Osteoarthritis of the knee joint is a degenerative damage to the cartilage of the knee joint, resulting in its destruction. Osteoarthritis is the most common pathology, and according to doctors, about 80% of people suffer from this pathology to one degree 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 a method that would completely help eliminate the disease.
Principles of treatment
There are several principles on how to treat osteoarthritis of the knee, which should be the basis for treating the disease:
- A knee joint damaged by arthrosis must be immediately relieved of excessive physical activity during therapy. It is not so easy to cure osteoarthritis of the knee joint, but it will enable the prevention of complications. If possible, it is generally necessary to limit the movement of the joint and adhere to the prescribed regimen prescribed by the doctor.
- In parallel with the treatment, do not take too much care of yourself, so as not to start atrophy of the muscle tissue. It is best to engage in affordable physical therapy. Which doctor treats the joint, he will give direction to exercise therapy.
- Physiotherapy is a great and effective way to improve your basic treatment. Physiotherapy always includes electro-, magnetic, laser therapy and shock wave therapy.
- The sanatorium-resort will also be useful for patients - with osteoarthritis, it is necessary to visit specialized resorts at least once a year.
- Necessary treatment is filling the joint with oxygen. For this, so-called oxygen therapy is performed.
- Drugs are primarily anti-inflammatory drugs and painkillers, intraosseous blockade.
- An indispensable component of proper rational treatment will be a change in eating habits, elimination of foods that cause excess salt in the body, saturation of the body with calcium, minerals and vitamins.
Medications
Conservative therapy includes treatment of gonarthrosis of the knee joint:
- nonsteroidal anti-inflammatory drugs;
- chondroprotectors.
Nonsteroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs are essential in the treatment of osteoarthritis. This group of drugs allows you to quickly stop the inflammation, remove the swelling, which is why the painful sensations quickly disappear. The drugs have antipyretic and analgesic effects. They are therefore recommended for the treatment of joint pathologies, including osteoarthritis of the knee joint.
Nonsteroidal anti-inflammatory drugs for the treatment of DOA of the knee joint (deforming osteoarthritis) are divided into several groups. According to their composition, they can be divided into acidic and non-acidic.
When using NSAIDs, you must remember the risk of side effects, so it is strictly forbidden to exceed the dose.
Due to their high efficacy, nonsteroidal anti-inflammatory drugs have been actively used in the treatment of various inflammatory diseases. However, doctors have noticed that they have a negative effect. The study revealed their negative effect on the kidneys, heart, blood and digestive tract. Therefore, doctors are trying to limit the prescribing of NSAIDs, including the treatment of osteoarthritis.
It is very important to achieve the maximum possible dose during the treatment of the disease, which would help to control the terribly painful symptoms, but did not bring any negative effects. Most of all suffer from nonsteroidal anti-inflammatory drugs:
- gastrointestinal tract organs;
- blood cells;
- kidneys;
- heart.
On the part of the stomach, complications such as ulcers, dyspepsia, internal bleeding, and even perforation of the stomach are possible. As for the liver, there is damage to hepatocytes - the main cells of the liver. Cardiac disorders are manifested by arterial hypertension and edema. Glomerular filtration decreases in the kidneys and interstitial nephritis may develop. Side effects on the blood are manifested in impaired platelet aggregation and an increased risk of bleeding.
Is it possible to completely abandon NSAIDs that negatively affect the body? As it turned out, no, because this group enables the restraint of the first and second phase of arthrosis. Therefore, the negative aspects of nonsteroidal anti-inflammatory drugs have forced manufacturers to look for new generations of these drugs.
As a result of research, 2 generations of cyclooxygenase enzymes 1 and 2 have been isolated. Cyclooxygenase 3 enzymes have recently been invented, which include oxicams. These drugs have much fewer negative effects, so they are actively used in the treatment of deforming arthrosis.
The latest generation drugs also enable effective treatment of arthrosis without damaging the body. The only drawback of the new drugs is the rather high price. Therefore, with prolonged use by physicians, old drugs are prescribed with probiotic support for the gastrointestinal tract.
Oxycams
Representatives of the new generation of nonsteroidal anti-inflammatory drugs are a group of oxicams.
Today, the group of oxicams is the most efficient and safest for patients with arthrosis.
Chondroprotectors
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 process of formation of cartilage components. Also this substance:
- prevents destructive processes in cartilage tissue;
- improves intraarticular fluid production;
- has anti-inflammatory action.
Glucosamine is an essential substance for the synthesis of cartilage tissue. It protects cartilage from free radicals and other factors that damage the integrity of cartilage tissue. Also, glucosamine is able to alleviate swelling and has an anti-inflammatory effect.
