Deformation of osteoarthrosis knee (aka gonartrosis or abbreviated DOA) is a degenerative-dystrophic disease of the knee joint, characterized by a chronic constant advanced course, Sinoviška shell, capsule, and the underwear, movement reduction and often disability.
The disease begins with changes in the articulated cartilage, which is why the joints of the bone surface occur.The interruption and loss of elasticity lead to its dystrophy and resorption, while the bone tissue exposed, sliding is disturbed, the joint gap is changing, the joint biomechanics is changing.Sinovian grenade washer and the creation of sinovial fluid is irritated (which nurtures cartilage and plays the role of physiological lubrication), leading to increasing its quantity in common (sinovitis).Against the background of joint spacing, Sinovijska fluid is reduced, Sinovi fluid for the rear wall of the articulated capsule, the Becker Cyst (which reached large sizes can cause pain in the posteal fossa).The thin and gentle fabric of the articulated capsule is replaced by a rough bonding tissue, the form of articulated changes.A perysorurpital tissue costs growing, osteofiti (pathological growth of bones) are formed.Blood circulation in periarticular tissues is disturbed, and the undervalued metabolic products, irritating hemoresceptors, develops a permanent pain syndrome.Against the background of changing anatomy in common, there is a violation of the works of the surrounding muscles, hypotrophies and spasm, the stroke is disturbed.There is a permanent limit to the amount of movement in common (contractions), sometimes so spoken that only movements (stiffness) or completely lack of movement (ANKILOS) are possible.
Gonartost is a fairly common disease: a suffering from 10% of the total planet population, and in the age of 60 it affects each third person.
Causes of gonartrosis
- Bone and joint injuries.
- Instrument diseases of joint diseases (rheumatoid, chlamydia arthritis, gout).
- Breach of mineral metabolism with various endocrinopathies (diabetes melitus, parathiroid disease, hemochromatosis).
- Diseases of muscle devices and neuropathia (Charcot disease).
In addition to the main reasons, they combine in unfavorable factors of gonartrosis development, which include:
- Excessive weight (literally puts pressure on the lower limbs);
- Age (disease is generally subject to older people);
- Women's gender (according to statistics in a woman, they ache more often);
- Increased sports and professional physical effort.
Symptoms of osteoarthrosis of knee joint
- Pain that increases when walking and weakening itself.
- Difficulties of famous, physiological movements in the joints.
- Characteristic "crumb" in the joints.
- Increasing joints in the amount and their visible deformation.
Gonartroze phases
Clinical phase Arthrosis knee joint
The disease passes through several phases.
- In the first phase of a person feels onlyA small feeling of discomfortor "seriousness" in a knee that tortures during walking or increasing physical effort.The radiological examination will be non-fluent: it is possible to identify only a small narrowing of the common gap, there will be no other changes.
- The second phase is characteristicTangible pain, whose seriousness is reduced in rest.There is a difficulty in joints in the joints, when walking, the characteristic "creaking" (of the patient can hear a conventional phrase in everyday life - "Kreuk").When conducting radiographs, they were found clear to distinguishing the narrowing of the common gap and individual osteophytes.
- When crossing gonartrosis into the next, third phase,The pain will permanently bother the patientIncluding at rest, there is violation of joint configuration, I.E.Intensify deformation due to edema at the time of merging inflammation.Radiographies determine the narrowing of the common gap of a moderate degree and more osteophytes.In the third phase, many are already applying for medical assistance, because the quality of life suffers significantly due to pain and difficulties in normal walking.
- The fourth phase is accompaniedEnvironment, exhausting pain.The minimum movement attempts become a difficult test for people, the joint deformity is visually visible, walking is extremely difficult.X -Ray reveals significant changes: a common gap in the pictures is practically not determined, multiple rude osteophytes, "articulated mice" (fragments of the destructive bone) that belong to the articulated cavity).This phase of gonartrosis almost always involves a disability.
Who treats the arthrosis of a common knee?
Therapist, rheumatologist and general practitioner (family doctor) can provide qualified medical care for gonartrosis (family doctor), but these experts treat common knees with uncomplicated arthrosis.When the synonitis or treatment is prescribed from the therapist does not give the appropriate effect, you cannot without help orthoped.In situations in which surgical care is needed, the patient is sent to a specialized orthopedic-traumatological department.
How and what do you treat the arthrosis of a common knee?
Methods of treatment The arthrosis of the knee joint, known to the current day, are divided into conservative, drugs and surgical unaccursions.
Methods of Neployment
Many patients wondering: "How to cure an arthrosis knee joint without tablets?"The answering, with regret, needs to be stated that gonartrosis is chronic disease, it is impossible to remove forever.However, many methods that exist today can significantly slow down its advancement and improve patient quality, especially when used in the early stages of the disease.
With timely search of the doctor, and patients sufficient motivation for healing, sometimes is enough to remove negative factors.For example, it provesReduction of excessive weightReduces the event of the main symptoms of the disease.
