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 doctors estimate that 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 indicates that the treatment of osteoarthritis of the knee joint still does not have methods that will help to completely eliminate the disease.
Principles of treatment
There are several principles for the treatment of osteoarthritis of the knee joint, which should be the basis for the treatment of the disease:
- The knee joint damaged by osteoarthritis should be immediately relieved of excessive physical activity during therapy. Osteoarthritis of the knee joint is not easy to treat, but it will prevent complications. If possible, it is generally necessary to limit joint movement and follow the prescribed regimen prescribed by your doctor.
- In parallel with treatment, do not pay too much attention to yourself, so that muscle tissue atrophy does not begin. It is good to do physical therapy at an affordable price. Whichever doctor treats you together will guide you to exercise therapy.
- Physiotherapy is an excellent and effective way to improve your basic treatment. Physiotherapy always includes electro-, magnetic, laser therapy and shock wave therapy.
- Sanatorium-resort treatment will also be useful for patients - with osteoarthritis, it is necessary to visit specialized spas at least once a year.
- The main treatment is to fill the joint with oxygen. For this, the so-called oxygen therapy is carried out.
- Medications are primarily anti-inflammatory drugs and analgesics, intraosseous blockers.
- An indispensable component of proper rational treatment will be a change in dietary habits, the elimination of foods that cause excess salt in the body, the saturation of the body with calcium, minerals and vitamins.
Medication
Conservative therapy includes treatment of gonarthrosis of the knee joint:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors.
Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs are key in the treatment of osteoarthritis. This group of drugs allows you to quickly stop the inflammation, eliminate the swelling, so that the painful sensations disappear quickly. The drugs have antipyretic and analgesic effects. Therefore, it is recommended for the treatment of articular pathologies, including osteoarthritis of the knee joint.
Non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of DOA of the knee joint are divided into several groups. According to their composition, they can be divided into acidic and non-acidic.
The risk of side effects should be borne in mind when using NSAIDs, so overdosing is strictly prohibited.
Due to their high effectiveness, non-steroidal anti-inflammatory drugs are actively used in the treatment of various inflammatory diseases. However, doctors noted that they had a negative effect. Research has shown that they have negative effects on the kidneys, heart, blood and digestive system. Therefore, doctors try to limit the prescription of NSAIDs, including in the treatment of osteoarthritis.
It will help prevent unbearable painful symptoms during the treatment of the disease, but it is very important to reach the maximum possible dose that does not have an adverse effect. Most non-steroidal anti-inflammatory drugs suffer from:
- organs of the gastrointestinal tract;
- blood cells;
- kidneys;
- heart.
Complications such as stomach ulcers, dyspepsia, internal bleeding or even perforation of the stomach are possible. As for the liver, there is damage to the hepatocytes, the main cells of the liver. Heart disorders manifest themselves with arterial hypertension and edema. In the kidneys, glomerular filtration is reduced and interstitial nephritis may develop. Side effects on the blood are manifested by impaired platelet aggregation and an increased risk of bleeding.
Is it possible to completely give up NSAIDs that have a negative effect on the body? It turned out not, because it is this group that allows you to stop the first and second stages of osteoarthritis. Therefore, the disadvantages of non-steroidal anti-inflammatory drugs have forced manufacturers to look for new generations of these drugs.
As a result of the research, 2 generations of cyclooxygenase enzymes 1 and 2 were isolated. Recently, cyclooxygenase 3 enzymes have been invented, including oxycamines. These drugs have less side effects, so they are actively used in the treatment of deforming osteoarthritis.
The latest generation of drugs also allows you to effectively treat osteoarthritis without harming the body. The only drawback of the new drugs is the very high price. Therefore, when used for a long time by the attending physician, old drugs with probiotic support of the gastrointestinal tract are prescribed.
Oxycameras
Oxycam is a new generation of non-steroidal anti-inflammatory drugs.
The oxicam group is the most effective and safe for patients with osteoarthritis today.
Chondroprotectors
Chondroprotectors are a group of drugs that protect cartilage tissue. The mechanism of action depends on the composition of the active components that make up these drugs. First of all, they are:
- glucosamine;
- chondroitin sulfate.
The action of chondroitin sulfate is based on the stimulation of the formation of cartilage components. Also this article:
- prevents destructive processes in cartilage tissue;
- improves the production of intraarticular fluid;
- has anti-inflammatory effect.
