Arthrosis of the knee joint is degenerative damage to the cartilage of the knee joint, as a result of which it is destroyed. Arthrosis is the most common pathology, and, according to doctors, about 80% of people suffer from this pathology to one degree or another. It is the third most common disease after cancer and heart disease. All this suggests that the treatment of arthrosis of the knee joint does not yet have a method that will help completely eliminate the disease.
Principles of treatment
There are several principles on how to treat arthrosis of the knee joint, which should be the basis for the treatment of the disease:
- Knee joints damaged by arthrosis must be immediately relieved of excessive physical activity during therapy. It is not so easy to cure arthrosis of the knee joint, but it will make it possible to prevent complications. If possible, it is generally necessary to limit joint movement and follow a prescribed regimen prescribed by a doctor.
- In parallel with the treatment, do not take too much care of yourself, so that atrophy of muscle tissue does not begin. It is better to engage in affordable physical therapy. Whichever doctor treats the joint, he or she will give instructions for exercise therapy.
- Physiotherapy is a great and effective way to improve your basic treatment. Physiotherapy has always included electro, magnetic, laser and shock wave therapy.
- Sanatorium-resort treatment is also useful for patients-with arthrosis, it is necessary to visit a specialized resort at least once a year.
- An important treatment is to fill the joints with oxygen. For this, so -called oxygen therapy is carried out.
- The drug is mainly anti-inflammatory and painkiller, intraosseous obstruction.
- An indispensable component of proper rational treatment is a change in eating habits, elimination of foods that give rise to excess salt in the body, saturation of the body with calcium, minerals and vitamins.
Medicine
Conservative therapy involves the treatment of gonarthrosis of the knee joint:
- non-steroidal anti-inflammatory drugs;
- chondroprotector.
Non-steroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs are fundamental in the treatment of arthrosis. This group of drugs allows you to quickly stop inflammation, eliminate swelling, because the painful sensation quickly disappears. The drugs have antipyretic and analgesic effects. That is why they are recommended for the treatment of articular pathology, including osteoarthritis of the knee joint.
Nonsteroidal anti-inflammatory drugs for the treatment of DOA of the knee joint (deformed osteoarthritis) are divided into several groups. According to their composition, they can be divided into acidic and non -acidic.
When using NSAIDs, you need to keep in mind the risk of side effects, therefore, it is strictly forbidden to exceed the dose.
Due to their high efficiency, non-steroidal anti-inflammatory drugs have been actively used in the treatment of various inflammatory diseases. However, doctors state that they have negative side effects. The study revealed its negative effects on the kidneys, heart, blood and digestive tract. That’s why doctors try to limit NSAID prescriptions, including in the treatment of arthrosis.
It is very important that during the treatment of the disease, the maximum possible dose is reached, which will help to withstand the painful symptoms, but does not bring negative effects. Most of all suffer from non-steroidal anti-inflammatory drugs:
- gastrointestinal tract organs;
- blood cells;
- kidney;
- heart.
From the side of the abdomen, complications such as ulcers, dyspepsia, internal bleeding, or even perforation of the abdomen are possible. As for the liver, there is damage to hepatocytes - the main cells of the liver. Heart disorders are indicated by arterial hypertension and edema. In the kidney, glomerular filtration is reduced and interstitial nephritis may develop. Side effects on the blood are manifested in impaired platelet aggregation and an increased risk of bleeding.
Is it possible to completely abandon NSAIDs that have a negative effect on the body? Apparently, no, because it is this group that makes it possible to withstand the first and second stages of arthrosis. Therefore, the negative aspects of non-steroidal anti-inflammatory drugs are forcing manufacturers to find a new generation of these drugs.
As a result of the research, 2 generations of cyclooxygenase enzymes 1 and 2 were isolated. Recently, the enzyme cyclooxygenase 3 has been created, including oxicams. These drugs have fewer negative effects, so they are actively used in the treatment of deformed arthrosis.
The latest generation of drugs also make it possible to treat arthrosis effectively without harming the body. The only drawback of the new drug is the relatively high price. Therefore, with prolonged use by attending physicians, old medications are prescribed with probiotic support for the gastrointestinal tract.
Oxycams
Representatives of the new generation of non-steroidal anti-inflammatory drugs are the oxicam group.
The oxicam group is the most effective and safe for arthrosis patients today.
Chondroprotectors
Chondroprotectors are a group of drugs that work to protect cartilage tissue. The mechanism of action is due to the content of active components that make up these drugs. First of all, these are:
- glucosamine;
- chondroitin sulfate.
The action of chondroitin sulfate is based on the stimulation of the process of formation of cartilaginous components. Also this material:
- inhibits destructive processes in cartilage tissue;
- increase intra-articular fluid production;
- has anti-inflammatory effects.
Glucosamine is an essential ingredient for cartilage tissue synthesis. It protects cartilage from free radicals and other factors that damage the integrity of cartilage tissue. Also, glucosamine is able to relieve swelling and has anti-inflammatory effects.
