Osteoarthritis of the knee joint is degenerative damage to the cartilage of the knee joint, which destroys it. 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 methods that would help to completely get rid of the disease.
Treatment principles
There are several principles for treating osteoarthritis of the knee joint that should be the basis for treating the disease:
- The knee joint damaged by osteoarthritis must be relieved of excessive physical activity immediately during therapy. Curing osteoarthritis of the knee joint is not that easy, but complications can be avoided. In general, if possible, it is necessary to limit the movement of the joint and follow the regimen prescribed by the doctor.
- In parallel with the treatment, do not pay too much attention to yourself so that atrophy of the muscle tissue does not begin. It is best to get affordable physical therapy. Whichever 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, magnet, laser and shock wave therapy.
- Sanatorium-resort treatment will also be useful for patients - with osteoarthritis, it is necessary to visit specialized resorts at least once a year.
- An essential treatment is to fill the joint with oxygen. For this purpose, so-called oxygen therapy is carried out.
- Medicines are primarily anti-inflammatory drugs and pain relievers, intraosseous blocks.
- An indispensable part of proper rational treatment is a change in eating habits, the elimination of foods that provoke excess salt in the body, saturation of the body with calcium, minerals and vitamins.
medication
Conservative therapy includes the treatment of osteoarthritis of the knee joint:
- Non-steroidal anti-inflammatory drugs;
- Chondroprotectors.
Non-steroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs are the basis for treating osteoarthritis. This group of drugs allows you to quickly stop inflammation and eliminate swelling, which will quickly make painful sensations go away. The drugs have an antipyretic and analgesic effect. Because of this, they are recommended for the treatment of joint diseases, including osteoarthritis of the knee joint.
Nonsteroidal anti-inflammatory drugs used to treat 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 the risk of side effects, so it is strictly forbidden to exceed the dosage.
Due to their high effectiveness, nonsteroidal anti-inflammatory drugs are actively used in the treatment of various inflammatory diseases. However, doctors found that they have a negative effect. The study showed its negative effects on the kidneys, heart, blood and digestive tract. This is why doctors are trying to restrict the prescription of NSAIDs, including those used to treat osteoarthritis.
It is very important that while treating the disease, the maximum possible dose is reached that would help contain the excruciatingly painful symptoms but not have any adverse effects. Mostly suffering 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, the hepatocytes - the main cells in the liver - are damaged. Heart disease is manifested by arterial hypertension and edema. In the kidneys, glomerular filtration decreases and interstitial nephritis may develop. Side effects on the blood are expressed in impaired platelet aggregation and an increased risk of bleeding.
Is it possible to completely give up NSAIDs that negatively affect the body? As it turned out, no, since it is this group that makes it possible to withhold the first and second stages of osteoarthritis. Hence, the negative aspects of nonsteroidal anti-inflammatory drugs forced manufacturers to look for new generations of these drugs.
As a result of the research, 2 generations of cyclooxygenase enzymes 1 and 2 have been isolated. Recently, cyclooxygenase-3 enzymes were invented, which includes oxicams. These drugs have much less negative effects, so they are actively used in the treatment of deforming osteoarthritis.
The latest generation of drugs also enable osteoarthritis to be treated effectively without harming the body. The only drawback of the new drugs is the rather high price. Therefore, with prolonged use, the attending physician will prescribe old drugs with probiotic support for the gastrointestinal tract.
Oxycams
The Oxicam group represents a new generation of nonsteroidal anti-inflammatory drugs.
The Oxicam group is the most effective and safest for patients with osteoarthritis today.
Chondroprotectors
Chondroprotectors are a group of drugs that are used to protect cartilage tissue. The mechanism of action is based on the content of active ingredients that make up these drugs. These are primarily:
- Glucosamine;
- Chondroitin sulfate.
The action of chondroitin sulfate is based on the stimulation of the processes of the 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 an essential substance for the synthesis of cartilage tissue. It protects the cartilage from free radicals and other factors that damage the integrity of the cartilage tissue. Glucosamine can also reduce swelling and have anti-inflammatory effects.
