Osteoarthritis of the knee joint is a degenerative lesion of the cartilage of the knee joint, as a result of which it is destroyed. Osteoarthritis is the most common condition and, according to doctors, about 80% of people suffer from this condition 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 methods that allow the disease to be completely eliminated.
Principles of treatment
There are several principles on how to treat osteoarthritis of the knee joint, which should be the basis of treatment for the disease:
- The knee joint damaged by osteoarthritis should be immediately relieved of any excessive physical activity during treatment. It is not that easy to cure osteoarthritis of the knee joint, but it will prevent complications. If possible, it is usually necessary to limit movement of the joint and follow the established regimen prescribed by the doctor.
- At the same time as the treatment, do not take too much care of yourself, so that the muscle tissue atrophy does not start. It is best to engage in affordable physical therapy. Which doctor treats the joint, he will give the direction of exercise therapy.
- Physiotherapy is a great and effective way to improve your basic treatment. Physiotherapy still includes electro-, magnetic, laser therapy, and shock wave therapy.
- Treatment in a sanatorium will also be useful for patients - with osteoarthritis it is necessary to visit specialized stations 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.
- The drugs are mainly anti-inflammatory and analgesics, intraosseous blockages.
- An indispensable part of the correct rational treatment will be a change in eating habits, the elimination of foods that cause excess salt in the body, the saturation of the body with calcium, minerals and vitamins.
Medication
Conservative treatment involves the 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 inflammation, eliminate puffiness, thanks to which painful sensations quickly disappear. The drugs have antipyretic and analgesic effects. This is why they are 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. Depending on their composition, they can be divided into acidic and non-acidic.
When using NSAIDs, you need to remember the risk of side effects. Therefore, it is strictly forbidden to exceed the dose.
Due to their high effectiveness, nonsteroidal anti-inflammatory drugs have become actively used in the treatment of various inflammatory diseases. However, doctors have noted that they have a negative effect. The study found their negative effects on the kidneys, heart, blood and digestive tract. This is why doctors try to limit the prescription of NSAIDs, including in the treatment of osteoarthritis.
It is very important that during the treatment of the disease the maximum possible dose is reached, which would help to limit the excruciatingly painful symptoms, but did not lead to negative effects. Most suffer from nonsteroidal anti-inflammatory drugs:
- organs of the gastrointestinal tract;
- blood cells;
- kidneys;
- heart.
From the stomach side, 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. Heart problems are manifested by high blood pressure and edema. In the kidneys, glomerular filtration decreases and interstitial nephritis can develop. Side effects on the blood are manifested by altered platelet aggregation and an increased risk of bleeding.
Is it possible to completely abandon NSAIDs that negatively affect the body? It turned out not, because it is this group that makes it possible to control the first and second stages of osteoarthritis. Therefore, the negative aspects of nonsteroidal anti-inflammatory drugs have forced manufacturers to seek new generations of these drugs.
As a result of research, 2 generations of cyclooxygenase 1 and 2 enzymes. Recently, cyclooxygenase 3 enzymes have been invented, among which are oxicams. These drugs have much less negative effects, so they are actively used in the treatment of deforming osteoarthritis.
The latest generation drugs also make it possible to effectively treat osteoarthritis without harming the body. The only downside of the new drugs is their 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 nonsteroidal anti-inflammatory drugs are the oxicam group.
The oxicam group is today the most effective and the safest for patients with osteoarthritis.
Chondroprotectors
Chondroprotectors are a group of drugs that are used to protect cartilage tissue. The mechanism of action is due to the content of active components that make up these drugs. These are first of all:
- glucosamine;
- chondroitin sulfate.
The action of chondroitin sulfate is based on the stimulation of the processes of formation of cartilage components. Also this substance:
- prevents destructive processes in cartilage tissue;
- improves the production of intra-articular fluid;
- has an anti-inflammatory effect.
Glucosamine is a substance essential for the synthesis of cartilage tissue. It protects the cartilage from free radicals and other factors that damage the integrity of cartilage tissue. In addition, glucosamine is able to relieve puffiness and have an anti-inflammatory effect.
