Knee osteoarthritis — a progressive degenerative-degenerative pathology. He shoots first, cartilage tissue, then destructive process of the bones.
Increasingly the development of osteoarthritis of the reasons physical load, low physical activity, metabolic and endocrine disorders. Leading clinical findings, pathology, pain, walking increased functional insufficiency of the knee and deformation. Evolving as osteoarthritis progresses, ankylosis (full or partial immobilization of the joint). When placing the results of instrumental diagnosis directs the Orthopaedic Research — arthroscopic surgery, radiography, SA, MRI. Severity 1 and 2 pharmacological drugs that are used in the treatment of osteoarthritis, exercise therapy, organized, physiotherapy treatments and massages. Conservative treatment pathology or ineffectiveness in determining the patient total knee replacement prepare the final stage.
The characteristic properties of diseases
Knee osteoarthritis (gonarthrosis) — the most common diseases, eye-catching, this is a joint. Under the influence of internal and external negative factors is the result of cartilage tissue, lack of nutrients. As a result, the slow regeneration of the nutrients broken and connective tissue structures. Hyaline cartilage is of premature aging. Those thins crack, dies, rough, strength, elasticity and flexibility. Its basic feature you cannot already cartilage — the low friction at bone joints. Subchondral bone is exposed and compressed, osteodejeneratif produce them changes. To stabilize the knee during walking grow, the edges flattened bone plaque formation osteophyte (bone growth).
Osteophyte of the knee joint.
The effects of initially healthy hyaline cartilage as a result of primary osteoarthritis, innate reduction, functional endurance. A secondary pathology caused by defects of already existing cartilage. They provoked previous injuries of the knee joint inflammatory process, aseptic necrosis, hormonal changes, background, metabolic disorders.
| Clinical and radiographic knee osteoarthritis | Custom signs |
| First | Knee mobility decreases slightly, stroke, joint space fuzzy, a little narrowed. Osteophyte formation bone formation observed at the edges of the plates a small amount of |
| Second | Flexion or extension of the knee in the tough sounds, clicks, crackle. NOV is moderate atrophy, narrowed joint space, osteophyte formation, a significant number of bone subchondral osteosclerosis detect |
| Third | The knee joint deformed, sharp limited mobility. Bone growth observed numerous full or partial mixing of the joint, subchondral cysts, pathological formations, a freely moving joint |
Causes and precipitating factors
Impetus to the development of destructive and degenerative cartilage process happens because the yellow immediately several negative factors. The development of osteoarthritis of the knee the cause for the violation of childhood and adolescence for the formation of ligament-tendon apparatus, dysplasia. This, in turn, the cause is hereditary predisposition. The destruction of the cartilage injuries that can provoke the various fractures, severe bruises, sprains, ligament rupture, partial or complete, Nov, tendon, meniscus. Promote the development of joint pathology overload. Post-traumatic osteoarthritis develops, few (3 to 5) years after the damaged bone or connective tissue structures. Pathology may occur after surgery. Also, incompetent doctors and causes significant cartilage damage and slowly heal. Predispose to the emergence of this disease, the following factors:
- excess body weight, which almost all Nov structures-skeletal system, especially the knee, of course overload;
- excessive physical activity often why micro-education, the more destructive processes of cartilage and progress;
- a sedentary lifestyle, in which blood flow is disrupted, and the lack of nutrients in the hyaline cartilage of the foot;
- the system of inflammatory and degenerative-degenerative pathology — rheumatoid arthritis, psoriatic arthritis, gout, osteoporosis, lupus erythematosus.
Clinical picture
In most cases, which shows nagging osteoarthritis of the knee, a dull pain, then another physical load. Why is his formation, osteophyte formation and soft tissue adjacent a stimulating effect on venous stasis, intro-articular hypertension, spasm, Nov. Typical of osteoarthritis, for the "startup" pain, joint swelling due to the crop, or reactive synovitis. Every time a person sits for a long time, then gets up, then the first step, some pain is felt. Emerging and supposedly "in our garden air attack" pain of a periodic character. Knee joints while walking "plates" as a result, the crushing of cartilage tissue between the two surfaces s damaged parts. Also typically for osteoarthritis the following symptoms:
- krepitasyon, crunch or knee flexion or extension, during the change of nature on a background of antoniushof cartilage bone structures relative to each other;
- hardness, intensity, which increases increases, boiling, joint cavity;
- Nov located in spasms, knees, usually that appears to reduce the pain;
- deformation joints, subchondral bone changes triggered destructive.