Chondroprotectors can restore cartilage tissue, but must be taken for a longer period of time - at least six months. Another major disadvantage of chondroprotectors is that they better protect the cartilage from destructive effects, but cannot slow down a pathological process that has already started.
Therefore, this group of drugs is included only at the first stage of the development of the disease with the active prescription of nonsteroidal anti-inflammatory drugs for treatment. Today there are three generations of chondroprotectors, the most famous of which are:
- Preparations made from animal cartilage;
- the second generation are monodrugs that contain either purified hyaluronic acid or chondroitin or glucosamine;
- the third generation is a combination of drugs that contain both 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 if the patient develops degree 3 gonarthrosis. However, if a patient in the second stage of the disease has a very pronounced pain syndrome, and it is difficult to remove even with pain relievers, and the osteoarthritis is constantly worsening, then surgery at this stage of the disease is indicated.
There are several methods of surgical intervention that will have the best effect on osteoarthritis of the knee. 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 to the kneecap. This method of treating osteoarthritis of the knee is the most radical and is no longer used as often because it restricts the patient's mobility.
Another operation to eliminate knee osteoarthritis is arthroscopic debridement. Treatment consists of removing dead particles. The disadvantage of the operation is significant - rehabilitation takes a long time, and the effect of the procedure lasts only 1 to 2 years. Such an operation can be carried out as early as the second stage of the development of the disease.
Periarticular Osteotomy - This surgery is performed when necessary to restore mobility to the joints. During the procedure, the surgeon saws off the bone parts that impair freedom of movement and sets them at the desired angle.
This shifts the center of gravity in the bone and the stress 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 procedure is endoprosthetics. Arthrosis surgery with endoprosthetics has no analogues - it has a long-lasting effect, and patients forget about knee problems for many years.
Knee arthroplasty is the most advanced technology. Modern methods of treatment allow the patient to extract the cartilage tissue affected by the pathological process, as well as bone particles. Instead, a more functional and reliable prosthesis is used. The advantages of such an operation are as follows:
- it is possible to fully restore the patient's motor functions;
- rehabilitation with such an operation is minimal;
- the prosthesis lasts for about three decades.
The only problem with the surgical treatment of osteoarthritis using the endoprosthetic method is the high cost of materials, since a high-quality prosthesis is quite expensive. The postoperative treatment is completed in the intensive care unit - the patient is given a drain for several days, from which the wound secretion is released.
The knee is coated with special coolants to relieve pain. Movement during the endoprosthetics is already possible 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 for pain relief, hormonal agents, and to wear a bandage for some time.
reviews
To evaluate the different methods of therapy, you can read the reviews of patients who were treated in different ways and who cured osteoarthritis of the knee joint:
- Woman, 45 years old: "I was diagnosed with osteoarthritis of the knee joint two years ago. My foot hurt, an unusual crunch occurred, 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 recommended. With the help of pain pills, I managed to get a stable analgesic effect - I took a group of oxicams. Now I continue to take chondroprotectors, there is still no deterioration ".
- Male, 62 years old: "I had osteoarthritis of the knee joint - apparently the consequences of the sport I did professionally in my youth are affected. Even switching to a coaching job didn't help ease the burden, so I kept getting actively involved, which resulted in me being diagnosed with osteoarthritis that I practically did not treat. I just drank pain medication hoping it would pass. As a result, stage 3 of the disease developed and I had to have an operation. Among all the techniques, the doctor suggested prosthetics, which was done to me last year. The operation was successful and I recovered fairly quickly. "
- Woman, 55 years old: "This year I was diagnosed with stage 1 osteoarthritis. Fortunately, I went to the doctor on time because I felt a heaviness in my legs. I thought it was a swelling as I had been overweight since childhood but it turned out to be osteoarthritis. Now I'm on anti-inflammatory drugs, but the doctor promises that I can recover with the help of chondroprotectors. I hope the operation doesn't come. "
Osteoarthritis of the knee joint is characterized by an insidious course if the pathology does not cause symptoms at the initial stage. Still, treatment is most productive at this point. Therefore, doctors insist on the timely diagnosis of the pathology and the prevention of diseases of the cartilage tissue.