Osteoarthritis of the knee joint — the progressive degenerative-dystrophic pathology. First of all, it is striking, cartilage tissue, and then in the destructive process involved the bony structures.
Reasons for the development of osteoarthritis disease are increased physical activity, low physical activity, metabolic and endocrine. Leading clinical symptoms, pathology, pain, worse when walking, loss of function of the knee joint and its deformation. During the progression of the disease, an ankylosis (fully developed or partial immobilization of the articulation). In the case of the placement of the diagnostic orthopedist focuses on the results of instrumental studies — arthroscopy, x-ray, CT, MRI. In the treatment of osteoarthritis severity 1 and 2 pharmacological drugs, movement therapy, performed, and physiotherapy massage can be used. With the ineffectiveness of conservative therapy, or the revealing of the pathology of the final stage of the patient prepare for the arthroplasty of the knee joint.
The characteristic features of the disease
Osteoarthritis of the knee (gonarthrosis) is one of the most diagnosed diseases of the temporomandibular joint. Under the action of external or internal negative factors in the cartilage tissue to a nutrient deficiency arises. As a result of impaired trophic, slows down the Regeneration of the connective tissue structures. Is damage, premature aging of the cartilage. He is thin, cracks, becomes rough, loses its strength and elasticity. Cartilage can no longer tissue, the basic purpose of reducing the friction in the joints of the bone to use. Subchondral bone to use to take off, compressed, in which they occur, osteosclerotic changes. For the stabilization of the knee joint when walking grow, the edges of flattened bony plates, with the formation of osteophytes (bony growths).
Osteophytes in the knee joint.
Primary osteoarthritis of the homeopath creates table on the initially healthy hyaline articular cartilage cartilage as a result of a congenital reduction in their functional endurance. Secondary pathology occurs when existing defects in cartilaginous tissue. They can be triggered by previous injuries in the knee joints, inflammation, aseptic necrosis, changes in the hormonal levels, metabolic disturbances.
| Clinical-radiological stages of arthrosis of the knee joint | Specific Symptoms |
| The first | The mobility of the knee joint is reduced slightly, the contours sustawnoj are the columns, indistinct, a little narrow. At the edges of the bony plates, the formation of small amounts of osteophytes observed |
| The second | To listen in flexion or extension of the knee, the crunch, crack, crackle. Muscle Atrophy. moderately, significantly articular surface of the slot is reduced, a considerable number of osteophytes formed in the bone tissue detectable subchondral osteosclerosis |
| The Third | The knee joint is deformed, drastically limited his mobility. There is a full or partial merger of the sustawnoj the columns, large number of bone use growths, subchondral cysts, pathological image, the free space of the articulation to move always in the hollow |
The causes and triggering factors
The impetus for the development of the destructive and degenerative process in hyaline articular cartilage to generate cartilage is usually of several negative factors. The reason for the development of osteoarthritis of the knee in childhood and adolescence, disorders of the formation of ligamentous tendon of the apparatus, the dysplasia of the. This, in turn, is due to hereditary predisposition. Provoke the destruction of the cartilage can various injuries — broken bones, severe bruises, strains, partial or complete rupture of the ligaments, muscles, tendons, meniscus. Excessive load on the joint can provoke the development of the pathology. Post-traumatic osteoarthritis develops over several (3 to 5) years after the damage to the connective tissue or of the bony structures. Pathology can occur after the surgery. Although the cause was not the incompetence of the doctors, but a significant damage to the cartilage and delayed Regeneration. To the emergence of the disease, the following factors also predispose to:
- obesity, in almost all structures of the musculoskeletal system, but especially the king's meadow, are excessive burdens;
- excessive physical activity often leads to micro training cartilaginous tissue and further progression of the destructive processes proceed;
- Lack of exercise, in which the blood supply to the legs is deteriorating and there is a nutrient deficiency in hyaline cartilage;
- systemic inflammatory and degenerative-degenerative diseases — rheumatic, psoriatic Arthritis, gout, osteoporosis, Lupus erythematosus.
The Disease
In most cases, arthrosis of the knee joint pain manifested at the end, dull pain after a physical load. The cause of its formation irritation osteophytes side by side on the soft tissue, venous stasis, intra-articular hypertension, muscle spasms will. For osteoarthritis characteristic of home" pain, appeared due to the swelling of the joints, or reactive Synovitis is ". When a person for a long time in a sitting Position and then stands up to feel the first steps of some of the pain. There are also so-called "siege caused" pain periodic character. Knee joints while walking "wedged" as a result of the entrapment of parts of the damaged cartilage tissue between the two surfaces of articulation. Also for the arthritis characteristic of the following symptoms:
- Crackling or crunching during flexion or extension of the knee, which in the case of a displacement of the bony structures to each other on the background of the Antoniushof of the cartilage;
- Stiffness, which increases in severity as you go through the adhesions of the articular surface of the slot;
- Muscle spasms, reduce you in the area of the knee, usually appear around the pain;
- Deformation of the joints, the benefit resulting destructive changes in the subchondral bone.
