Knee Arthrosis: Symptoms, Treatment

Among the diseases of the muscle-bone system, osteoaarthrosis is a frequency leader.It is believed that the vast majority of the planet up to 60 years have initial signs of changes in articulated cartilage, and 14% already have osteoarthrosis manifestations.The most common version of this disease is the osteoarthritis of the knee joint.

Still, "arthrosis" or "arthritis"?

Don't mix these two concepts.Arthrosis is a process of change primarily joint structure, and arthritis is inflammation that could arise on the background of the "intact" structure and the background of arthrosis.

Changes in bone with arthrosis can be compared, for example, with weight lean growth on trunk trunks, which grows near concrete fence and puts pressure on this fence with all weight.

Usually the surface of the bones are facing each other separate two layers of cartilage and meniscuses (additional crisp plates).In addition to the role of "buffer" between bones, cartilage provides skating bones and a mechanical correspondence to each other.Meniscus, which, due to large or small (but frequent) injuries, and also loses elasticity, can be completely or partially broken even more.

With age, especially in the presence of hereditary predisposition, the articular cartilage is thinner.Therefore, the bones of the hips and lower legs, which make up the wrist knees with their ends, are dangerously approaching each other, friction can be spotted between them.

Usually parallel with the thinning of cartilage over the years there is another unpleasant event: the amount of intra -ticular liquid decreases.This liquid is not just a pure mechanical "lubrication" of the compound from the interior.Provides bone nutrition, meniscies and wrist cartilage.Violation of "supply" of all these structures is right is a disaster for the wrist!

If there is physical overload of the wrist, then the bone surfaces appear on the surfaces of bones and start growing, more similar to pointing or spiking.For the knee joint, such overloads will be raising weights (including excess of your body!), For example, the roots of the garden), keeping on the stairs, running, carrying unpleasant shoes, straight legs and many others.It is now easy to imagine what is happening in your knee joints during the development of arthrosis and how it is manifested.

How do you work together?

Each of us is at the end, in the end, eventually saw the wrist cartilage.It includes small surfaces of contact bones.Under the articulated cartilts is a subhondral or cleaned bone.The human muscle-bone system is arranged in a similar way.

Most of the person's joints consist of bones, sinovial (articular) shells and intra -ticular liquids.

What happens with Arthrosis compound?

Under the influence of all these burden that have already mentioned, there is compaction and growth of thin bone, as a result, increased trauma of articulated cartilage.

It produces the cartridges formed due to microtrows fall into the sinovi fluid.It is so decorated with nature that foreign substances are for the Sinovi shell and cause their inflammation.The formation of sinovial fluid is disturbed, which is usually a kind of "transporter", similar to the continuous cycle of blood enrichment and purification.In addition, shared fluid becomes less than hyaluronic acid.It's worth saying about this acid.

Hyaluronic acid provides the viscosity of the Sinovian liquid, creates a "effect of buffer" and "lubrication effect" between the bones, reducing their friction to each other.Thanks to this substance that the joint liquid in consistency reminds of egg proteins, not water.Another important role of hyaluronic acid is to ensure the delivery of nutrients from articulated fluids deep into the joint cartilage, because there is nowhere to eat on it: blood vessels are not suitable directly to cartilage.In the same way, the "spent" substances from the cartilage in articulated fluid are removed: using hyaluronic acid molecules.

Thus, an improved bone gasket appears and unbearable conditions for articulated cartilage.

The cancer is receiving a signal for adjusting these extreme conditions, and its change begins, otherwise referring to the remodel.This is mainly manifested by reducing the component of the cartilage.

In the late stage of the development of arthrosis, the bone becomes rigid, but at the same time fragile, the cartilage itself is partially impregnated with calcium - calcified.

Symptoms

The development of arthrosis begins with mild pain in the knee, which appear after walking steps, physical activities, long walking on foot.Such a slight pain can occur for several months, or even years.Then they became more pronounced.In the initial stage of disease development, knee bones are not deformed, but a slight swelling of the community itself may be noticed.

In the second phase of disease development, the pain becomes more intense and occurs after a slight cargo.In addition to pain, crumbs appear in the knee joint, which differs from the usual soft abuse of a healthy joint with pain.In addition, the joint deformity becomes noticeable, the touch bones become wider and rude.Noseting elbow more than 90 degrees becomes problematic.

In the third phase of the disease, the pain in the knee becomes strong and constant, not even passes even at rest.The mobility of the knee becomes minimal, often does not bend more than 90 degrees and is not spreading to the end.The deformation of the bone joint becomes so strong that there is a valgus (x-shaped) or variability (O-form) the curvature of the legs.

