Knee osteoarthritis is a complex disease of degenerative nature that affects bone and cartilage Department of the knee. The disease most often affects the knee Department of the lower limbs. Pathological changes in cartilage and periarticular areas, which in most cases develop on the background of injuries, biological aging, disorders of an autoimmune nature, seriously inhibit the locomotor capacity of the legs. The joint becomes logopedija loses stability, normal motor and cushioning. In the end, he gradually deformed, and in the last stages completely out of order.
Degeneration in the joint tissues occur not only in a physical dysfunction of the lower extremities, and a strong pain in them. In severe pathology causing disability, and in some cases paralysis of the legs. In connection with such a disappointing forecast of the disease is important as early as possible to identify, and immediately proceed to its treatment.
Important about the disease
Patients important to investigate the therapeutic tactics read the following material to possess full information regarding the mechanism of origin and clinical manifestations of pathology. Just note that arthrosis and arthritis are closely linked, since the disease is a consequence of arthritic disease. But where there are the unfortunate diseases that ruthlessly destroy the most important bone connection? What is the severity of gonarthrosis and what manifestations it is possible to recognize it?
Causes of osteoarthritis
Degenerative pathogenesis launch the following factors provocateurs:
- once the trauma – fractures of the tibia, dislocated knee, damage to the body of the meniscus, tears and torn ligaments, falling to his knees, all kinds of injuries;
- excessive physical exertion;
- sedentary lifestyle;
- high body mass index;
- systemic pathology of rheumatoid, gouty, psoriatic type, systemic lupus erythematosus;
- genetically inherited weakness of ligament-muscular system, or congenital underdevelopment of the structural elements of joints;
- violations of metabolism and blood flow;
- hormonal failure, diabetes and other endocrine pathologies;
- moved or chronic infectious and inflammatory diseases.
Quite often, people themselves become perpetrators in order to develop articulate intractable disease. Often, getting injured, they ignore the contact, preferring to do the first drug from pain, homemade lotions and the like. A few years later, due to held in the past, inadequate treatment, they come to the doctor already with gonarthrosis, in the best case – moderate. And there is one physical prevention and analgesic ointments, as a very early period, it will not do to act often have radically applying surgical tactics.
The stage of destruction
In orthopedics, the disease is divided into stage from which further pushes the expert when drawing up the regimens. The extent, the nature, the location, the nature of the origin of the destruction of the bone joints in the knee are revealed through a series of diagnostic procedures such as x-rays, MRI, CT, ultrasound, different types of blood and urine of the patient.
Qualitative treatment of the question can not be deployed without information about the state of the knee joint, and the peculiarities of the patient, and without a visit to the doctor and obtain from him adequate therapeutic recommendations. Thus, in order to improve the quality of life, do not ignore a visit to a skilled specialist, only he is able to tell you whether you can do skilled conservative through-or still in your problem will be effective only surgery.
Pathology has several stages of development, according to the classification of Kellgren's only four of them. They all characterize the severity of morphological changes (presence of osteophytes, reducing the volume of the articular cartilage and the degree of thinning, narrowing of the joint space, etc.) and clinical symptoms (limitation of flexion/extension, the rate of supporting ability, the nature and intensity of pain, etc.).
- Osteoarthritis of the first stage is a disease that is in its infancy. External symptoms are mild or absent, congruence, and shape of joint is satisfactory. On x-rays or MRI pictures traced small marginal osteophytes at the edges of the articular surfaces, in podsolennom Department mild subchondral osteosclerosis, small bone cyst. The joint space is usually normal or modified, but not essential.
- When disease of the second degree, in addition to the above indicators, osteosclerotic lesion is more pronounced, clearly visible narrowing of the interarticular gap. The patient begins more and more pain relief at the time of the walk, descending/climbing stairs, long standing, sometimes at night. Develops lameness, movement in the joint purchase of inferiority, especially when bending.
- The third stage is characterized by a sharp progression of irreversible degenerations and deformations. Joint configuration significantly distorted, the distance between the articular surfaces is greatly reduced, bone growths in the form of spikes of increased size. The pain becomes prolonged and pronounced, and disturbs man even in a state of rest, the limp is getting worse. Addicted to supporting devices and assistance.
- The fourth stage of degenerative pathogenesis, when there are bulk osteophyte proliferation, hyaline cartilage is completely destroyed, the joint space disappears or is barely seen, the articulated bone epiphyses forming the joint, the strongest strain. The knee joint is recognized as completely non-viable on the musculoskeletal system of the person becomes incapacitated.