Chondroprotectors are able to restore cartilaginous tissue, but it must be taken for a relatively long time - at least six months. Another major drawback of chondroprotectors is that they better protect the cartilage from damaging effects, but are unable to slow down the pathological process that has already begun.
Therefore, this group of drugs is included for treatment only in the first stage of disease development with active prescription of non-steroidal anti-inflammatory drugs. Today there are three generations of chondroprotectors, the most famous of which are:
- preparations from animal cartilage;
- the second generation is mono-drugs containing either purified hyaluronic acid, or chondroitin or glucosamine;
- the third generation is a combination of drugs that include both glucosamine and chondroitin sulfate.
Today it is possible to use chondroprotectors in conjunction with anti-inflammatory drugs.
Operation
In some cases, degenerative arthrosis of the knee joint is treated exclusively with surgery. Usually, surgery is performed when the patient has grade 3 gonarthrosis. But if the patient in the second stage of the disease has a very pronounced pain syndrome, and is difficult to remove even with painkillers, and arthrosis is constantly exacerbated, then surgery is indicated at this stage of the disease.
There are several methods of surgical intervention that give the best effect for gonarthrosis. Each technique has its own characteristics and results.
Arthrodesis is a procedure in which joint tissue is completely removed and the femur and tibia join together with the patella. This method of treating gonarthrosis is the most radical and is not used so often today, as it leads to limitation of patient mobility.
Another operation to remove knee arthrosis is arthroscopic debridement. Treatment consists of removing dead particles. The disadvantages of the operation are significant - it takes a long time for recovery, and the effect of the procedure lasts only from 1 to 2 years. Such surgery can be performed already in the second stage of development of the disease.
Periarticular osteotomy - this operation is performed if necessary to restore joint mobility. During the procedure, the surgeon cuts the part of the bone that interferes with free movement and fixes it at the desired angle.
Thus, the center of gravity in the bone shifts, and the load on the cartilage tissue disappears. Currently, this type of joint surgery is practically not used, as it is quite complicated and requires a lengthy recovery process. The positive effects of treatment are also temporary.
The most successful intervention is endoprosthetics. Surgery for arthrosis using endoprosthetics has no analogues - it provides a long -lasting effect, and patients forget about knee problems for years.
Knee arthroplasty is the most advanced technique. Modern treatment methods make it possible to extract from patients cartilage tissue affected by pathological processes, as well as bone particles. Instead, a more functional and reliable prosthesis is placed. The advantages of such surgery are as follows:
- it is possible to fully restore the patient's motor function;
- recovery with such operations is minimal;
- the prosthesis lasted about three decades.
The only problem with the surgical treatment of arthrosis with the method of endoprosthetics is the high cost of materials, because high-quality prostheses are quite expensive. Postoperative treatment is completed in the intensive care unit - the patient is given drainage for several days, from which wound secretions are released.
To relieve pain, the knee is covered with a special cooling agent. It is possible to move during endoprosthetics already on the third day, on the tenth day the patient continues treatment in the rehabilitation center. After treatment, it is possible to prescribe non -steroidal medications for pain relief, hormonal agents, and make sure you wear a bandage for some time.
Reviews
To evaluate the various methods of therapy, you can read reviews of patients who have been treated in various ways, and those who have cured arthrosis of the knee joint:
- Woman, 45: "Arthrosis of the knee joint was discovered in me 2 years ago. I was sick to step on my feet, unusual dryness appeared, and I went to the doctor. The onset of the second stage of the disease was diagnosed and treatment with non -steroidal drugs and chondroprotectors was advised"With the help of pain pills, I managed to achieve a stable analgesic effect - I took a bunch of oxicam. Now I continue to take chondroprotectors, no more deterioration".
- Man, 62: "I suffered from arthrosis of the knee joint - apparently, as a result of sports, which I was professionally involved in in my youth, affected. Although going for coaching work did not help reduce the load, so I continued to be actively involved, as a result I was diagnosed witharthrosis, which I practically did not treat. I just took painkillers, hoping it would pass. As a result, stage 3 of the disease progressed, and I had to undergo surgery. Among all the techniques, the doctor recommended a prosthetic, which had been performed on me for yearslast. The operation was successful and I recovered quickly. "
- Woman, 55: "This year I was diagnosed with stage 1 arthrosis. Luckily, I went to the doctor on time because I felt heaviness in my legs. I thought it was swollen, because I had been overweight since childhood, but, it turned out, it was arthrosis. Now I am taking anti-inflammatory drugs, but the doctor promised that I would be able to recover with the help of chondroprotectors. I hope it will not come to surgery. "
Arthrosis of the knee joint is characterized by a dangerous course, when in the early stages of the pathology does not give symptoms. However, this is when the treatment is most productive. Therefore, doctors emphasize the timely diagnosis of pathology and prevention of disorders in cartilage tissue.