Glucosamine is an important substance for the synthesis of cartilage tissue. It protects cartilage from free radicals and other factors that disrupt the integrity of cartilage tissue. Glucosamine is also able to eliminate swelling and have anti-inflammatory effects.
Chondroprotectors are able to restore cartilage tissue, but they should be taken for a long time - at least six months. Another major disadvantage of chondroprotectors is that they protect the cartilage more from destructive effects, but do not slow down the pathological process that has already begun.
Therefore, this group of drugs is included only for the treatment of the first stage of the disease with the active appointment of non-steroidal anti-inflammatory drugs. Today, there are three generations of chondroprotectors, the most popular of which are:
- preparations made from animal cartilage;
- second-generation mono-drugs containing either purified hyaluronic acid or chondroitin or glucosamine;
- The third generation is a combination of drugs that contain both glucosamine and chondroitin sulfate.
Today, chondroprotectors can be used in combination with anti-inflammatory drugs.
Operation
In some cases, degenerative osteoarthritis of the knee joint can only be treated surgically. Surgery is usually performed when the patient develops grade 3 gonarthrosis. However, if a patient in the second stage of the disease has a very obvious pain syndrome, and even if it is difficult to eliminate with painkillers, and osteoarthritis is constantly worsening, surgery is indicated at this stage of the disease.
There are several surgical interventions that work best for gonarthrosis. Each technique has its own characteristics and results.
Arthrodesis is a procedure in which joint tissue is completely removed and the femur and calf bone are joined to the patella. This method of treating gonarthrosis is the most radical and is not often used today, because it leads to limited mobility of the patient.
Another operation to remove knee osteoarthritis is arthroscopic debridement. The treatment consists of the removal of dead particles. The disadvantage of the operation is significant - it takes a long time to rehabilitate, and the effect of the procedure lasts only 1 to 2 years. Such an operation can already be performed in the second stage of the disease.
Periarticular osteotomy - this operation is performed when necessary to restore joint mobility. During the procedure, the surgeon cuts the parts of the bone that impede free movement with a saw and places them at the desired angle.
Thus, the center of gravity in the bone changes and the load on the cartilage tissue disappears. Currently, such a joint operation is not used in practice, because it is very complicated and requires a long rehabilitation process. The positive effects of treatment are also temporary.
The most successful intervention is endoprosthesis. There is no surgical analogue for osteoarthritis using endoprosthetics - it has a long-lasting effect and patients forget about knee problems for many years.
Knee arthroplasty is the most advanced technique. Modern treatments allow the patient to remove cartilage tissue 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:
- 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 with endoprosthetics is the high cost of materials, because high-quality prostheses are very 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.
The knee is covered with special cooling substances to relieve pain. During endoprosthetics, it is possible to move on the third day, and on the tenth day the patient continues treatment in the rehabilitation center. After treatment it is possible to prescribe non-steroidal anti-inflammatory drugs, hormonal agents and be sure to wear a bandage for a while.
Reviews
You can read the reviews of patients treated in different ways and those who treat osteoarthritis of the knee joint to evaluate different therapies:
- A 45-year-old woman said: "I was diagnosed with osteoarthritis of the knee 2 years ago. It hurt me to step on my foot, there was an unusual crack and I went to the doctor. I had a stable analgesic effect - I took a group of oxycam. Now I continue to take chondroprotectors, there is no worsening. "
- A 62-year-old man said: "I had osteoarthritis of the knee joint - it seems that the results of professional sports in my youth affected my performance. Going to coaching did not help to reduce the load, so I continued to be active, resulting in a diagnosis of osteoarthritis"I only took painkillers, which will pass. As a result, stage 3 of the disease developed and I had to have surgery. Among all the methods, the doctor offered me prostheses last year. The operation was successful and I recovered quickly. "
- The woman, 55, said: "This year I was diagnosed with stage 1 osteoarthritis. Fortunately, I went to the doctor on time because I felt heaviness in my legs. I thought I had swelling because I was overweight as a child, but it turned out to be osteoarthritis. NowI am taking anti-inflammatory drugs, but the doctor promises that I can recover with the help of chondroprotectors. I hope he will not come for surgery. "
Osteoarthritis of the knee joint is characterized by an insidious course when it does not show pathological symptoms at an early stage. However, this is the time when treatment is most productive. Therefore, doctors insist on timely diagnosis of pathology and prevention of disorders of cartilage tissue.