Osteoarthritis of the knee: treatment,prevention

Update: December 2018

Gonarthrosis or osteoarthritis of the knee is non-inflammatory.
progressive intraarticular cartilage disease
degenerative-dystrophic violation of its structure and functions.
Most often it occurs in older women, as well as after
injuries of the knee or hip in professional athletes even in
young age.

Many people believe that the development of arthrosis is associated with the deposition of salts,
however, this is not the case; indeed, arthrosis can occur
salt deposits in the ligament apparatus in the tendons, but the causes
arthrosis of the knee joint are different, they are associated with a violation of the structure
and feed intake to intra-articular cartilage.

In this article we will look at the changes that occur
with osteoarthritis of the knee joint, treatment and prevention, care
patient with this serious illness.

What happens with osteoarthritis of the knee joint?

Articular cartilage plays a very important role for human movement –
it is a durable, elastic, smooth normal gasket, the function of which
is to ensure easy sliding of articulated bones to each
relative to each other as well as load sharing and depreciation
when walking man.

But, in the event of provoking factors – injuries, prolonged
muscle spasms, metabolic disorders in the body,
genetic location, with regular excessive loads and
etc., the cartilage becomes rough, thinner, as if it dries out and
even cracked. In this case, instead of a soft slip
severe friction occurs, the surfaces of the joint literally cling
each other, the first degree of arthrosis begins when the cartilage
loses its depreciation properties.

Further, the degeneration process does not stop, but slowly
progresses, while reducing depreciation, the bones gradually begin
flatten out as if to increase the articular area appear
osteophytes – bone growths when tissue is reborn
increases, forming growths. This is the second degree of arthrosis, with
both the capsule and the warp are subject to rebirth
joint, from lack of movement and pumping, the structure of the knee
atrophy of the joint, the joint fluid becomes more viscous,
thick, weakens and the supply of nutrients to the cartilage that
worsens the condition even more.

Due to the thinning of the cartilaginous pad, the distance is reduced
between articulated bones up to 80%.  Therefore when walking from
resulting anomalous friction without shock absorber, destruction
joint begins to grow rapidly, quickly leading to a third
the degree of osteoarthritis of the knee joint, the symptoms of patients
very pronounced:

  • Morning stiffness, soreness and at rest, and
    load
  • Pain when moving, especially when descending and ascending
    the stairs
  • The man begins to limp, spare the sick limb
  • In severe cases, a person can only walk with a cane.
    or crutches

In the third degree of osteoarthritis, joint mobility may decrease.
to a minimum, since high-grade cartilage tissue is practically not
remains, therefore, no super preparations, ointments, medications or
arcane methods will not be able to restore the lost cartilage
tissue, and because of the deformation of the bones impossible normal operation
the joint. In this case, only surgical treatment is possible.

Treatment methods

With conservative therapeutic drug treatment
osteoarthritis of the knee is very important to conduct a combination therapy such
way to simultaneously solve several problems:

  • The first treatment condition is to establish the correct one as soon as possible.
    diagnosis. And the sooner the therapy is started, the greater the chances of a successful
    treatment and prolongation of the remission period with the least consequences and
    cartilage damage
  • It is necessary to take painkillers as prescribed.
    the doctor
  • To speed up the recovery of cartilage, you need to improve it.
    nutrition
  • In the area of ​​the joint should increase blood circulation
  • Strengthen the muscles surrounding the sore joint
  • Reduce the pressure on the articular bones, strive
    increase the distance between them
  • Повысить подвижность the joint.

Артроз коленного сустава

Therefore, the main methods of treatment of arthrosis include:

  • Acceptance of NSAIDs
  • In case of osteoarthritis of the knee joint, drugs are indicated –
    chondroprotectors that repair cartilage tissue
  • Vasodilator drugs, warming ointments and nonsteroidal
    anti-inflammatory creams, ointments
  • Desensitizing drugs (Suprastin, Cetrin
    see allergy pills)
  • Holding various compresses on the joint
  • Joint injection
  • Manual therapy and physiotherapy
  • Performing a special set of exercises
  • Spa treatment

