Knee arthritis: Symptoms, treatment

Among the diseases of the musculoskeletal system, osteoarthritis is a frequency leader.It is believed that the majority of the planet's population at the age of 60 showed signs of initial changes in articular cartilage and 14% showed signs of osteoarthritis.The most common version of this disease is osteoarthritis of the knee joint.

However, "Arthrosis" or "arthritis"?

Do not mix these two concepts.Arthritis is a process that changes mainly the structure of joints and arthritis is an inflammatory condition that can occur both on the background of the structure that is not affected and on the basis of arthritis.

For example, bone changes with arthritis can be compared to the growth of the knot on the trunk, developing close to the concrete fence and putting pressure on this fence with all its weight.

Typically, the surface of the opposite bone is separated by two layers of cartilage and cartilage (additional cartilage panels).In addition to the role of the online buffer between bones, cartilage provides the glance of bones and mechanical correspondence to each other.Cartilage, due to large or small injuries (but often), and also loses their elasticity, can be completely or partly broken.

For age, and especially in the presence of a genetic tendency, cartilage is thinner.That is why the bones of the hips and lower legs, creating knee joints to their heads, are in danger, friction can even arise between them.

Usually in parallel with the thinness of cartilage over the years, another uncomfortable event occurs: the amount of internal liquid decreases.This liquid is not only a pure mechanical lubricant of the joint from the inside.It provides nutrition of bones, cartilage and articular cartilage.Violation of the "supply" of all these structures is a real disaster for joints!

If the physical overload of the joints, then the growth of the bone appears on the surface of the bone and starts to grow, similar to the point or thorn.For knee joints, such overload will be lifting weights (including overweight of your body!), Physical work with an emphasis on the knee (for example, weeding in the garden), walking continuously on the stairs, running, uncomfortable shoes, flat feet and many others.Now it's easy to imagine what is happening inside the knee joint during muscle disease development, and the way it shows its appearance.

How to operate together?

Each of us has seen articular cartilage many times at the end, for example, chicken bones.It includes small areas of contact bone.Under the articular cartilage is the lower epidural bone or subdued.Human skeletal muscle system is arranged in the same way.

Most people's joints include bones, shells (joints) and internal liquid.

What happens to joints to arthritis?

Under the influence of all the loads mentioned, there is a compression and growth of thin bone, as a result of this, increasing the injury of articular cartilage.

Products of cartilage cartridges formed by Microtrauma fall into the epidemic.It is so naturally arranged that they are foreign water for synovial shells and stimulate its inflammation.The formation of the fluid is disturbed, usually a type of conveyor, similar to a continuous enrichment and blood refining cycle.In addition, the joints become less than hyaluronic acid.It is worth talking about this acid.

Hyaluronic acid provides the viscosity of the fluid fluid, creating a buffer effect of the buffer and the lubrication effect on the network between bones, reducing their friction together.Thanks to this substance, the liquid matches consistency like egg protein, not water.Another important role of hyaluronic acid is to ensure the supply of nutrients from the joints deep into the articular cartilage, because there is no place to bring nutrition to it: the blood vessels are not suitable for cartilage.In the same way, substances that have spent from cartilage into joint fluid are removed: using hyaluronic acid molecules.

Therefore, an advanced bone seal occurs and the conditions cannot be tolerated to be created for articular cartilage.

Cartilage receives a signal to adapt to these harsh conditions, and its change begins, in another way, it is called repair.This is mainly manifested by a decrease in the elasticity of cartilage.

In the late stage of the development of muscle disease, the bone becomes rigid, but at the same time fragile, the cartilage itself is partially impregnated with calcium - calcified.

Symptom

The development of arthritis begins with a bit of pain in the knee, appearing after walking the stairs, physical activity, long walking.Such mild pain may appear for several months, or even for many years.After that, they became more pronounced.At the initial development stage of the disease, the knee bone is not deformed, but may observe a bit of swelling of the joint.

In the second stage of the development of the disease, the pain becomes more intense and occurs after a mild load.In addition to pain, a crisis appears in the knee joint, unlike the usual soft abuse of a healthy joint to pain.In addition, the deformation of the joints becomes noticeable, the bones become wider and rude.The knee tape is more than 90 degrees.

In the third stage of the disease, knee pain becomes serious and constant, not even passing even in the remaining time.The ability to move the knee becomes at least, usually it does not bend more than 90 degrees and does not last until the end.The deformation of the joints becomes so strong that the curvature of Valgus (Figure X) or changes (O) of the leg.