Diagnostics

Inspection

In the early stages of the disease, the wrist does not change, mobile, muscles around her are saved and strong enough.Only palpation (pressure) of certain points, more often on the inside of the joint, is the local (local) pain determined.The doctor asks the patient to carry out a few squats, bend, corrects his leg in his knee, putting his face on the couch and leads the flexibility himself (this is called "passive" movements).In this case, except for pain and limiting the amount of movement, you can determine crumbly, by clicking on the joints.With a pronounced inflammatory component, the wrist increases in size, it seems that "pump" is with liquid.With a large process bending in the knee, it can be partially or completely absent, when examining, the area of the joint appears uneven, tuberous, the limb can be curved.

Laboratory and instrumental research

• The mandatory laboratory program includesGeneral, biochemical and immunological blood tests, urine analysis.In general blood test will be paid: Increased leukocyte levels and increased rates of an erythrocyte settlement, indicating inflammation.In biochemical blood analysis, metabolic metabolic indicators are important, the level of the enzyme "liver".The immunological analysis will be determined the presence or absence of signs of the system inflammation - proves the levels of C-reactive protein.Inrence analysis will reveal the content of "sand" - crystals of urinary acid.
• Analysis of Sinovian (articulated) liquidIt is prescribed in case this liquid is in sufficient quantities.It is, when the wrist is swollen, swollen.In the conditions of respect for sterility, the doctor pierces the shared capsule to a strictly defined place, inserts a needle in the articular cavity, and then removes excess fluid.Part of the obtained material enters the analysis laboratory.At the end of the procedure, the anti -infalmal remedy from the glucocorticosteroid group is most often given to a common cavity (for example, diprospic).
• radiography.The image of both knee joints is required, it is necessary to compare a sick knee with healthy.The picture is paid to the width of the common spacing (evaluates the state of meniscus and cartilage), the presence or absence of bone spikes-osteophytes, signs of destruction (destruction) bones.
• Ultrasound of knee jointThey will answer questions about the preservation of the meniscus, the presence of a bakery cyst, the severity of inflammation, the presence or absence of urinary acid crystals (in the presence of gout).
• MRI (magnetic resonance).This study is prescribed if the ultrasound does not give an exhaustive response to the Specialist's questions.The MRI is mandatory for those patients planning to implement arthroscopy.
• Arthroscopy.It allows you to visualize, it personally estimated the state of common.The method is necessary for controversial diagnoses, suspicion of traumatic damage to menus and ligaments (then directly during the study, can quickly remove the torn meniscus or ligaments).

Treatment Arthrosis Knee joint

The principles of comprehensive treatment should be followed, which include:

1. Detailed awareness of the patient on illness

2. Use of physiotherapy exercises, which includes: specific exercises for compounds in a false position, swimming
3. Maintaining optimal body weight
4. Carrying orthosis (soft bend or at least elastic bandage) during the increased load on the joint - on the road, during the walk and so on.
5. Not -kerative methods (physiotherapy).This type of treatment gives excellent results precisely with the arthrosis of the knee joint (gonartrosis).Obviously, this is due to the fact that it is common to the influence of factors such as magnetic and laser radiation.To treat your knee joint, you can use magnetic currents, UHF, CRYO-exposure (translated from the Greek means the effect of cold).Physiotherapy procedures are widespread, treatment courses are usually short -vi - 10, maximum sessions every day or every other day.Only only possible contraindications, which include tumor processes, thyroid glands and pelvic bodies, as well as systemic (autoimmune) inflammatory diseases.
6. Drug therapy.

Principles of osteoarthritis therapy:

• Soften
• Delay further destruction of shared structures
• Return the lost function of the shared function.

Non-steroidal anti -infalmator medications

For pain relief, medications from the NSAID Lee NSAIDA are used - not -steroidal anti -infalmalmic medications.They are used in the form and in the form of applications (use on the skin).Applications (local therapy) are a very efficient method, especially when it comes to early stages of the disease.Before using gel or creams containing NSAIDs, it is necessary to ensure that there is no change on the skin, whether it is rash, pustules or cracks.The general rule of local treatment is to use the selected cream or gel at least twice a day, and if an unpleasant sensation arises - to cancel the complete disappearance of these events.Intramuscular application of painkillers is currently not recommended, as the risk of side effects as a result of the application by the syringe does not decrease, but the opposite.In the event of an expressed inflammation, the accumulation of large amounts of fluid, intraarticular glucocorticosteroicosteroid medications, but it should be noted that this procedure should be performed no more than 1 times every 3 months.

Chondroprotectors

The larger "step" anti -inflammatory effect with osteoarthritis are hondroitin or glacosamine preparations.They, like NSAID, are struggling with inflammation at thin articulated structures, but they have fewer side effects, which is the most important to keep your anti-inflammatory effect a few months after canceling.