Drug treatment

Nonsteroidal anti-inflammatory drugs

To eliminate pain, as well as relieve inflammation,
traditionally appointed nonsteroidal anti-inflammatory
remedies, since it is impossible to start treatment for pain. NSAIDs on
the pharmaceutical market is now represented in a large assortment,
as in tablet form, ointments, and injections:

  • Celecoxib – Celebrex
  • Etoricoxib – Arcoxia
  • Tenoksikam – Texamen
  • Nimesulide – Nise, Nimulid, Nimika
  • Naprksen – Bongezin
  • Meloxicam – Movalis, Artrozan, Meloxicam
  • Ketorolac – Ketanov, Ketarol, Ketorolac
  • Ketoprofen – Artrozilen, Bystrummkaps, Ketonal, Fleksen
  • Ibuprofen – Burana, Faspik, Ibuprofen, Nurofen
  • Diclofenac – Voltaren, Naklofen, Ortofen, Diklak

It should be understood that these drugs do not treat osteoarthritis of the knee
joint, but only eliminate some symptoms of the disease,
more possess a number of side effects and their long
use not allowed.

Prolonged use is not only dangerous
effects, but it has been proven that these drugs affect
synthesis of proteoglycans, leading to dehydration of cartilage tissue at
prolonged exposure.

Therefore, taking NSAIDs should be taken very seriously,
use only in cases of severe pain. Taking a pill from
pain relief, the patient can thus gradually accelerate
процесс разрушения the joint. More details about NSAIDs, their
classification, contraindications, side effects, you can learn
from our article Backache Injections.

Preparations for the restoration of cartilage tissue – tablets,
injections, creams

Of course, when the cartilage tissue is already severely damaged, in 3 stages
Glucosamine and chondroitin sulfate diseases that reduce
structure and nourishing cartilage tissue used for treatment
arthrosis of joints ineffective. But with 1-2 degrees of development
arthrosis – chondroprotectors are the most necessary, useful
drugs for therapy.

It is chondroprotectors for arthrosis of the knee joint that bring
most benefit, they have virtually no contraindications and they
very rarely side effects. However, their action is different, to
For example, glucosamine stimulates natural mechanisms for
restoration of cartilage, as it starts the production of basic
elements of cartilage, which subsequently protects their destruction.

Chondroitin sulfate also has the property of neutralizing enzymes,
that corrode cartilage and stimulates growth
collagen protein, in addition, it promotes water saturation
cartilage tissue with water, increasing the ability of proteoglycans
save, retain water.

Moreover, most doctors insist on a complex effect.
chondroprotectors and several courses per year because
a one-time admission or a single course does not lead to the desired
result. In addition, do not exaggerate too much
of these drugs in the treatment of arthrosis, yes they are effective,
but in cases where the destruction process has gone too far,
it is already impossible to grow a healthy new cartilage tissue and hope for
hondoprotectors not worth it, with grade 3 arthrosis most often helps
only surgical treatment.

Moreover, even at 1-2 degrees chondroprotectors have
slow impact, lead to improvement not immediately, therefore
At least 2-3 courses per year are required. Also, doctors recommend
adhere to the following rules when using
chondroprotectors:

  • Use glucosamine and chondroitin sulfate in the complex, rather than
    separately
  • Conduct courses 2-3 times a year, or six months in a row.
  • During the course, follow the dose – daily dose
    chondroitin sulfate – 1000 mg, glucosamine 1500-1000 mg.

Chondroitin is presented in pharmacy chains in the form of tablets,
injection and ointment:

  • in ampoules – Mukosat (300-500 rubles. 5 ampoules), Hondrolon (800-900
    rubles), Artradol (700 rubles), Chondrogard (1100 rubles), Hondroitit
    sulphate (300 rubles), chondrolone (800 rub)
  • in tablets – Struktum (about 1000 rubles), Chondroitin (300 rubles),
    Hondroksid (450 rub)
  • ointments, gels – Chondroitin (80 rubles), Hondroksid (300 rubles)

Glucosamine

  • injections – Don (1100 rubles), Elbon (700 rubles)
  • в капсулах, пакетиках —  Элластэнга активный глюкозамин
    (120 caps. 2500 rub), Dona powder (1200 rub), Stoparthrosis powder
    (700 rub)
  • gel – Ellastanga (400-500 rubles)

Combination drugs – which include and
glucosamine and chondroitin sulfate:

