Osteoarthritis of the knee — progressing degenerative diseases-degenerative disease. To begin with, it reaches the tissues, the cartilage, and then, in the destructive process of the involved bony structures.
The cause of the development of osteoarthritis make sure high levels of physical, motor, low activity, metabolic and endocrine disorders. The main clinical manifestations of the disease, — the pain increased when walking, lack of functional knee-joint, and air bubbles. To the extent that the progression of the arthritis, develops, ankylosis partial or total immobilization of a joint). When making the diagnosis of limb-focuses on the outcomes of the research tools that are available — arthroscopy, x-ray, computed tomography, magnetic resonance imaging. In the treatment of osteoarthritis of the 1-and 2-degree-of-gravity, are used drug of drug therapy for a year, they are carried out sessions of physical therapy, and massage treatments are available. When failure of therapy is conservative, and identification of the pathology is in its final stages, the patient is prepared for surgery at the joint replacement of the knee joint.
The characteristics of the disease
Osteoarthritis of the knee (gonarthrosis) — one of the most common disorders diagnosed affect this joint. Under the influence of internal or external factors affecting the cartilage and the tissues occurs with a deficit of nutrients. The result is a broken, trophic, reduces the regeneration of connective tissue structures. It occurs in the premature aging and hyaline cartilage. It fine-tunes, crack it, it becomes irregular, loses its strength, firmness and elasticity. The cartilage tissue, it can no longer fulfill its main task — to reduce friction in the joint of the bone. Subchondral bone bare, compacted, these occur in osteosclerotic changes. For stabilization of the knee joint along the way to grow up, flattened the edges of the plates to the bone with formation of osteophytes (bone tumors).
Bone spurs in the joint of the knee.
The primary-to-win, we have to be infected in the initially healthy cartilage, hialina, resulting in moments, reducing your functional strength. However, the pathology that occurs when the already existing defect in the articular cartilage of the body's tissues. They can also be caused by a pre-existing injury or joints of the knee, the inflammatory process, necrosis, aseptic, hormonal changes, disorders of the metabolism.
| Clinical-radiographic stage of osteoarthritis of the knee | The specific signal |
| The first | The mobility of the knee joints is slightly decreased, and the edges of the crack and joint becomes ambiguous, there is little to pick up. At the edges of bone, the lps can occur in the formation of a very small number of bone spurs |
| The second | During flexion and extension of the fine people of listen for pops, clicks, sounds like a cracking, popping or snapping sound. The muscles moderately, it is withered, and visibly close to the articular cleft is made up of a significant number of osteophytes, the bony tissue is detected, subchondral osteosclerosis |
| The third | The joint of the knee is deformed and drastically limited mobility. Occurs in a total or partial joint fusion in the slot, a large number of tumors in bone, subchondral cysts, and pathological formations, moves freely in the cavity of the joint |
The causes and factors that may cause the
The impetus for the development of ndt-degenerate process, hyaline cartilage is usually to a number of factors will last. For the sake of the development of osteoarthritis of the knee in children and adolescents is the disruption of the formation of the ligament-tendon unit, dysplasia. This, in turn, is due to an inherited predisposition. Lead to the destruction of articular cartilage in a wide variety of injuries — fractures, severe contusions, dislocations, partial or complete breaks in the ligaments, muscles, tendons, ligaments, menisci. Stress on the joint lead to the development of the disease. Post-traumatic osteoarthritis develops over several (3 to 5) years after the damage to the connective tissues or bone structures. The condition can occur after the surgery. And the reason is not the lack of skill of the doctors, and to the considerable damage of the articular cartilage, and its slow regeneration. The occurrence of the reported diseases also predispose to the following factors:
- the excess weight of the body, where nearly all of the structures of the musculoskeletal system and, in particular, to their knees, exposed to excessive loads;
- excessive physical activity often leads to microtraining in the tissues of the articular cartilage and the progression of the destructive processes;
- a sedentary lifestyle, which worsens the blood supply to the legs and can create a deficit of nutrients to the hyaline articular cartilage;
- the system of inflammatory and degenerative diseases degenerative disease — arthritis, psoriatic arthritis, gout, osteoporosis, systemic lupus erythematosus.
The condition of the
In the majority of cases of osteoarthritis of the knee it manifests as nagging, dull pain after, regular physical activity. The cause of their occurrence from the accounts of it, if the effect of the injection bone spurs in the coming of the soft tissues, venous stasis, dentroarticular high blood pressure, muscle spasms. For the arthritis, it is typical for the "top" of the pain, which appears due to the swelling of the joint, or reactive synovitis. When a person is in a seated position, then stand up, so the first step, if you feel any pain. There were the so-called "siege" of the pain of a recurring character. The joints of the knee during the trip, "the firm as a result of the crushing of the damaged parts of the tissues of the cartilage between the two surfaces of the joint. Also, for the of the arthritis, ma-talkie udogodnienia jak x one of the following symptoms:
- scratching or denting, during the flexion and extension of the fine on the knee, which are formed when the displacement of bony structures relative to each other in the middle of the Antoniushof cartilage;
- the rigidity, the severity of which increases as the fit to articulate in the slot;
- muscle spasms are located in the region of the knee (usually up to reduce the pain.
