Knee osteoarthritis is a complex disease of degenerative nature that affects the bone and cartilaginous part 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 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, as the disease is a consequence of arthritic disease. But where the connection is ill-fated disease that ruthlessly destroy the most important bone Union unity? 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 sorts of bumps;
- excessive exercise;
- sedentary lifestyle;
- high body mass index;
- systemic pathology for rheumatoid, gouty, psoriatic type, systemic lupus erythematosus;
- genetically inherited weakness of the ties binding the musculoskeletal system or congenital underdevelopment of the structural elements of joints;
- violations of metabolism and blood circulation;
- 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 referral to a specialist, preferring to do the first drug from pain, homemade lotions and the like. A few years spent in past inadequate treatment, they come to the doctor already with gonarthrosis, in the best case – moderate. And ironed). already one physical prevention and analgesic ointments, as a very early flow, will not do, often have to act radically, using surgical approach.
The stage of destruction
In orthopedics these diseases are divided into stages, 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 connections of the unity of the knee 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 both on the state of the knee joint, and the peculiarities of the patient, and without a visit to the doctor and getting the proper therapeutic recommendations. Thus, in order to improve the quality of life, do not ignore a visit to a skilled specialist, only he can tell you whether you can do skilled using conservative Chi still if 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, podsolennom Department mild subchondral osteosclerosis, small bone cyst. The joint space is usually normal or modified, but not essential.
- Disease another degree, in addition to the above indicators, osteosclerotic fireplace is more pronounced, clearly shows the 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 non-negotiable 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 continuous and severe white and disturbs a person even at rest, the lameness increases. The connection is dependent on the support of devices and assistance.
- The fourth stage of degenerative pathogenesis, when there are enterprises split 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.
The 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, transported very hard, and on the 2nd, and 3-4 tbsp. Into a common list of symptoms includes:
- pain, mostly mechanical type (dull, aching, sharp, unexpected, periodic and permanent);
- the crunch when moving;
- stiffness of the joint;
- limitation of range of motion;
- m Yazov 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";
- the "jamming" of the knee, occurs when a sudden blockage of the movements of bone joints of unity.
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, on a different 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.
Conservative treatment
Bezoperatsionnye methods of treatment suitable in the initial phase of deforming arthrosis. The principle of non-surgical treatment includes:
- 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;
- implicit re-transmission of the 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 often remains unnoticed. Basically you have to have to deal with osteoarthritis in full bloom", which covered a large-scale joint structures and periarticular touched 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 "closure" joint, because of its aggressive impact on biological structures, however, sometimes it is the place to be, for example, if a person is not able to undergo implantation. Its essence lies in removing the articular surfaces and the fixed connection the connection of bones articulated together by special locking devices in an advantageous position. Over time, there is a natural fusion of these elements. Artificial ankylosis completely 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 to advantageously distribute the load on the cartilage elements.
Exercise irreversible pathogenesis will not fix it, you have to understand it. Ointments, and even medications from the series of 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 running state Affairs, as it is to prepare bone-m atovi apparatus 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 joints are very pronounced character, in this phase of the disease ultimately reduces the level of life and disability of the patient. Bone and cartilage damage has reached a critical point at which the tissue of the bone connections of the unity of no functional importance can't imagine. Hyaline cover almost completely destroyed.
- Important the cartilage is not restored by itself, including through non-surgical means.
- Nude and exposed surfaces of the interacting bone ends give an unnatural pressure on each other constantly RUB against each other, seriously injuring the surrounding soft tissue which every day is being distorted even more.
- The person experiences terrible pain, not to mention the lost ability to walk normally. Patients experience daily torment, 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 poor remains 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 detached osteochondral 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 again to prove himself.
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 to the ill-fated disease, and disability, where she "awarded".
The disease progresses rapidly and can reach moderately high phase of up to 4 degrees in a matter of months. Surgery should take place as early 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, healing, after they come, and this fact should humble ourselves. Therefore, the swing carrying on, proceed with caution.
Your physical ability is entirely dependent on your decision! You can life continue to suffer from stiffness and pain, vainly testing "empty" can of treatment: medications and non-standard vehicles that do not 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 one step far 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 the rehabilitation course of 3-4 months, provides:
- physical rehabilitation by means of special therapeutic exercises;
- medications (antibiotics, antithrombotics, and the like);
- therapy program that includes 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 you do nothing and run the 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 spoiled. Sore knee are concerned about more pain syndrome appears more frequently and more intensively than in the beginning of the disease. Especially pronounced pain immediately after morning awakening, during ascent and descent via the stairwell. There is often discomfort numbness which connection is 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 treatment necessarily involves a qualified holistic approach.
- If the doctor sees no urgent need for surgery in the first place is assigned to the reduction of the load on the problem unit. In the presence of excess weight, to ensure good discharge affected by osteoarthritis the fifth tent, is necessary to adjust the body weight with their diet which will recommend a 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 bow yazki, canes, crutches, walkers.
- 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, which includes substances that are 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 are physical, 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, m of asovih, cartilaginous tissues. If you bought vibroacoustic device for home use, first consult with a specialist 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. So how many people with osteoarthritis of 2nd St. very interested in alternative methods for his salvation, we suggest to familiarize with the most popular ones. And the connection ASMO, so they are unique, as it is presented to them online.
Stem cells for the treatment of knee
We will focus on mesenchymally autologous transplantation of stem cells of a patient with osteoarthritis of the knees, taken from the crest of the pelvic or femoral bone. Cell therapy, according to concerned sources, will allow to achieve not only self-healing of the 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. However, in practice, yet there is no "live" x-ray evidence, which confirmed that after the 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 the dangerous 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 is valid not for long, forget about it.
Mud treatment
Curative mud sources unique components (magnesium, chromium, iodine, bromine, calcium nitrate, etc.), help reduce painful symptoms, strengthen the blood flow to the sore areas, stimulation of metabolism. The greatest value they represent for people with mild disease or patients who already underwent an operation on his leg. Hold therapy with mud valid and 2 degrees, if the doctor believes that natural means 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 product that allows you to maintain joint structures in good condition. Gelatinous substrate, diluted in the 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 soft Azovo ligamentous elements. Experts emphasize that this method has no medicinal properties, it only contributes to the prevention of osteoarthritis. Therefore, if you already had the pathogenesis of 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 to wear medium and heavy nature of this approach and as a preventive measure is not useful.
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. In this regard, the informal flow of joint disease connection associated with the excess of toxins accumulated in the body due to the energy of disharmony. The damaging mechanism of disturbed energy balance (Wool) in the first place 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 Pierre's tent, 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 osteoarthritis may not be returned even with the help of high scientific technology, is it possible to believe that herbal herbal powders, treatment of views and other tactics Ayurveda cure irreversible deformation?!
Saline compresses
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 edema which soft tissues that cover the bone structure, without damage to biological structures. But it is not to cure the disease and not to cure 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, hot ale coupling connection. Hot treatments are dangerous when purulent-inflammatory processes in the joint cavity, they are only extremely complicate the clinical picture. Therefore, do not use such recipes without being sure that the defeat is not accompanied by a similar process.