  • in tablets – Artra (600-1500 rub) Doppelgerts glucosamine and
    chondroitin active capsules (300 rubles), Teraflex (700-1000 rubles),
    Glucosamine и хондроитин (250-300 руб.), Нэйчез баунти комплекс (500
    Rub.), Kondronova capsules (350 rub), Toad Stone Hondoprotector
    Sustamed (130 rubles), Solgar (2000 rubles)
  • cream – Honda (150 rub)
Vasodilator drugs

These include Trental – Agapurin (150-200 rubles), Vazonid Retard
(300 руб), Пентоксифиллин (60 руб), Трентал  (160 -1000 руб),
а также известный Ксантинол никотинат, теоникол — эти средства
are quite useful in complex treatment, because
relieve spasm of small vessels, improve blood supply in the joint,
improve nutrient delivery and eliminate possible
vascular pain. They also need to be taken in conjunction with
chondroprotectors.

Also, to improve blood flow if arthrosis is not
accompanied by synovitis (fluid accumulation), the doctor may
recommend the use of warming ointments and liquids such
like Espol, Menovazin, Nikofleks-cream, Gevkamen – they give
feeling of comfort and warmth, rarely give side effects.

Gymnastics with arthrosis of the knee

With osteoarthritis of the knee, treatment, drugs, gymnastics,
мази, компрессы – все должно  назначаться только лечащим
a doctor. Therapeutic gymnastics should be performed slowly, without jerks,
bouncing, twisting the joint, without squats. The best thing
perform it in the morning for 20 minutes, lying or sitting, for 10 repetitions
every exercise.

Задачи лечебных физических упражнений – это prevention
further destruction of cartilage, disease progression,
slow down the development of stiffness, increase blood supply
in the joint, relax the muscle spasm that causes pain. In
time of exacerbation of the disease can not do gymnastics.

  • Lying on your back, straighten your legs, arms along your body – you can perform
    exercise bike, just straighten your legs parallel to the floor,
    make circular movements with the feet, or strain them, counting to 10,
    on the exhale, tighten your arms to your chest, while inhaling while returning to
    starting position, move aside, sliding on the floor first
    one leg, then the other.
  • Sitting on a chair, legs down – straightening the legs while bending
    foot, on 10 accounts holding this position, pull
    alternately each knee to the stomach, supporting with hands and
    return to the starting position.
  • Standing on the floor with a support on the wall to perform back and forth swings
    alternately with each leg.
  • Standing by the chair – put one foot on the chair, it should be
    fully extended, in the direction of this leg to perform springy
    movement-bending, hands resting on the thigh, while trying to
    straighten your leg stronger.
  • Lying on the stomach – alternately lift each leg in
    straightened state, holding up to 3 accounts.
  • Sitting on the floor – spreading the legs apart, gliding along the floor, and
    also tighten the knees of both legs to the belly on the exhale, and on the inhale
    return to the starting position.

Physical therapy, laser, manual therapy, compresses

Among the therapies, physiotherapy is important, the doctor
may prescribe the following types of physiotherapy treatment –
electrophoresis, magnetic laser therapy, laser therapy, UHF,
phonophoresis with hydrocortisone, as well as diadynamic currents. Also
very effective for different types of massage
acupuncture, manual therapy courses.

Therapy with local remedies such as medical bile,
Bishofit or Dimexide also has a certain effect. Bishofit
possesses anesthetic, warming and anti-inflammatory
action. Similar properties and medical bile.
As for Dimexidum, this drug is very active.
used in many diseases because it really
penetrates the skin and has a strong absorbing effect,
reduces inflammation, improves metabolism at the site of application
compress

In addition to the above methods of drug treatment of arthrosis,
to slow down the destruction of cartilage tissue as much as possible to the patient
You should follow a lot of rules and impose restrictions on your life:
control weight as overweight increases the load on
affected joint, avoid heavy loads, but at the same time
do physical therapy, wear comfortable shoes, preferably with
specially selected insoles, use a cane for
facilitate movement.

When expressed degenerative-dystrophic changes in
arthrosis of the knee, лечение консервативными способами малоэффективно.
Therefore, with disability, severe pain
syndromes, surgery is recommended –
arthroplasty.

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