Diagnose

Investigate

In the early stages of the disease, the joints do not change, mobile, the muscles around it are preserved and strong enough.Only by touching (pressure) of certain points, more often on the inner surface of the joint, is the local (local) pain that is determined.The doctor asked the patient to perform a number of squats, bend, straighten his feet into the knee, put his face on the bench and expand the bend itself (this is called the passive motion of Islam).In this case, in addition to pain and motion limit, you can determine brittle, click the joints.With a clear inflammatory ingredient, the joint is increased in size, it seems it is pumped up with liquid.With a far -up development process, bending at the knee can be partially absent or completely, when checked, the surface of the joint seems uneven, tuberous, limb can be bent (the shift of the limb, suggestive).

Laboratory and tool research

• The compulsory laboratory survey includesGeneral blood tests, biochemistry and immunity, urine analysis.In general blood tests, attention will be paid: The increase in leukocytes and the red blood cell resolution rate increases, showing inflammation.In the biochemical analysis of blood, metabolic indicators are very important, the level of liver enzymes.In immunity analysis, the presence or absence of signs of systemic inflammation will be determined - this is shown by the degree of reaction protein C. Urine analysis will reveal the content of "sand" - uric acid crystal.
• Analysis of the fluid liquid (joint)It is specified in the case when this liquid is sufficient.That is, when the joint is swollen, swollen.In terms of infertility compliance, the doctor penetrates the joint capsules in a strictly defined place, inserting the needle into the joint cavity, then removing excess liquid.Part of the material obtained into the laboratory for analysis.At the end of the process, anti -inflammatory drugs from glucocorticosteroid groups are often used in the joints (for example, Diprospan).
• X -ray.An image of both knee joints is required, this is necessary to compare the sick knee with a healthy one.In the image, the attention is paid for the width of the general distance (it is evaluated by cartilage and cartilage), the presence or absence of the spearheads, signs of destruction (destruction) of the bone.
• Ultrasound of the knee jointHe will answer questions about the conservation of cartilage, the presence of bakery cysts, the severity of inflammation, the presence or absence of uric acid crystals (with the presence of gout).
• MRI (magnetic resonance images).This research is stipulated if the ultrasound does not give a full answer to an expert's question.MRI is mandatory for patients who are planning to conduct joint endoscopy.
• Endoscopy joints.Allows you to imagine, that is, individuals assess the status of the joint.This method is indispensable for controversial diagnosis, suspected injury damage to cartilage and ligaments (then directly during the study, can quickly remove cartilage or torn ligament).

Knee joint treatment

Comprehensive treatment principles should be followed, including:

1. Detailed perception of patients about the disease

2. The use of physiotherapy exercises, including: specific exercises for joints in the lying position, swimming
3. Maintain optimal body weight
4. Wear a orthosis (soft tape or at least a elastic band) during the process of increasing the load on the joint - on the road, while walking, etc.
5. Non -method (physiotherapy).This type of treatment produces excellent results for the joints of the knee joint (gonarthrosis).Obviously, this is due to the fact that the joint is available for the effects of factors such as magnetic radiation and laser.To treat knee joints, you can use magnetic lines, UHF, exposure to cryo (Greek translation means the effect of cold).Physiotherapy procedures are very common, short -term treatment courses - 10, maximum daily or every day.It should only be memorized about the contraindications possible, including tumor processes, thyroid disease and pelvic organs, as well as systemic (autoimmune) (autoimmune) (autoimmune) (autoimmune) diseases.
6. Drug therapy.

Principle of osteoarthritis treatment:

• Reduce pain
• delay further destruction of general structures
• Recovery of lost joint function.

Steroid anti -inflammatory drugs

To relieve pain, drugs from NSAID Lee Nsaids -Anti -inflammatory infections are not not used.They are used in and in application form (application to the skin).Applications (local therapy) are a very effective method, especially when it comes to the early stages of the disease.Before using gel or cream containing NSAID, it is necessary to make sure there is no change on the skin, whether it is a rash, pustules or cracks.The general principle of local treatment is to use cream or gel selected at least twice a day, and if the discomfort arises - to cancel the completely disappearing of these manifestations.The intramuscular management of painkillers is currently not recommended, because the risk of side effects due to the use of syringe use does not decrease, but the opposite.In the case of pronunciation, the accumulation of a large amount of liquid, glucocorticosteroids are allowed, but it should be noted that this process should be done not exceeding 1 time after 3 months.

Chondroprotector

A higher step of anti -inflammatory steps with osteoarthritis is chondroitin or glucosamine preparations.They, like NSAIDs, fights inflammation at the level of thin joint structure, but has fewer side effects, and most importantly retain their anti -inflammatory effects a few months after canceling.

