Arthrosis of the knee joint is 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 in one way or another. It is the third most common disease after cancer and heart disease. All this suggests that the treatment of osteoarthritis of the knee joint does not yet have methods that would completely help to eliminate the disease.
Principles of treatment
There are several principles on how to treat osteoarthritis of the knee joint, which should be the basis for the treatment of the disease:
- The knee joint damaged by osteoarthritis must be immediately freed from excessive physical activity during therapy. It is not so easy to cure osteoarthritis of the knee joint, but it will prevent complications. If possible, it is generally necessary to limit the movement of the joint and follow the established regimen prescribed by the doctor.
- In parallel with the treatment, do not take too much care of yourself, so that the atrophy of muscle tissue does not begin. It is best to engage in affordable physical therapy. Which doctor treats the joint, he will give the direction to practice the therapy.
- Physiotherapy is a great and effective way to improve basic treatment. Physiotherapy always includes electrotherapy, magnetotherapy, laser therapy 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 drugs are mainly anti-inflammatory and painkilling drugs, intraosseous blocks.
- An indispensable component of the correct rational treatment will be a change in eating habits, the elimination of foods that cause an excess of salt in the body, saturation of the body with calcium, minerals and vitamins.
Drug
Conservative therapy involves the treatment of gonarthrosis of the knee joint:
- non-steroidal anti-inflammatory drugs;
- chondroprotector.
Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs are essential in the treatment of osteoarthritis. This group of drugs allows you to quickly stop inflammation, get rid of swelling, as a result of which painful sensations quickly disappear. The drugs have antipyretic and analgesic effects. That is why they are recommended for the treatment of joint pathologies, including osteoarthritis of the knee joint.
Non-steroidal anti-inflammatory drugs for treating DOA of the knee joint (deforming osteoarthritis) are divided into several groups. Based on their composition, they can be divided into acidic and non-acidic.
When using NSAIDs, it is necessary to remember the risk of side effects, therefore it is strictly forbidden to exceed the dosage.
Due to their high efficiency, non-steroidal anti-inflammatory drugs have been actively used in the treatment of various inflammatory diseases. However, doctors noted that they have a negative effect. The study revealed their negative effects on the kidneys, heart, blood and digestive system. That's why doctors are trying to limit the prescription of NSAIDs, even in the treatment of osteoarthritis.
It is very important that the maximum possible dose is reached during the treatment of the disease, which would help to contain the excruciatingly painful symptoms, but did not bring any negative effects. Especially suffer from non-steroidal anti-inflammatory drugs:
- organs of the gastrointestinal tract;
- blood cells;
- kidneys;
- heart.
On the stomach side, complications such as ulcers, dyspepsia, internal bleeding or even stomach perforation are possible. As for the liver, there is damage to the hepatocytes, the main cells of the liver. Heart disorders are manifested by arterial hypertension and edema. In the kidneys, glomerular filtration decreases and interstitial nephritis can develop. Side effects on the blood manifest themselves in reduced platelet aggregation and an increased risk of bleeding.
Is it possible to completely abandon NSAIDs that adversely affect the body? As it turned out, no, since it is this group that allows you to curb the first and second stages of arthrosis. Therefore, the negative aspects of non-steroidal anti-inflammatory drugs have forced manufacturers to look for new generations of these drugs.
As a result of the research, 2 generations of cyclooxygenase 1 and 2 enzymes were isolated. Recently, cyclooxygenase 3 enzymes, which include oxicams, have been invented. These drugs have much less negative effects, so they are actively used in the treatment of deforming arthrosis.
The latest generation drugs also make it possible to effectively treat osteoarthritis without damaging the body. The only drawback of the new drugs is the rather high price. Therefore, with prolonged use by the attending physician, old drugs with probiotic support for the gastrointestinal tract are prescribed.
Oxycam
Representatives of a new generation of non-steroidal anti-inflammatory drugs are the oxicam group.
The oxicam group is today the most effective and safe for patients with osteoarthritis.
Chondroprotector
Chondroprotectors are a group of drugs that serve 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 formation processes of cartilage components. Also this substance:
- prevents destructive processes in the cartilage tissue;
- improves the production of intra-articular fluid;
- has an anti-inflammatory effect.
Glucosamine is an essential substance for the synthesis of cartilage tissue. It protects the cartilage from free radicals and other factors that damage the integrity of the cartilage tissue. In addition, glucosamine is able to relieve swelling and have an anti-inflammatory effect.