Chondroprotectors are able to restore cartilage tissue, but they need to be taken for a fairly long time - at least six months. Another big drawback of chondroprotectors is that they further protect the cartilage from destructive effects, but cannot slow down a pathological process that has already started.
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 nonsteroidal anti-inflammatory drugs. Today there are three generations of chondroprotectors, the best known of which are:
- preparations made from animal cartilage;
- the second generation consists of mono-drugs containing either purified hyaluronic acid, or chondroitin or glucosamine;
- the third generation is a combination drug comprising both glucosamine and chondroitin sulfate.
Today it is possible to use chondroprotectors with anti-inflammatory drugs.
Surgery
In some cases, degenerative osteoarthritis of the knee joint is treated exclusively with surgery. Usually, the operation is performed when the patient develops grade 3 knee osteoarthritis. But if a patient in the second stage of the disease has a very pronounced pain syndrome, and it is difficult to eliminate even with pain relievers, and osteoarthritisis constantly worsening, then the operation is indicated at this stage of the disease.
There are several methods of surgical procedures that give the best effect for knee osteoarthritis. 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 with the kneecap. This method of treating knee osteoarthritis is the most radical and is less used today, as it leads to a limitation of the patient's mobility.
Another operation to eliminate osteoarthritis of the knee is arthroscopic debridement. Treatment consists of removing dead particles. The downside of the operation is significant - rehabilitation takes a long time, and the effect of the procedure lasts only 1-2 years. Such an operation can be carried out from the second stage of the development of the disease.
Periarticular osteotomy - this operation is performed if necessary to restore joint mobility. During the procedure, the surgeon saws off the parts of the bone that hinder free movement and places them at the desired angle.
Thus, the center of gravity of the bone shifts and the load on the cartilage tissue disappears. At the moment, this type of joint surgery is practically not used, because it is quite complex and requires a long process of rehabilitation. The positive effect of the treatment is also temporary.
The most effective intervention is the stent. Surgery for osteoarthritis with the help of stents has no analogue - it gives a lasting effect, and patients forget about knee problems for many years.
Knee replacement surgery 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 osteoarthritis by the endoprosthetic 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 drainage for several days, from which the wound secretion is released.
To relieve pain, the knee is coated with special cooling agents. It is possible to move during the endoprosthesis from the third day, on the tenth day the patient continues the treatment in the rehabilitation center. After treatment, you can prescribe nonsteroidal pain relieving drugs, hormonal agents, and be sure to wear a bandage for a while.
Comments
To assess the different treatment methods, you can read reviews of patients treated in different ways and those who have cured osteoarthritis of the knee joint:
- Woman, 45 years old: "Osteoarthritis of the knee was discovered in me 2 years ago. It hurt to step on my foot, an unusual crunch appeared and I went to the doctor. Second-degree onset of the disease was diagnosed and treatment with non-steroidal drugs and chondroprotectors was advised. With the help of painkillers, I managed to achieve a stable analgesic effect - I took a bunch of oxicams. Now, I continue to take chondroprotectors, there is no deterioration yet ".
- Male, 62: "I had osteoarthritis of the knee joint - apparently the consequences of sport, in which I was professionally involved in my youth, have been affected. Even leaving for a coaching position did not help reduce the load, so I continued to actively engage, as a result of which I was diagnosed with osteoarthritis, which I hardly treated. . I only drank pain relievers hoping 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 prostheses, which were done to me last year. The operation was successful and I recovered fairly quickly. "
- 55-year-old woman: "This year I was diagnosed with stage 1 osteoarthritis. Fortunately, I went to the doctor in time because I felt a heaviness in my legs. I thought it was swelling because I had been overweight from childhood, but it turned out to be osteoarthritis. 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 that will not come to the operation. "
Osteoarthritis of the knee joint is characterized by an insidious course, when at the initial stage the pathology does not give symptoms. However, this is when processing is most productive. Therefore, doctors insist on the timely diagnosis of pathology and the prevention of disorders of cartilage tissue.