Osteoarthritis of the knee joint is a degenerative damage to the cartilage of the knee joint, as a result of which it is destroyed. Osteoarthritis 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 of this suggests that treating osteoarthritis of the knee joint does not yet have methods that would completely help eliminate the disease.
Principles of treatment
There are some principles on how to treat osteoarthritis of the knee joint, which should be the basis for treating the disease:
- Osteoarthritis-damaged knee joint should be relieved immediately of excessive physical activity during therapy. It is not so easy to cure osteoarthritis of the knee joint, but it will make it possible to prevent complications. If possible, it is generally necessary to limit the movement of the wrist and follow the established regimen prescribed by the doctor.
- In parallel with treatment, do not take too much care of yourself, so as not to start atrophy of muscle tissue. It is better to engage in affordable physical therapy. Whichever doctor treats the wrist, he will give direction to exercise therapy.
- Physiotherapy is a great and effective way to improve your basic treatment. Physiotherapy always includes electro-, magnetic, laser and shock wave therapy.
- Sanatorium treatment will also be useful for patients - with osteoarthritis, it is necessary to visit specialized resorts at least once a year.
- An essential treatment is to fill the joint with oxygen. For this, so-called oxygen therapy is performed.
- The treatment is mainly anti-inflammatory and pain relievers, intraosseous blockages.
- An indispensable component of correct rational treatment will be a change in dietary habits, the elimination of foods that provoke an excess of salt in the body, the saturation of the body with calcium, minerals and vitamins.
Treatment
Conservative therapy includes the treatment of gonarthrosis of the knee joint:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors.
Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs are the basis in the treatment of osteoarthritis. This group of drugs allows you to quickly stop the inflammation, eliminate the swelling, due to which the painful sensations go away quickly. The drugs have antipyretic and analgesic effects. This is why they are recommended for the treatment of joint pathologies, including osteoarthritis of the knee joint.
Non-steroidal anti-inflammatory drugs for the treatment of knee joint DOA (deforming osteoarthritis) are divided into several groups. According to their composition, they are divided into acids and non-acids.
When using NSAIDs, you need to keep in mind the risk of side effects, therefore, it is strictly forbidden to overdose.
Due to their high efficacy, non-steroidal anti-inflammatory drugs have been actively used in the treatment of various inflammatory diseases. However, doctors noticed that they have a negative effect. The study revealed their negative effects on the kidneys, heart, blood and digestive tract. This is why doctors are trying to limit the prescription of NSAIDs, including in the treatment of osteoarthritis.
It is very important to achieve the maximum possible dose during the treatment of the disease, which would help curb the painful torturous symptoms, but would not bring negative effects. Most suffer from non-steroidal anti-inflammatory drugs:
- organs of the gastrointestinal tract;
- blood cells;
- kidneys;
- heart.
On the part of the stomach are possible complications such as ulcers, indigestion, internal bleeding, or even perforation of the stomach. As for the liver, there is damage to the hepatocytes - the main cells of the liver. Cardiac disorders are manifested by hypertension and edema. In the kidney, glomerular filtration is reduced and interstitial nephritis may develop. Blood side effects are manifested in impaired platelet aggregation and an increased risk of bleeding.
Is it possible to completely abandon NSAIDs that negatively affect the body? As it turned out, no, as it is this group that makes it possible to curb the first and second stage of osteoarthritis. Therefore, the negative aspects of non-steroidal anti-inflammatory drugs forced manufacturers to seek new generations of these drugs.
As a result of the research, 2 generations of cyclooxygenase enzymes 1 and 2 were isolated. Recently, cyclooxygenase 3 enzymes have been invented, which include oxycams. These drugs have far fewer adverse effects, so they are actively used in the treatment of deforming osteoarthritis.
The latest generation medicines also make it possible to treat osteoarthritis effectively without harming the body. The only drawback of the new drugs is the rather high price. Therefore, with prolonged use by the attending physician, older medications are prescribed with probiotic support for the gastrointestinal tract.
Oksikamerat
Representatives of a new generation of non-steroidal anti-inflammatory drugs are the oxycame group.
The oxycamone group is the most effective and safest for osteoarthritis patients today.
Chondroprotectors
Chondroprotectors are a group of drugs that serve to protect cartilage tissue. The mechanism of action is due to the content of active ingredients 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 processes of formation of cartilaginous components. Also this substance:
- prevents destructive processes in cartilage tissues;
- improves intra-articular fluid production;
- has an anti-inflammatory effect.
