Arthrosis of the knee joint is a degenerative damage to the cartilage of the knee joint, as a result of which it is destroyed. Arthrosis is the most common pathology, and, according to doctors, about 80% of people suffer from this particular 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 arthrosis of the knee joint does not yet have methods that would completely help eliminate the disease.
Treatment principles
There are several principles on how to treat arthrosis of the knee joint, which should be the basis for treating the disease:
- The knee joint damaged by arthrosis should be immediately relieved of excessive physical activity during therapy. It is not so easy to cure arthrosis of the knee joint, but it will make it possible to 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 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 exercise therapy.
- Physiotherapy is a great and effective way to improve your baseline treatment. Physiotherapy always includes electro-, magnetic, laser therapy and shock-wave therapy.
- Sanatorium-resort treatment will also be useful for patients - with arthrosis, it is necessary to visit specialized resorts at least once a year.
- An essential treatment is to fill the joint with oxygen. For this, the so-called oxygen therapy is carried out.
- Medication is primarily anti-inflammatory drugs and pain relievers, intraosseous blockages.
- An indispensable component of correct rational treatment will be a change in dietary habits, the elimination of foods that provoke an excess of salt in the body, saturation of the body with calcium, minerals and vitamins.
Medication
Conservative therapy involves the treatment of gonarthrosis of the knee joint:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors.
Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs are basic in the treatment of arthrosis. This group of drugs allows you to quickly stop inflammation, eliminate puffiness, due to which painful sensations quickly go away. The drugs have antipyretic and analgesic effects. That is why they are recommended for the treatment of articular pathologies, including osteoarthritis of the knee joint.
Non-steroidal 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 need to remember about 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 become 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 tract. That is why doctors try to limit the prescription of NSAIDs, including in the treatment of arthrosis.
It is very important that during the treatment of the disease the maximum possible dose is reached, which would help to contain the excruciatingly painful symptoms, but did not bring negative effects. Most of all suffer from non-steroidal anti-inflammatory drugs:
- organs of the gastrointestinal tract;
- blood cells;
- kidneys;
- heart.
From the side of the stomach, complications such as ulcers, dyspepsia, internal bleeding, or 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. In the kidneys, glomerular filtration decreases 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, since it is this group that makes it possible to restrain the first and second stages of arthrosis. Therefore, the negative aspects of non-steroidal anti-inflammatory drugs forced manufacturers to look for new generations of these drugs.
As a result of research, 2 generations of cyclooxygenase enzymes 1 and 2 were isolated. Recently, cyclooxygenase 3 enzymes have been invented, which include oxicams. These drugs have much less negative effects, therefore they are actively used in the treatment of deforming arthrosis.
The latest generation drugs can also effectively treat arthrosis without harming the body. The only drawback of the new drugs is the rather high price. Therefore, with prolonged use by the attending physician, old drugs are prescribed with probiotic support for the gastrointestinal tract.
Oxycams
Representatives of a new generation of non-steroidal anti-inflammatory drugs are the oxicam group.
The oxicam group is the most effective and safe for patients with arthrosis today.
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 processes of formation of cartilaginous components. Also this substance:
- prevents destructive processes in 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 cartilage from free radicals and other factors that damage the integrity of the cartilage tissue. Also, glucosamine is able to relieve puffiness and have an anti-inflammatory effect.
Chondroprotectors are capable of restoring cartilaginous tissue, but they must be taken for a rather long time - at least six months. Another big drawback of chondroprotectors is that they more protect cartilage from destructive effects, but cannot slow down the pathological process that has already begun.
Therefore, this group of drugs is included for treatment only at 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 from animal cartilage;
- the second generation is mono-drugs that contain either 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 arthrosis of the knee joint is treated exclusively by surgery. Usually, the operation is resorted to when the patient develops 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 arthrosis 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 treating gonarthrosis is the most radical and is not used so often today, since it leads to a restriction of the patient's mobility.
Another operation to eliminate knee arthrosis is arthroscopic debridement. 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 carried out already at the second stage of the development of the disease.
Periarticular osteotomy - this operation is performed if necessary to restore joint mobility. During the intervention, 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, since 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. Surgery for arthrosis using endoprosthetics has no analogues - it gives a long 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 patient's motor functions;
- rehabilitation with such an operation is minimal;
- the prosthesis lasts about three decades.
The only problem with the surgical treatment of arthrosis by the method of endoprosthetics is the high cost of materials, since a high-quality prosthesis is quite expensive. Postoperative treatment ends in the intensive care unit - the patient is given a drainage 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 endoprosthetics already on the third day, on the tenth day the patient continues treatment in the rehabilitation center. After treatment, it is possible to prescribe non-steroidal drugs to relieve pain, 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 cured arthrosis of the knee joint:
- Woman, 45 years old: "I was diagnosed with arthrosis of the knee joint 2 years ago. It hurt me to step on my foot, an unusual crunch appeared, and I went to the doctor. The onset of the second degree of the disease was diagnosed and treatment with non-steroidal drugs and chondroprotectors was advised. With the help of pain pills, I managed to achieve a stable analgesic effect - I took a group of oxicams. Now I continue to take chondroprotectors, there is no deterioration yet ".
- Male, 62 years old: "I had arthrosis of the knee joint - apparently, the consequences of sports, which I was professionally involved in in my youth, affected. Even leaving for 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 arthrosis, 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. Among all the techniques, the doctor suggested prosthetics, which was carried out to me last year. The operation was successful and I recovered pretty quickly. "
- Woman, 55 years old: "This year I was diagnosed with stage 1 arthrosis. Fortunately, 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 arthrosis. Now I am taking anti-inflammatory drugs, but the doctor promises that I will be able to recover with the help of chondroprotectors. I hope it won't come to the operation. "
Arthrosis of the knee joint is characterized by an insidious course, when at the initial stage the pathology does not give symptoms. Nevertheless, 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.