- the deformation of the joint due to a destructive change in subchondral bone.
When you read a person, it is difficult to climb stairs, take long walks because of the constant pain in the right knee. While the medical condition often have a history of complicated and synovitis — inflammation of the joint tissues and shells. Clinically, they manifest themselves in the formation of a rounded, rubber seal, hyperemia, strong edema, increase of body temperature up to 37,1—38 °C. in the absence of medical treatment for the osteoarthritis, it's tricky to be spontaneous in a hemarthrosis (bleeding into the cavity of the knee joint), in whole or in part, to the loss of mobility in the osteonecrosis femoral condyle (outside) subluxation patellar.
The diagnosis
The clinical presentation of the arthritis, especially in complicated, synovitis and very similar with many of the symptoms of inflammatory diseases of the musculoskeletal system. For this reason, the differential diagnosis for any exceptions to arthritis, tendonitis, of the tendovaginitis. With the help of search tools to determine the state of the knee-joint, and the degree of physical activity. The diagnosis of arthritis, the most informative x-ray. On the received images of the well-marked established, bone spurs, narrowed joint cleft, the deformation of bone structures (cysts, subchondral osteosclerosis). The symmetrical narrowing of the joint cleft, the joints of my knees, which have been put to death with the win. Is likely to expose the operation, you will need both of them to the states. In more detail, to assess the changes in the hyaline cartilage that allow for an ultrasound scan, magnetic resonance imaging, computed tomography. The survey is conducted to identify inflammatory or degenerative lesions of the soft tissues, muscles, ligaments, and tendons. When necessary to perform the arthroscopy operation, a minimally invasive operation. In the process of carrying out the procedures of the diagnosis, scanned the inside of the joint, it's made of some bio-based materials — the synovial shell, liquid oxygen, joints, cartilage, and tissue quality. When a synovitis with the location of the punch is extracted from the pathological exudate to improve the well-being of the patient, and the study of its composition.
The method of treatment
Osteoarthritis of the knee in the 1-degree-of-gravity, rather it responds well to treatment with the department of physical education, and in the course of the time-limits for receipt of chondroprotectors. Usually, there is no need for the use of prescription painkillers, as well as the symptoms expressed are not brilliant or completely gone. When you read of the tribe of the 2-level is also applied to a conventional treatment. But if the disease has progressed, or to be diagnosed with the destruction of a significant amount of tissue and cartilage, an operation that was usually there. In some cases, the patients are shown in the arthrodesis — artificial analog-to ankylosis, or complete immobilization of the knee joint.
Non-drug therapy
Patient-to-win, 2-or 3-degree-from the first days of treatment is recommended for wearing in a rigid or semi-rigid orthosis would significantly restrict the mobility of the knee joint. A slight injury of the articular cartilage, allow the use of a permanently elastic-soft build — cushions of the knee joint. They will register with the joint in an effort to further the destruction of the body's tissues. Patients should result in a decrease in the physical activity, don't lift the weight, to avoid a long walk. They are assigned to a physical therapy (5 to 10) in order to improve the circulation of blood in the knee joint, and to stimulate the regeneration of connective tissue structures:
- the magnetic therapy;
- laser therapy;
- high-frequency electrotherapy;
- electrophoresis with painkillers and protectors of the articular cartilage;
- stunning, with ozokerite and paraffin.
Strengthen the lesions of muscular-ligamentous apparatus and to improve the motor function of the knee joint to help-only classes on a regular basis to deal with physical exercises. The doctor picks up the therapy and for the year of exercise an individual basis for each patient taking into account the extent of the arthritis, and physical condition. The first workout is under your control. When you win, is expressly prohibited on any of the heavy moving. To improve the circulation of the blood, but at the same time, lead to even more mikrotemperaturnye of the articular cartilage. The movements should be gentle, to be measured with a small amplitude. In the early stages of gonarthrosis there were changes in the articular cartilage, can be solved by using the only by the ministry of education in the physical. Good to set yourself hirudotherapy, or treatment of the medical infection of the blood. When there is no information on the joint is placed in the 3-4 to give, generally in the region of the knee cap. Ringed worms, biting your skin, and when injected into the blood, the sputum, with a large number of biologically active substances.
Pharmacological drugs
With a view to the resolution of a sharp pain in the knee, they are carried out drug screen corticosteroids. Hormone are often combined with anesthetics. Intra-articular injection, when you win, they are only carried out when an urgent need, as well as corticosteroids which is characteristic of so-called effects of the exposure. The most commonly in the treatment of arthritis, is applied to the anti-inflammatory non-steroids and in a variety of drug forms:
- solutions for parenteral introduction
- tablets;
- creams, and gels.
In the therapeutic scheme, which is necessarily included chondroprotectors in the form of injections or tablets. These tools can also stimulate the regeneration of the wear and tear of the cartilage, has anti-inflammatory, analgesic and swelling in on the action. Any pain in the knee, there should be a signal to immediately gain access to speech. In a timely manner, spent for the treatment of arthritis will help to prevent the development of serious complications and, in some cases, warns the disability of the patient.