Chondroprotectors are a collective name for a group of drugs that have a hondroidal sulphate and glucosamine - "construction bricks" cartilage.Despite the obvious treatment of high costs with hondroprotectors, their convenience for patients and efficiency is difficult to overestimate.First, these substances accepted from the inside are perfectly absorbed from the stomach, and the losses of the medicine "along the road" on the cartilage are minimal.Second, they are able to suppress inflammation in the wrist, and in addition, they reliably slow down the process of destroying a wrist cartilage!The courses are most often prescribed, because they have a fairly long "AS" that last several months, and sometimes even up to six months.

Medications that are covered with hyaluronic acid are so - so-wereked hialuronati.These funds are sold in the form of prepared syringes for intra -ticular administration.Hyaluronets are artificial synonyms of liquids.The effect of treatment with this method can last up to 12 months.

Surgical treatment Arthrosis knee joint

As with the arthrosis of the hip joint, in the event of serious changes and permanent loss of function, surgery occurs.With gonartroz, two types of interventions are currently being performed: Arthrudeza (motionless layer) and endoprosthik.The first operation is rarely performed, according to special indications, when installing endoprosthesis is impossible for any reason.The result of this operation is that the knee becomes stationary.But it doesn't hurt.EndoProsthetics Operation is much more profitable in terms of function.Recall that this operation is not performed with great body weight - the risk of complications in the postoperative period is too large.From the moment of removing damaged parts of the common and denture installation until the function is completely renovated, not more than three week passages.

How should you not be a funny osteoAAAART?

Over time, osteoaarthrosis is not rotated, but only worsens, especially retaining the provocation of factors.Consider the main sources of danger to the health and life of the patient with osteoarthritis.

• Chronic pain of various intensities- a very important risk factor, especially in older people.A constantly experienced unpleasant sensation can lead to sleep disorders, reduced background of mood, and even depression.It is difficult to predict which chain of harmful events withdraw these phenomena.
• Vena pathology.Permanent inflammation in the area of the knees, the growth of bone spikes-osteophytes, which mechanically injures the abducteal vessels, can lead to developing or advancing varicose veins of veins.Sometimes the orthopedia refuse to do the knees until varicose nodes are removed, but flexible (vein specialists) do not begin surgery in the veins until changes in the knee joints are made.
• Reduced limb function.With the ultimate process, the wrist can completely lose the ability to move, and that is in most cases a sign of disability.
• Involvement of other joints.We have already learned how such a seemingly ordinary phenomenon, such as straight feet, can "withdraw" the knee joint and lead to the development of osteoarthrosis.In the same way - along the chain - there is involvement in the painful process of knee joint from the opposite side.If the patient ignores the recommendations, he refuses to wear a reed, preferring "Lump on his two," the hook joint arthrosis develops soon.The legs are twisted, a walk becomes "duck."
• immobility.This serious complication occurs in cases where the bones of the wrist was largely destroyed, there is no cartilage, the jig movement is abruptly painful or impossible due to fusion (it's called "ankylosis") bone with each other.In this situation, only the operation can help the patient, but only if technically feasible.The overcoming is dangerous in the general sense: cause obesity, osteoporosis, muscle atrophy, rapid development of internal organs diseases.In addition, the immobilized person, of course, should be carefully taken care of.
• Inacciousness.Unfortunately, there are a number of countries that are impossible, and one of them is far, "neglected" osteoarthritis in patients over 80 years with difficult diseases.

Prevention

• Exclude joint injuries.It would seem: there is nothing easier.For a while, leaving the jumps, running, walking the stairs, dance, high heels are not hard at all.In practice, it turned out that this point that causes the highest protest by patients.A person, if she recently suffers, is usually not ready for the fact that a matter will miss an important point in his daily life.But if you do not follow these advice, there is a risk of rapidly reducing the quality of life and disability.
• Weight reduction and maintenance in optimal restrictions is an extremely important recommendation!No matter how miraculous effect that or that tool has, fat people will not be able to appreciate it.Because while the joints are overwhelmed with excess weight, microtrows are repeated daily.This can reduce all efforts to "No".In addition, for some methods of treatment, obesity is a direct contraindication.
• Walking with support.The universal rule for unloading compound by support is this: a reed, crutch or handrail should be in hand versus affected ode.That is, if the right hurts the knee, the reed should be kept on the left and vice versa.
• A correction of straight feet.It seems, how can a flat rate and armrose of knee joints?It turns out directly.If the foot is incorrectly installed (we are now talking about longitudinal or mixed flat feet, not about transverse), the load has redistributed in the knee joint.In this case, the severity of the body with the step does not fall on the center of the joint, but on the right or left.Accordingly, right or left meniscus suffers more, and since we suffer more, we wear out faster.Further comes "Order" of the articulated cartilage where the meniscus cannot handle its function.This process ends with the formation of typical one-way "Arthrose" changes in the knee joint (the appearance of the bone exit).