Chondroprotectors are able to restore cartilage tissue, but they must be taken for quite a long time - at least six months. Another big disadvantage of chondroprotectors is that they better protect the cartilage from destructive effects, but they cannot slow down a pathological process that has already begun.
Therefore, this group of drugs is included for treatment only in the first stage of the development of the disease with the active prescription of non-steroidal anti-inflammatory drugs. Today there are three generations of chondroprotectors, the most famous of which are:
- preparations based on animal cartilage;
- the second generation consists of single drugs that contain 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 together with anti-inflammatory drugs.
operation
In some cases, degenerative osteoarthritis of the knee joint is treated exclusively surgically. Usually, the operation is resorted to when the patient develops a grade 3 gonarthrosis. But if a patient in the second stage of the disease has a very pronounced pain syndrome, and it is difficult to remove even with painkillers, and the osteoarthritis is constantly aggravated , then the operation 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 joint tissue is completely removed and the femur and tibia are fused together with the patella. This method of treatment of gonarthrosis is the most radical and is not used so often today, as it leads to a limitation of the patient's mobility.
Another operation to eliminate knee osteoarthritis is arthroscopic debridement. The treatment consists of removing the dead particles. The disadvantage of the operation is significant - it takes a long time to rehabilitate, and the effect of the procedure lasts only from 1 to 2 years. Such an operation can be performed already at the second stage of the development of the disease.
Periarticular osteotomy: This is done as needed to restore joint mobility. During the procedure, the surgeon saws off the parts of the bone that interfere with free movement and sets them at the desired angle.
Thus, the center of gravity in the bone shifts and the load on the cartilage tissue disappears. At the moment, 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 surgery is the endoprosthesis. Surgery for osteoarthritis with the use of endoprostheses has no analogues - it gives a lasting 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 extract from the patient the cartilage tissues affected by the pathological process, 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 completely restore the motor functions of the patient;
- rehabilitation with this operation is minimal;
- the prosthesis lasts about three decades.
The only problem with the surgical treatment of osteoarthritis with the endoprosthesis method is the high cost of materials, since a high-quality prosthesis is quite expensive. Postoperative treatment is completed in the intensive care unit: the patient is given a drain for several days, from which the wound secretion is released.
To relieve pain, the knee is covered with special cooling agents. It is possible to move during the endoprosthesis already on the third day, on the tenth day the patient continues the treatment in the rehabilitation center. After treatment, it is possible to prescribe non-steroidal pain relieving drugs, hormonal agents and be sure to wear a bandage for some time.
Reviews
To evaluate the various methods of therapy, you can read the reviews of patients who have been treated in various ways and those who have treated osteoarthritis of the knee joint:
- Woman, 45: "Osteoarthritis of the knee joint was discovered in me 2 years ago. It hurt to step on my foot, an unusual crunch appeared and I went to the doctor. The second onset was diagnosed. degree of the disease and treatment with non-steroidal drugs and chondroprotectors was recommended. With the help of pain pills, I was able to achieve a stable analgesic effect: I took a group of oxicams. Now I continue to take chondroprotectors, not c 'is still getting worse ".
- Male, 62 years old: "I had osteoarthritis of the knee joint - apparently, the aftermath of sport, in which I was professionally involved in my youth, were affected. Even going on a coaching job did not help. to reduce the load, so I continued to actively engage, as a result of which I was diagnosed with osteoarthritis, which I practically did not treat. I drank only painkillers, hoping that it would pass. As a result, stage 3 of the disease developed and I had to undergo surgery. Of all the techniques, the doctor suggested the prosthesis, which was done on me last year. The operation was successful and I recovered fairly quickly. "
- Woman, 55: "This year I was diagnosed with stage 1 osteoarthritis. Luckily I went to the doctor in time because I felt heaviness in my legs. I thought it was swelling, as I was overweight since childhood, but, how It turned out, it was osteoarthritis. Now I'm taking anti-inflammatory drugs, but the doctor promises I'll be able to recover with the help of chondroprotectors. I hope it doesn't get to the operation. "
Arthrosis of the knee joint is characterized by an insidious course, when in the initial phase the pathology does not give symptoms. However, it is at this time that the treatment is most productive. Therefore, doctors insist on the timely diagnosis of pathology and the prevention of disorders in the cartilage tissue.