Symptoms and complaints
The severity of clinical manifestations depends not only on the pathological features, but also from the factor of individuality. Anyway, pleasant enough in gonarthrosis, is very hard and on the 2nd, and 3-4 tbsp. Into a common list of symptoms includes:
- pain, mostly mechanical type (dull, aching, sharp, sudden, periodical and permanent);
- the crunch when moving;
- stiffness of the joint;
- limitation of range of motion;
- muscle weakness of the limbs;
- hyperthermia of the skin and swelling in the knee area;
- gait changes, manifested by lameness and mowing of the feet;
- instability or syndrome "drawer";
- "jamming" of the knee, occurs when a sudden blockage of the movements of bone joints.
Important! Conservative treatment of arthrosis of the knee joint will not help if the disease has a complicated course that can already happen in the worst case, the second stage in the development of bone and cartilage degeneration. In contrast to the traditional conservative therapy and alternative methods, all without exception, surgery for severe gonarthrosis 2-3-4 degree – the only way for a long period of life helps to visibly improve the quality of life.
Bezoperatsionnye methods of treatment suitable in the initial phase of deforming arthrosis. The principle of nonsurgical treatment involves:
- systematic execution of physical therapy, was developed by a professional individually;
- the procedures of physical therapy;
- use of painkillers in the form of ointments, tablets, injections, etc.;
- proper nutrition and following a special diet prescribed by a doctor;
- compliance with special regime of daily physical activity;
- a complete rejection of bad habits;
- unquestioning passage of repeated diagnostic control;
- annual visit to a specialized sanatorium-resort medical facilities.
Surgery for osteoarthritis of the knee
Now take a look at surgical ways in which often there is a need, because in the early stage, the pathology is often invisible. Mostly have to deal already with osteoarthritis in full "bloom", which covered a large-scale joint structures and affected periarticular matter.
- Arthroplasty – helping more than 95% of the cases as fully as possible to restore locomotor and basic functions of the knee Department of the lower extremity. A difficult operation, followed by a difficult rehabilitation, but the effect is worth it. After approximately 3 months after installation of the artificial analogue of the native joint is subjected to irreversible pathological changes, returned full range of motion of the legs completely eliminated the pain.
- Introduzione – uncommon procedure for the "short" articulation, because of its aggressive impact on biological structures, however, sometimes it is the place to be, for example, if a person has no opportunity to undergo implantation. Its essence lies in removing the articular surfaces and the stationary articulated connection of the bone with a special locking devices in an advantageous position. Over time, there is a natural fusion of these elements. Artificial ankylosis entirely blocks the mobility of the joint, but allows to achieve a good support ability of the limb and reduce pain.
- Osteotomy of the knee – also used in extreme situations for the same reason as arthrodesis, in particular when it is necessary to delay hip replacement for several years. At the time of the operative session, the specialist performs the artificial fracture, podpilivaya bones and having them at a more correct angle, so that it is advantageous to distribute the load on the cartilage elements.
Exercise irreversible pathogenesis will not fix it, you have to understand it. Ointments and even drugs from the chondroprotectors, not to mention my grandmother's advice to be treated gelatin, too, a special role will not play. High than they can help in a bad situation is to prepare the musculoskeletal system to the operation.
Modern knee implants are able to withstand normal everyday loads, with perfectly functioning for at least 15 years, and often 20-25 years. A person can even with the replaced joint to do some sports.
Treatment 3rd degree
Stage 3 arthritis surgery. Changes in the joint are very pronounced character, in this phase, the disease ultimately reduces the life and health of the patient. Bone and cartilage damage has reached a critical point at which the tissue of the bone connection no functional importance can't imagine. Hyaline cover almost completely destroyed.
- Important the cartilage is not restored by itself, including through non-surgical methods.
- Bare and flattened surface interactive bone ends exert unnatural pressure on each other, RUB against each other constantly, seriously damaging nearby soft tissue and every day is being distorted even more.
- The person feels terrible pain, not to mention lost ability to walk normally. Patients experience daily of flour, and when the dream is not a joy, and a day of pain there is no rest. Relatively tolerant as noted, only a few people.
- Anti-inflammatory analgesic drugs, usually have a mild effect, but often does not "work". In chondroprotectors makes no sense, since the strengthening and nurturing the meager remnants of the cartilage, does not help the situation.