Glucosamine is an essential substance 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 have an anti-inflammatory effect.
Chondroprotectors are capable of restoring cartilage tissue, but they must be taken for quite a long time - at least six months. Another major drawback of chondroprotectors is that they protect the cartilage more from destructive effects, but they can not slow down a pathological process already started.
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:
- animal cartilage preparations;
- 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 along with anti-inflammatory drugs.
operation
In some cases, degenerative osteoarthritis of the knee joint is treated exclusively with surgery. Usually, surgery is directed when the patient develops grade 3 gonarthrosis. But if a patient in the second stage of the disease has a very pronounced pain syndrome and is difficult to remove even with sedatives, and the arthrosis is constantly aggravated, then surgery is indicated at this stage. of the disease.
There are several methods of surgical interventions that give the best effect for gonarthrosis. Each technique has its own characteristics and results.
Arthrodesis is a procedure in which the wrist tissue is completely removed and the femur and tibia join together along the patella. This method of treating gonarthrosis is more radical and is not used as often today, as it leads to a restriction of patient mobility.
Another operation to eliminate knee osteoarthritis is arthroscopic debridement. Treatment consists of removing dead particles. The disadvantage of surgery is significant - it requires a long time for rehabilitation, and the effect of the procedure lasts only from 1 to 2 years. Such an operation can be performed already in the second stage of disease development.
Periarticular osteotomy - this operation is performed if necessary to restore joint mobility. During the procedure, the surgeon removes the bone parts that interfere with free movement and places them at the desired angle.
Thus, the center of gravity in the bone shifts, and the load on the cartilage tissue disappears. At present, this type of joint surgery is practically not used, as it is quite complex and requires a long rehabilitation process. The positive effect of the treatment is also temporary.
The most successful intervention is endoprosthetics. Surgery for osteoarthritis using endoprosthetics has no analogues - it gives a long-term effect and patients forget about knee problems for many years.
Knee arthroplasty is the most advanced technique. Modern methods of treatment make it possible to remove from the patient cartilage tissue affected by the pathological process, as well as bone particles. Instead, a more functional and reliable prosthesis is placed. The advantages of such an operation are as follows:
- it is possible to completely restore the patient's motor functions;
- rehabilitation with such an operation is minimal;
- the prosthesis lasts about three decades.
The only problem with the surgical treatment of osteoarthritis with the method of endoprosthetics is the high cost of materials, as a high quality prosthesis is quite expensive. Postoperative treatment ends in the intensive care unit - the patient is given drainage for several days, from which the wound secretion is released.
To relieve pain, the knee is covered with special cooling agents. Movement during endoprosthetics is already possible on the third day, on the tenth day the patient continues treatment at the rehabilitation center. After treatment, it is possible to prescribe non-steroidal pain medications, hormonal agents, and make sure to wear a bandage for a while.
evaluations
To evaluate different methods of therapy, you can read reviews of patients who have been treated differently and those who have cured knee osteoarthritis:
- The woman, 45 years old: "I was diagnosed with osteoarthritis of the knee 2 years ago. I injured my leg, an unusual crack appeared and I went to the doctor. I was diagnosed with the beginning of the second degree of the disease and treatment with"With the help of pain pills, I was able to achieve a lasting analgesic effect - I took a group of oxycams. Now I continue to take chondroprotectors, there is no worsening yet.
- Male, 62 years old: "I had osteoarthritis of the knee - apparently affected by the consequences of the sport I played professionally in my youth. Even leaving for a job as a coach did not help reduce the load, so I continuedto be actively engaged, as a result of which I was diagnosed with osteoarthritis, which I practically did not treat. I drank only sedatives in the hope that it would pass. As a result, stage 3 of the disease developed and I had to undergo a"Among all the techniques, the doctor suggested the prosthesis, which was performed on me last year. The operation was successful and I recovered very quickly. "
- Woman, 55 years old: "This year I was diagnosed with stage 1 osteoarthritis. Thankfully I went to the doctor on time because I felt heaviness in my legs. I thought it was swelling, as I was overweight since childhood, but as it turned out, it was osteoarthritis. Now yes"I am taking anti-inflammatory drugs, but the doctor promises me that I will be able to recover with the help of chondroprotectors. I hope he will not have surgery. "
Osteoarthritis of the knee joint is characterized by an insidious course, when in the initial stage the pathology does not give symptoms. However, it is at this time that treatment is most productive. Therefore, doctors insist on timely diagnosis of pathology and prevention of disorders in cartilage tissue.