Chondroprotector is a collective name for a group of drugs containing simultaneously chondroitin sulfate and glucosamine - construction bricks.Although high cost treatment is clear with chondroprotors, their convenience for patients and the effect is difficult to appreciate too much.First, these substances, accepted inside, are perfectly absorbed from the stomach, and the losses of the drug on the way along the way to cartilage are minimal.Second, they can inhibit arthritis, and, in addition, slow down the process of destroying articular cartilage!Most of them are often prescribed courses, because they have a fairly long Ace, lasting a few months, and sometimes even up to six months.

Hyaluronic acid -based drugs are Hyaluronates that are treated like that.These funds are sold in the form of prepared injection tubes for internal governance.Hyaluronets is an artificial translation.The effectiveness of treatment with this method can last up to 12 months.

Surgery to treat knee joints

As with Arthrosis of hip joints, in case of serious change and persistent function, it has come to operation.With Gonarthrosis, two types of interventions are currently being implemented: Arthrodesis (immovable compound) and Endoprosthetic.The first activity is rarely done, according to special indications, when the installation of an endrosthesis is impossible for any reason.The result of this activity is that the knee becomes motionless.But it does not hurt.Endoprosthetic activity is much higher in function.Remember that with a large body weight, this activity is not done - the risk of complications during postoperative period is too large.From the time of removing the damaged parts of the joints and installing prosthetic foot until the function is completely restored, no more than three weeks have passed.

How can it cause ridiculous osteoarthritis?

Over time, osteoarthritis does not turn away, but only worsen, especially while maintaining stimulating factors.Consider the main sources of danger to the health and life of a patient with osteoarthritis.

• Chronic pain has different intensity- A very important risk factor, especially in the elderly.Continuing to experience discomfort can lead to sleep disorders, mood reduction and even depression.It is very difficult to predict a series of adverse events that pull the phenomenon listed.
• Pathology of veins.Continuous inflammation in the knee area, the growth of bone spines cells, can damage the popleal vessels, which can lead to the development or progression of varicose veins of the leg veins.Sometimes, orthopedic doctors refuse to operate their knees until the varicose veins are removed, but the doctor Phlebolog (intravenous expert) does not start surgery in the vein until there are significant changes in the knee joint.
• Reduce spending function.With a distant development process, the joints can completely lose its ability to move, and in most cases, this is a sign of disability.
• participation of other joints.We have found such a seemingly normal phenomenon, like a flat foot, can pull the knee joint and lead to the development of osteoarthritis.In the same way - along the string - there is a participation in the pain of the knee joint from the opposite side.If the patient ignores recommendations, refuses to wear sticks, likes to limp on two people, the joint disease of the hip will soon develop.The legs are twisted, gait becomes a "duck".
• motionless.Serious complications of the disease occur in the case of osteoarthritis greatly destroyed, no cartilage, movement in the joints very painful or impossible because of the union (this is called each other's eye disease).In this situation, only surgery can help patients, but only when it is technically feasible.Overcoming is dangerous in the common sense: it causes obesity, osteoporosis, muscle atrophy, the rapid growth of diseases of internal organs.In addition, a motionless person, of course, constantly needs to take care of himself.
• Inexperienced.Unfortunately, there are a number of states that make it impossible, and one of them is very far away, forgotten osteoarthritis in patients over 80 years of age suffering from serious diseases.

Prevent

• Eliminate joint injury.It seems: nothing easier.For a while, abandoning the dance, running, walking on the stairs, dancing, high heels is not difficult.In fact, it turned out that this point caused the most protests on the patient's side.One person, if he has suffered recently, is often not ready for reality that some important points in his daily life will be missed.But if you do not follow these advice, there is a risk of rapid reduction in quality of life and disabilities.
• Losing weight and maintaining it within optimal limits is an extremely important recommendation!Whether this miraculous effect or that tool, fat people will not appreciate it.Because while the joints are overloaded with overweight, Microtraumas is repeated daily.This can reduce all efforts to not be available.In addition, for some treatments, obesity is a direct contraindication.
• Walk with support.The universal rule for unloading by using support is like this: a stick, crutches or handrails should be in the hands of the affected limb.That is, if the knee must hurt, the stick should be kept on the left, and vice versa.
• Flat foot adjustment.It seems, how can you connect the feet and knee joints of the knee joint?It turned out directly.If the foot is improperly installed (now we are talking about flat or mixed foot, not on the horizontal side), the load is remedied in the knee joint.In this case, the severity of the body with a step does not fall into the center of the joint, but on the right or left side of it.Accordingly, the right or left cartilage suffers more, and because it is more affected, we are worn out faster.Next is the Viking waiting line of articular cartilage where cartilage cannot cope with its function.This process ends with the formation of typical "Arthrose" changes in the knee joint (the appearance of bone development).