Chondroprotectors are able to regenerate cartilage tissue, but they must be taken for quite a long time - at least six months. Another major disadvantage of chondroprotectors is that they protect the cartilage more from destructive action, but they cannot slow down but start the pathological process.
Therefore, this group of drugs is included in the treatment only in the first stage of disease development with active prescribing of nonsteroidal anti-inflammatory drugs. Today there are three generations of chondroprotectors, the most famous of which are:
- Animal cartilage preparations;
- the second generation are monolithic drugs containing either purified hyaluronic acid, or chondroitin or glucosamine;
- the third generation is a combination of drugs that include glucosamine and chondroitin sulfate.
Today, it is possible to use chondroprotectors along with anti-inflammatory drugs.
Operation
In some cases, degenerative osteoarthritis of the knee joint is treated exclusively surgically. Surgery is usually resorted to when a patient develops grade 3 gonarthrosis. But if the patient in the second stage of the disease has a very pronounced pain syndrome and it is difficult to remove it even with painkillers, and the arthrosis is constantly getting worse, then surgery is indicated at this stage of the disease.
There are several methods of surgery 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 merge with the patella. This method of treating gonarthrosis is the most radical and is not used as often today, because it leads to limited mobility of the patient.
Another operation to remove knee osteoarthritis is arthroscopic debridement. The treatment consists of removing dead particles. The disadvantage of the operation is significant - it takes a long time for rehabilitation, and the effect of the procedure lasts only from 1 to 2 years. Such an operation can be reported in the second phase of the disease.
Periarticular osteotomy - this operation is performed if it is necessary to restore joint mobility. During the procedure, the surgeon cuts off the parts of the bone that interfere with free movement and places them at the desired angle.
Thus, the center of gravity in the bone shifts, and the load on the cartilage tissue disappears. Currently, this type of joint surgery is practically not used because it is quite complex and requires a long rehabilitation process. The positive effect of the treatment is also temporary.
The most successful intervention is endoprosthetics. Arthrosis surgery with endoprosthetics has no analogues - it gives a long-lasting effect, and patients forget about knee problems for years.
Knee arthroplasty is the most advanced technique. Modern methods of treatment enable the extraction of cartilaginous tissues affected by the pathological process, as well as bone particles. Instead, a more functional and reliable prosthesis is placed. The advantages of such an operation are the following:
- it is possible to completely restore the patient's motor functions;
- rehabilitation by such surgery is minimal;
- the prosthesis lasts for about three decades.
The only problem with surgical treatment of osteoarthritis by endoprosthesis is the high cost of the material, because a high-quality prosthesis is quite expensive. Postoperative treatment ends in the intensive care unit - the patient is given several days of drainage from which the secretion from the wound is released.
To relieve pain, the knee is covered with special coolants. On the third day, it is possible to move during endoprosthetics, and on the tenth day, the patient continues the treatment in the rehabilitation center. After the treatment, it is possible to prescribe non-steroidal painkillers, hormonal agents and be sure to wear a bandage for a while.
Reviews
To evaluate different methods of therapy, you can read reviews of patients who have been treated in different ways and those who have been treated for osteoarthritis of the knee:
- Woman, 45 years old: "I was diagnosed with osteoarthritis of the knee joint 2 years ago. I was hurt because I stepped on my leg, there was an unusual squeak and I went to the doctor. I was diagnosed with second degree disease and treatment with non-steroidal drugs and chondroprotectors was recommended. against the pain I managed to achieve a stable analgesic effect - I took a group of oxaxes. Now I continue to take chondroprotectors, there is no worsening yet. "
- A 62-year-old man: "I had osteoarthritis of the knee joint - obviously affected by the consequences of sports, which I did professionally in my youth. Even going to work as a coach did not help to reduce the load, so I continued to be active, which is why I was diagnosed with osteoarthritis, which I practically did not treat. I only took painkillers, hoping it would pass. As a result, I developed stage 3 disease and had to have surgery. Of all the techniques, the doctor suggested prosthetics that were done for me last year. The surgery was successful and I recovered fairly quickly. "
- Woman, 55 years old: "This year I was diagnosed with stage 1 osteoarthritis. Luckily, I went to the doctor on time because I felt heaviness in my legs. I thought it was swelling, since I was overweight since childhood, but, as it turned out"It was osteoarthritis. I'm taking anti-inflammatory drugs now, but the doctor promises that I will be able to recover with the help of a chondroprotector. I hope there will be no surgery. "
Osteoarthritis of the knee joint is characterized by an insidious course, when in the initial stage the pathology does not give symptoms. However, it is at this point that the treatment is most productive. Therefore, doctors insist on timely diagnosis of pathology and prevention of disorders in cartilage tissue.