In osteoarthritis, the man is difficult to get with stairs and long walks because of the constant pain of the knee. The pathology is very often complicated by synovitis — inflammation of the synovial membranes. Clinically, they manifest the formation of circular elastic gaskets, redness, severe swelling, fever up to 37,1 to 38 °C. If no medical Intervention osteoarthritis complicated kind of spontaneous hemarthrosis (bleeding, loss of mobility, osteonecrosis of the femoral condyle in the cavity of the knee joint), in full or in part, with an outer Subluxation of the Patella.
Diagnosis
The clinical picture of osteoarthritis, mainly due to Synovitis, is quite similar to the symptoms of many inflammatory pathologies of the musculoskeletal system. Therefore, the differential diagnosis is carried out to the exclusion of Arthritis, tendinitis, tenosynovitis. With the help of instrumental studies joint and the extent of the functional activity determines the state of the king's meadow. In the diagnosis of osteoarthritis informative the x-ray. On the obtained images clearly visible by the developments osteophytes, constricted sustavnaya the gap, Deformation of the bony structures (cysts, subchondral osteosclerosis). Symmetrical joint space narrowing of the knee joints, osteoarthritis is affected. Probable Operation under both limbs need to pull. In Detail, the changes in hyaline articular cartilage rate created to allow cartilage, ultrasound, MRI, CT. Studies are also longing for the detection of inflammatory or degenerative lesions of the soft parts, muscles, ligaments, and. If necessary, arthroscopy is a minimally is invasive surgical Manipulation. In the implementation of the diagnostic method, the inner surface of the articulation, the fence biomaterials, synovium, synovial fluid, cartilage tissue. In the case of Synovitis, with the help of the puncture pathological exudate is extracted both for the improvement of the well-being of the patient and for the study of its composition.
The tactics of treatment
Osteoarthritis of the knee 1 severity pretty well on the therapy with the help of physiotherapy and long-term use chondroprotectors. In General, the use of painkillers does not require, as the symptoms of the absence of pronounced light or. In the case of osteoarthritis of the knee 2 degrees, a conservative treatment. But if the disease progresses or the destruction of a significant number of the cartilaginous tissue, the surgical Operation, in General, arthroplasty. In some cases, patients arthrodesis — artificial analogously to ankylosis, or complete immobilization of the knee shows.
Non-drug therapy
Patients osteoarthritis 2 or 3 degrees from the first days of treatment is recommended, the wearing of rigid or semi-rigid orthoses, which significantly restrict the mobility of the knee joint. In the case of small damage to the cartilage sufficiently soft elastic bandages — knee-pads. Fix the articulation, warn that the further destruction of tissue. Patients do not need to lift weights to motor skills, avoid long walk. Physical therapy (5-10 sessions) appointed for the improvement of blood circulation in the king's meadow, Stimulation and Regeneration of the connective tissue structures:
- Magnetic field therapy;
- Laser therapy;
- High-Frequency Electrotherapy;
- Electrophoresis with anesthetics and cartilage protectors;
- Applications with ozokerite and (or) Paraffin.
Strengthening the muscle and ligaments, and improvement of the motor function of the knee, regular physical therapy will help. Doctor physiotherapy exercises are selected individually for each patient, taking into account the degrees of osteoarthritis and physical preparation. The first Trainings are under his control. In the case of osteoarthritis is prohibited strictly any Intensive movement. They improve blood circulation, but at the same time even more mikrotemperaturnye cartilage provoke. Movements should be smooth, measured with a small Amplitude. In an early stage of osteoarthritis of the knee resulting destructive changes of the cartilage can be resolved only with the help of physiotherapy. Well leech therapy, treatment or medical leeches proved. If no values are set on the joint of 3-4 leeches, usually in the area of the kneecap. Annelid worms to bite the skin and inject saliva into the blood with a huge amount of biologically active substances.
Pharmacological Preparations
For the elimination of severe pain in the king's meadow pharmacological Blockade performed with glucocorticosteroids it. Hormonal agents generally combined with anesthetics. Intra-articular injections for osteoarthritis only. in case of acute need, such as for corticosteroids, typical of the pronounced side effects and symptoms The most commonly in the treatment of osteoarthritis non-steroidal anti-inflammatory drugs in various dosage forms:
- Solutions for injection;
- Tablets;
- Ointments and gels.
In the therapeutic scheme necessarily chondroprotectors are involved in the Form of injections or tablets. These agents stimulate the Regeneration of worn cartilage, anti-inflammatory, analgesic and Anti-edematous action. No pain in the king's meadow, a Signal for an immediate treatment to an orthopedic surgeon should. To avoid in time, carried out the treatment of osteoarthritis of the development of severe complications, in some cases, the disability of the patient warns.