The consequences of arthrosis of 2-3 degrees sometimes try to treat minimally invasive operation (arthroscopy), in which you can remove the marginal osteophytes and also to remove loose bone and cartilage fragments from the joint cavity. Such manipulations, as evidenced by the reviews, several facilitate the patient's condition slightly improves the motor function, but temporarily. Osteoarthritis in the knee joint remains active and in the near future will once again manifest itself.
Pathogenesis of grade 3-4 – this is a very serious problem which is really only a much more complex reconstructive and plastic operating tactics. To date, there is no such procedure, which could be compared with arthroplasty. Knee replacement prosthesis, repeats mechanical features, configuration, shapes and sizes of natural authority will give the opportunity to say goodbye as the ill-fated disease, and disability, where she "awarded".
The disease progresses rapidly and is able to reach moderate-middle phase of up to 4 degrees in a matter of months. Surgery is necessary to pass as soon as possible, while the degenerative processes did not penetrate deeply into bone. Heavily damaged bones can cause difficulties with the production of the prosthesis.
Many, not realizing that the severity of the incident degeneration comparable with conservative and unconventional tactics, trying by all means to circumvent the operation, swallowing a handful of pills, applying ointments on the sore area. Someone speaks to an osteopath, private doctors, practitioners of various alternative methods. Unfortunately, against nature will not go, of healing, after they come, and this fact should humble ourselves. Therefore, flip out the meaningless venture, act wisely.
Your physical viability is entirely dependent on your decisions! You can life continue to suffer from stiffness and pain, vainly testing of "empty" methods of treatment: drugs and unconventional tools that have evidence of effectiveness in your severity of illness. And can undergo surgical treatment and start living a full life, free from past suffering and supporting devices.
To worry about surgery is needed, modern technology has leaped forward, and today abroad brilliantly changing knee joints durable implants. After such implantation, implemented in a good clinic, the risk of complications is minimal (1-2 %), and restoration of function of the mobility occurs in more than 95% of cases. After hip replacement will follow a rehabilitation course of 3-4 months, including:
- physical recovery, through special medical gymnastics;
- medications (antibiotics, antithrombotics, etc.);
- the program of physiotherapy, including myostimulating, anti-inflammatory, analgesic and wound healing treatments;
- massages (in the later stages of rehabilitation).
Good to know! On 1 degree the disease can be stopped and prevented conservatively. If nothing is done and start osteoarthritis of the knee, allowing him to move from 1 to 2 degree, the medication will already be much more problematic, but for a certain category of patients is still appropriate non-surgical approach. The last two stages is always surgery.
Treatment of 2nd degree
When osteoarthritis of moderate severity quality of life is becoming badly tarnished. Sore knee worries stronger, painful syndrome manifests itself more intensively than it was in the beginning of the disease. Especially pronounced pain immediately after morning awakening, during ascent and descent via the stairwell. Often there is a unpleasant feeling of numbness, which appears after a long walk and a long standing in one position. Flexion in the knee region is reduced, the patient is unable to bend the leg, as required by physiology. Man begins to spare his limb, almost trying not to step on her, which causes progressive atrophy of the muscles.
Emphasize that the treatment necessarily implies a qualified holistic approach.
- If the doctor sees no urgent need for surgery, priority is assigned to reducing the burden on the troubled Department. In the presence of excess weight, to ensure good discharge affected by osteoarthritis joint, it is necessary to adjust the body weight with their diet that you recommend your doctor.
- All patients prescribed the use of special orthopedic devices at the time of movement. This, depending on the existing problem can be the knee the clips, elastic underwear, elastic bandage, cane, crutches, Walker.
- Additionally, the orthopedic surgeon will prescribe a unique set of exercises that will strengthen and increase endurance of muscles of the affected limb.
- Also osteoarthritis in temperate secondary manifestation involves the use of drugs, including the substances present in the cartilage tissues of the knee. These include formulations based on chondroitin sulfate, hyaluronic acid injections, medicines with glucosamine. They can't rebuild the cartilage, but it is saturated with nutrients, making it possible to achieve remission of the disease.
- Recommended treatments and physiotherapy treatment, but they are used only after disappear all signs of inflammation. Physical sessions, for example, laser, magnet or ultrasound, should take place within medical facilities. Thanks to physical therapy improves nutrition and metabolism in bone, muscle, cartilage. If you bought vibroacoustic device for home use, first ask the expert about the possibility of its application in your diagnosis and features of operation of the device.
