joint by precise injection, which will relieve pain and help to avoid the use of anti-inflammatory drugs in the future.
If patellofemoral osteoarthritis has already caused complications or is accompanied by other degenerative-dystrophic pathologies of the knee joint, then treatment is carried out according to the treatment regimen of osteoarthritis of the knee joint.
The reasons
- An occupational disease of athletes who experience increased stress on the knee joints. Athletes experience joint injuries and strain injuries, bruises and ligament ruptures. After retiring from sports, the muscle structure 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 "standing"
- Genetic predisposition
- Congenital diseases of the joints and bones
- Lack of collagen
- Knee injury
- Excess weight that puts more strain 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:
- Osteoarthritis of the knee joint 1 degree. . . There is a slight narrowing of the gap of the joint, the edges of the surface are slightly sharpened, a slight restriction of movement. During the arthroscopic examination, the doctor probes the softening of the cartilage.
- Osteoarthritis of the knee joint of the 2nd degreecharacterized by a significant limitation of the movement of the knee joint, a strong tightening. 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.
- Osteoarthritis of the knee grade 3- this is already a complete restriction of movement, when deformation of the joint has occurred, deformation and compaction, osteophytes and cysts are observed on the surface of the joint. There were changes in the cartilage tissue throughout its thickness.
- Osteoarthritis of the knee grade 4- arthroscopy shows the total absence of cartilage tissue.
Medical treatment
In the complex treatment of osteoarthritis of the knee joint, pharmacotherapy occupies an important place. By 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 osteoarthritis of the knee joint, drug therapy helps to eliminate pain, normalizes blood circulation in the problem area, improves metabolism and nutrition of cartilage, activates recovery processes and increasesjoint mobility.
Since it is impossible to apply other therapeutic methods against the background of acute pain sensations, first of all, the patient is prescribed analgesics and anti-inflammatory drugs. However, it is not recommended to use these 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 thedehydration and further destruction of cartilage tissue.
Chondroprotectors are used to restore nutrition to cartilage, regenerate cartilage plaque, and improve the quality of synovial fluid.. . . The drugs in 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 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 heating 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 are shown to use nonsteroidal 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 suspect the presence of disease or arthritis of the knee joint - drug therapy, started on time and correctly selected, can save thejoint and help avoid surgical intervention.
Medicines for the treatment of osteoarthritis of the knee joint
Treatment for 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 joint cartilage, activating metabolic processes and restoring joint mobility.
What drugs are prescribed for osteoarthritis of the knee joint?
- For successful treatment of the disease, you first need to relieve pain and eliminate the inflammatory process. For this, nonsteroidal anti-inflammatory drugs are used. However, you should not get carried away with these funds - with prolonged use they tend to hide the true clinical picture of the disease.
- To restore the cartilage 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 any real improvement, you will need to undergo 2-3 treatments 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 osteoarthritis is accompanied by synovitis, preference is given to ointments based on nonsteroidal anti-inflammatory substances.
- Intra-articular injections are used to provide emergency care for osteoarthritis. 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 skin barriers, that is, 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, gives a warming effect. Medicinal bile has the same properties as dimethyl sulfoxide with bischofite, but its use is limited by certain contraindications. Medical bile should not be taken by patients with skin pustules, high body temperature, and inflammation of the lymph nodes.
Before starting any medication for osteoarthritis of the knee joint, it is necessary to consult a doctor, discuss the dosage, features of administration and duration of treatment.
Injections into the knee joint for osteoarthritis
Intra-articular injections are one of the most effective methods of treating osteoarthritis of the knee joint. This rather expensive procedure significantly reduces pain and inflammation, and modern new drugs not only improve the general condition of the patient, but also treat the affected cartilage tissue.
Injections into the knee joint for osteoarthritis are quite a difficult procedure, therefore, you should consult a doctor, even if the patient knows which drugs need to be injected and in what quantity.
For intra-articular injections, the following drugs are most often prescribed:
- Corticosteroid hormones. These are the most common remedies, since the effect after their introduction is achieved within a few minutes. However, to relieve inflammation and pain, corticosteroids negatively affect the joint itself - the cartilage tissue remains degenerative. In addition, drugs in this group cause narrowing of blood vessels, which further destroys joint tissue. Therefore, the use of corticosteroid hormones is only justified in case of unbearable pain in the later stages of osteoarthritis. The injection can only be repeated 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 these drugs is particularly effective in the early stages of osteoarthritis. The course of treatment is 5-10 injections.
- Hyaluronic acid. A very effective drug, but at the same time expensive. 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 containing hyaluronic acid into the knee, the friction of the affected joint surfaces decreases, and the mobility of the knee improves. Such injections are very effective at the initial stage of osteoarthritis, a slightly less effect is observed in the second stage, and with osteoarthritis of the third knee joint, these drugs only briefly relieve the patient's condition. The course of treatment usually includes three to four injections once a year.