Exclusion of pathological physical effort and on the contrary,Therapeutic gymnastics classesWith the use of rational physical programs, they reduce pain intensity.It has been proven that exercises to strengthen the forces of a four-glaval hook into force are comparable in force with antinamal medications.
If we treat your knee wrist arthrosis then we have to striveProper nutrition: To improve the elastic properties of articulated cartilage will help products that contain a large amount of animal collagen (Čozice, crabs, cute and paved dishes, the violation of metabolic processes in the body and accumulation of excess weight to obesity are potentially.
Complex treatment Arthrosis Knee joint also includes the appointment of very efficient even with advanced forms of diseasePhysiot -rocedure.With wide use in different categories of patients who suffer from this disease proved their efficiencyMagnetotherapy: After several proceedings, pain intensity decreases, as a result of improving blood circulation, edema reduction and eliminating muscle cramp increases the mobility of the wrist.The effect of magnetotherapy is particularly vivid during the development of active inflammation in the common: the severity of the edema is significantly reduced, the appearance of sinovitis regresses.Not so popular, but not less effective in treating the compound of knee with arthrosis are such methods of physiotherapy asLaser therapy and cryotherapy(Cold exposure), possessing an expressed effect of hospital.
Medicine treatment
In the efficient treatment programs, your knee joint arthroses are used by medicines below.
Not -steroidal anti-inflammatory drugsProduced in the forms for external (various gel, fats) and systemic use (tablets, candles, solutions), long have proven their efficiency in the treatment of osteoarthrosis and are widely prescribed by doctors.Blocking inflammation at the enzyme level, they remove joint pain and their swelling, slowing the response of the disease.It must be borne in mind that long-term systemic techniques can cause the development and deterioration of ulceric processes in the gastrointestinal tract, and also negatively affect kidney and liver functions.Therefore, patients, taking a cure for a long time, should also prescribe medications that protect the stomach of the gastric mucosa and regularly oversees laboratory indicators of internal organs.
Glucocorticosteroids (GKS)- hormonal medicines with expressed anti-inflammatory effect.Since the powerful anti -inflammatory agent, GCs have certain contraindications, because they are able to call a range of significant side effects.In systematic forms for gonartrosis, they are practically not prescribed.As a rule, efficient treatment of arthrosis includes the injections of GC in PERI -hman pain points, which increases the intensity of the fight against inflammation and minimizes the risk of undesirable side effects of the drug.With one introduction of GCS, the effect of its use lasts up to 1 month.In accordance with National Osteoarthritis Treatment Recommendations, you should not perform more than three drug injections per year in the same compound.
With the ultimate, "neglected" osteoarthritis, when a person experiences unbearable pain that does not fall even at rest, violating a normal sleep, the prescription is possibleOpioid hospital.These medications are used only according to the prescription doctor, which in any case considers the feasibility of their appointment.
Chondroprotectors(with literal translation - "protection of cartilage").This name is implyed as various medications united by one property - a structural -modifying effect, ie.Possibility to slow down degenerative changes in cartilage and narrowing a common gap.They are produced in forms and for oral administration (glucosamine, chondroitine sulfate, piastalin), and for the introduction to the common cavity (Hyaluronates).Of course, these medications do not perform a miracle and do not "grow" a new cartilage, but may suspend its destruction.In order to achieve persistent effect, they must be used for a long time, regular courses several times a year.
Surgical treatment of the arthrosis of common knees
The most popular type of surgical care for gonartrosis isEndoprosthetics, IERemoving your own compounds with simultaneous installation of metalloProstheza that replaces it, whose design is similar to the anatomy of a common knee.At the same time, the prerequisite for this type of surgical treatment is: the absence of the gross deformation of the Charter, formed "false joints", humane scrambled and expressed muscle atrophy.With a serious osteoporosis (significant reduction of mineral density) does not show the "sugar" bone will not endure the introduction of metal needles, and at the site of the installation will be quickly recovery (resorption) of tissue bones.Therefore, a timely solution for the issue of endoprosthesis needs is so significant - it should be accepted when you grow old and the general condition of the human body still enable the operation of the operation.
Despite the wide distribution of the endopripetics of the common knee, the results of such operations are often unsatisfactory, and the percentage of complications is high.This is due to the characteristics of endoprothes design and the complexity of the surgical intervention (replacement of the hip joint is much easier in technical terms).
Arthromedullary Shunting- Connection of bone marrow channels Noise with the hull hose joint with a shunt - hollow metal pipe.Therefore, the fatty bone marrow from the lower third of the femur enters the joint of the knees, feeds the cartilage and lubricate it, which achieves a significant drop in pain.
Summing the above, I would like to note that the treatment of gonartrosis is a complex social task.And although today medicine cannot offer a medicine that eliminates it forever, or other ways to complete this disease, a healthy lifestyle, in a timely manner, seeking medical assistance and the implementation of medical recommendations may suspend its progression.