People climb stairs and long walks because of the constant pain makes it difficult osteoarthritis knee. Along often complex pathology synovitis — synovial inflammation shells. Clinically manifest hyperemia round elastic sealing formation, strong swelling, increased body temperature 37,1—38 °C. in the absence of medical intervention complicated by spontaneous osteoarthritis hemarthrosis (bleeding cavity knee) full or partial loss of mobility of the femoral condyle bone necrosis of the outer patellar subluxation.
Diagnosis
Clinical osteoarthritis, synovitis particularly complex, quite many inflammatory pathologies with similar symptoms, Nov-skeletal system. Therefore, the exceptions for the differential diagnosis of arthritis, the departure of tendovaginitis . Ile instrumental studies determined the degree of the condition the knee joint and functional activity. Diagnosis of osteoarthritis most informative radiography. The difference in the received image of osteophytes, narrowed joint space, bone deformation structures (cysts, subchondral osteosclerosis). Symmetric joint space narrowing of the knee joint affected by osteoarthritis of the cracks. Probably, of course, you will have two transactions every limb. To assess the changes in more detail let yellow cartilage, ultrasound, MRI, sa. Studies also are tracked to identify inflammatory or degenerative lesions in the center, soft tissue, Nov, ligaments and tendons. If necessary, arthroscopy is minimally invasive surgical manipulation. The diagnostic process of the inner surface when it is scanned biomaterials an unforgettable stay fence — synovial membrane, synovial fluid, cartilage tissue. Dedicated to improve the output of a puncture with his sons during both pathological patient taken with an ideal base for exploring composition.
Tactical therapy
Severity of osteoarthritis of the knee quite well 1-defying treatment with exercise therapy and long-term chondroprotectors. It is usually not necessary to use, it is not possible to have symptoms such as pain relief medications, gloss or missing altogether. Conservative treatment of osteoarthritis of the knee 2 degrees. But if the disease progresses, the cartilage tissue destruction or a significant amount of diagnostic, surgical procedures, arthroplasty usually. In some cases, arthrodesis is indicated in patients with artificial analog of aspiration, or full immobilization of the knee.
Non-drug therapy
The patient 2 or 3 degrees of osteoarthritis, treatment is recommended on the first day wearing hard or semi-rigid orthosis, a knee joint that restricts mobility significantly. The use of slightly damaged cartilage sufficiently soft elastic bandage — bandage. The joints they record, warn, more tissue destruction. Patients to reduce motor activity, not to lift heavy weights, to prevent long-term within walking distance. Assigned to physiotherapy treatment (5-10 sessions) to increase blood circulation and regeneration of connective tissue structures in the knee:
- magnetotherapy;
- laser therapy;
- high frequency electrotherapy;
- savers with electrophoresis anesthesiology and cartilage;
- ozokerit with applique and (or) paraffin.
To strengthen Nov-fiber machinery and physical therapy exercise therapy to improve motor function just the knee along the courses. The doctor selects for each patient individually according to LFC's degree osteoarthritis exercise and physical preparation. To go through his first training under control. Osteoarthritis is strictly prohibited, any heavy traffic. They will improve blood circulation, but at the same time the trigger mikrotemperaturnye more cartilage. Should be moving in soft, measured small amplitude. You can repair cartilage with early destructive changes resulting in the treatment of gonarthrosis exercise. Good has established itself, and leech therapy, therapeutic or medicinal leech. In the absence of the Joint put 3-4 readings Leech, usually the area of the patella. Annelids and squirt bite skin, blood, saliva, a large amount of biologically active substances.
Pharmacological drugs
Glucocorticosteroids are tracked in the center of the knee with severe pain medicated to eliminate the blockade. Hormonal drugs are usually combined anesthesiology. Intra-articular corticosteroid injections in osteoarthritis is characterized by side and is made of only the immediate need during the manifestation. Most commonly applied in the treatment of osteoarthritis non-steroidal anti-inflammatory drugs, drugs, etc .. forms:
- for injecting solutions;
- pill;
- ointments and gels.
Included in this treatment scheme as chondroprotectors injection or pill. These tools promoting the regeneration of worn cartilage, anti-inflammatory, analgesic and antitumor activity. Knee pain is a podiatrist for emergency treatment to be any signal. A timely treatment osteoarthritis that prevent the development of serious complications, disability and in some cases alerts you sick.