Injections into the knee joint for osteoarthritis are strictly contraindicated in the following cases:
- infection of the skin or subcutaneous tissue in the area planned for the injection;
- sepsis;
- infectious arthritis;
- haemophilia;
- the presence of a viral infection;
- lack of results from previous injections;
- individual intolerance to the drug.
It is also unacceptable to give intra-articular injections for prophylactic purposes.
Orthopedic knee pads for osteoarthritis of the knee joint
During the treatment of osteoarthritis of the knee joint, to prevent various injuries, as well as to support damaged tissue and relieve stress in the joint, knee pads are used.
An orthopedic knee brace 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 hang down, a well-fitting knee brace will not squeeze the leg and cause swelling. and other unpleasant consequences of prolonged compression.
Orthopedic knee braces for osteoarthritis 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 brace, you should pay attention to the following features:
- Type of knee brace - is selected depending on the severity of the 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 reinforcing ribs - for pain when going up and down stairs etc.
- articulated - for different types of pain;
- to support tendons - used if the pain is localized under the kneecap.
- Of great importance is the material from which the knee brace is made, since not only the degree of attachment, but also the intensity of the warming effect depends on it. Modern knee pads are made from cotton, lycra, nylon, neoprene, elastane, camel and dog hair.
- The size of the knee brace, which is calculated individually for each patient.
The doctor will help determine the parameters of the future purchase - he will not only select the optimal size and type of knee brace for the patient, but also indicate which material will be most effective.
Orthopedic knee braces for osteoarthritis can be purchased at a pharmacy or a specialized store of medical equipment, the price is quite acceptable. You should beware of such purchases from non-specialized outlets or from questionable companies, because you can easily buy a fake, which, if it is not harmful, certainly will not help.
Adequate nutrition
Nutritionists have been studying the nutritional characteristics of various peoples for many years. By 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 done repeatedly 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 point it was believed that the use of tomatoes contributed to the development of the disease, and 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.
Good nutrition is the key to healthy joints.
To prevent the development of the disease, it is necessary to understand that nutrition plays a key role in osteoarthritis of the knee joint. From a diet point of view, the consumption of meat products belonging to the fast food segment should be minimized. These products are:
- semi-finished products from meat production waste: sausages, sausages, sausages of all kinds, etc.
- smoked meats sold in stores (most often this type of products is 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 everyone is able to give up the above food items. Many over the years have gotten into 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 in 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 was better to refuse semi-finished products, smoked meats and fast food. But what about the meat if it is syringe?
The ideal option, of course, is to buy meat from trusted suppliers, but in urban conditions this advice is impractical.
In this regard, it is necessary to use such cooking methods so that as many harmful chemical compounds as possible are destroyed. Sometimes the use of this factor alone has achieved an excellent effect in the fight against osteoarthritis.
How to properly cook food for osteoarthritis of the knee joint
It should be remembered that nutrition 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 meat and remove the skin from poultry. The greatest amount of harmful substances is found in fat.
Boiling, baking, baking in foil, and steaming are the healthiest ways to prepare food.
In case of osteoarthritis of the knee joint, jelly and jelly meat should not be eaten. There is a review from the "Grandma in the Yard Said" series that these dishes are good for joints, but they are not. A person with osteoarthritis will only get worse with high cholesterol.
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 fat in the second. Better to get used to vegetable soups, so popular in Western countries. Mushroom soups are also useful.
An attempt to replace meat for soup with dry broths and cubes will do no 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 is therefore harmful for osteoarthritis 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 cook frozen fish properly.
Prevention of osteoarthritis of the knee joint
It is impossible to allow the state of life to worsen due to the disease, therefore, the causes that lead to osteoarthritis should be excluded. It is much easier to prevent the disease than it is to deal with expensive and long-term treatment.
- You have to lose weight.
- The joints require constant physical activity: jump rope, squats, short runs. But everything should be moderate. Excessive exercise also leads to illness. Alternate joint loads with adequate rest.
- Due to knee injuries, osteoarthritis develops. When skiing, skating, cycling or rollerblading, padded knee pads should be worn. On sale there is a sufficient selection of sheep wool binding and warming knee pads.
- Don't ignore someone else's help if the weight is overwhelming.
- Eat more vegetables and fruits. It should be noted that vegetarians hardly suffer from osteoarthritis. Substitute olive or mustard oil for the mayonnaise. Especially useful are plums, dried apricots, apricots, apples, raspberries, cranberries with honey.
- Strong tea and coffee remove calcium in large amounts.
- Homemade cottage cheese and cheese will help strengthen the bones.
- Walking with a cane will prevent you from overloading the knee joints.
- Shoes should be comfortable, with low heels.
- Swimming and water aerobics will relieve stress on the whole body and fatigue in the knee joints.
- Among 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 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 serious illness. And in the event of the manifestation of the disease, they will slow down the development of pathological processes.