We have considered the basic principles on which is based the official the treatment of arthritis, corresponding to the standards of Orthopaedics. Since many people with osteoarthritis of 2nd St. very interested in alternative methods for his salvation, we offer to meet with the most popular ones. Find out on so much if they are unique, as we present them online.
Stem cells for the treatment of knee
We will talk about mesenchymally of autologous stem cells in patients with gonarthrosis of the knee, taken from the crest of the pelvic or femoral bone. Cell therapy, according to concerned sources, thus achieving almost self-renewal of the entire joint due to the activation of regenerative processes of self-healing in the damaged segment. Thanks to this technology it is theoretically possible to achieve improvement of the legal units of bone and cartilage of the body. In practice, however, there was no "live" x-ray evidence, which confirmed that after introduction of stem cells into the affected area of the joint is healthy.
The positive impact of stem cells on the joints and bones are not proven and doubtful, because this technique in orthopedics is still not recognized. Its scientists are just learning and experimenting. Moreover, there is information regarding unsafe effects on the human body stem cells, which, in the opinion of highly qualified specialists, capable to provoke a cancer. What about those people who paid for the procedure, it was satisfied with the result? Here you can only say one thing: many patients believe for the money, and in eternal life, but the placebo effect only lasts so long, don't forget about it too.
Curative mud sources unique components (magnesium, chromium, iodine, bromine, calcium nitrate, etc.), contribute to reducing painful symptoms and improving blood flow to the sore areas, stimulation of metabolism. The greatest value they represent for people with mild disease or patients who have undergone surgery on the leg. Hold therapy with mud valid and 2 if the doctor believes a natural remedy in combination with the basic medical program will reduce the aggression of pathological phenomena (stop the progression) and improve the overall clinical picture. Mud therapy is practised in special medical institutions of health resort type. Natural healing mud on the basis of peloids are used in the form of applications and in combination with the method of galvanization (electrophoresis).
The use of gelatin
Natural gelatin is a safe way to support joint structure in good condition. Gelatinous substrate, diluted in water, it is recommended to use inside. According to some doctors, the gelatin it's faster and more productive will affect the bone, cartilage and muscular-ligamentous elements. Experts emphasize that this method has no medicinal properties, it only helps prevent osteoarthritis. Therefore, when held to the pathogenesis relationalities in the absence of pathology or in the early stages should be considered as a measure of prevention of occurrence or progression of degenerative changes. When the disease is moderate and severe in nature, the approach and prophylactically will not work.
Ayurveda for joints
Modern alternative medicine is known by many extraordinary developments, among which the treatment according to Ayurveda different parts of the musculoskeletal system. According to this informal flow, the affected joints associated with the surplus of toxins accumulated in the body due to the energy of disharmony. The damaging mechanism of disturbed energy balance (Wool) primary is the weakening of Agni, or digestive fire, leading to accumulation in the intestine undigested food residue (AMA). They produce toxins that the blood transportorul to the joint, where harmful substances are deposited and inhibit metabolism.
According to Ayurveda osteoarthritis klassificeret into several types, and for each invented their own system of treatment, the basis of each of them are diet, herbal medicine, intake of Ayurvedic pills and powders, yoga and breathing exercises, non-traditional massage, auto-trainings on healing, etc. of Course, all this sounds great, but if the arthritis cannot be reversed, even by the scientific of high technology, is it possible to believe that herbal powders, treatment thoughts and tactics of other Ayurveda cure irreversible deformation?!
Salt is used for preparation of saturated salt solution used for impregnation of compresses applied to the sore spot for a few hours. This therapy should not be considered as independent means, and especially as a cure of osteoarthritis. Salt can temporarily soothe pain, get rid of the swelling of the soft tissue covering the bone structure, without any damage to biological structures. But it will not cure the disease and not put on the feet of the patient. Its action is purely symptomatic. A solution is prepared from the calculation: per 1 liter room temperature of water taken 100 g of salt.
Worth to see! Sometimes salt is used in dry-heated form, which is placed in a pouch, and carry out local heating of the knee. Sometimes as wet, but the hot dressings. Hot treatments are dangerous when purulent-inflammatory processes in the joint cavity, they will ultimately only exacerbate the clinical picture. Therefore, do not use such recipes without being sure that the defeat is not accompanied by a similar process.