Have you ever had knee pain? It will be very uncomfortable when you suddenly become weak or unable to go downstairs on your knees. Arthritis of the knee joint is not life-threatening, but it can greatly deteriorate its quality.
What is knee joint disease?
Knee joint disease(Arthritis, osteoarthritis, knee osteoarthritis). Gonorrhea is arthritis of the knee joint (this disease has nothing to do with gonorrhea). In advanced cases, surgery alone is sufficient. Do you need it? Then don't let yourself fall into that state.
Causes of knee arthritis.Distinguish primary and secondary arthritis of the knee joint. If the cause cannot be determined, this type of arthritis is called primary arthritis, which is inherited through the maternal line. If the grandmother suffers from knee arthritis, then the daughter and granddaughter may develop the disease at a young age.
Secondary arthritis is caused by trauma, congenital knee abnormalities, body overload (exercise, occupation), and endocrine disorders.
The risk factors are overweight, female, and old age. Cartilage is very sensitive to the reduction of female sex hormones. With the development of menopause, all joints begin to "collapse". Therefore, older women who are overweight are more serious and suffer from knee arthritis more frequently.
Knee anatomy.The knee joint is formed by the femur, tibia and bone. The joint surface of the bone is covered with a layer of cartilage. The extra cartilage spacer between the bones is called the meniscus and has a cushioning effect. The synovium of the knee joint is the largest, forming a large elbow and bursa.
The joint cavity is filled with synovial fluid, which can nourish articular cartilage. Synovial fluid contains hyaluronic acid, which is necessary for smooth sliding of joint surfaces. Ligaments, muscles and tendons guide and restrict joint movement.
General instructions.With arthritis of the knee joint, destruction of articular cartilage occurs. Knee joint disease is divided into three stages. In the first stage, the nutrition of the articular cartilage and meniscus is destroyed. The cartilage loses its elasticity and ruptures. Abnormal friction between the bones. Joint overload is accompanied by inflammation and pain in the knee.
In the second stage, the joint cartilage and meniscus are destroyed. The bone's response to load is marginal growth-osteophytes ("thorns"). The amount of fluid in the joint decreases and the joint space becomes narrower. As a result, knee pain has already occurred during normal exercise and walking.
In the third stage, natural movement was significantly restricted, resulting in significant bone deformation of the knee joint.
Symptoms of knee arthritis.The main symptoms of arthritis are pain, restricted mobility and deformity of the knee joint. Arthritis of the knee joint is long-term, and symptoms increase slowly and irreversibly. If the knee pain suddenly appears, it is probably not arthritis.
Arthritis of the knee joint gradually begins with overload, long walks, discomfort or slight pain in the knee when ascending from a squatting position when going downstairs. When resting, the pain passed quickly.
In the second stage, knee pain has already appeared from normal exertion. The amount of active movement of the knee joint is reduced. The shape of the joint changes due to bone deformation and the accumulation of abnormal fluid in the joint.
In the third stage, pain becomes chronic, not only during exercise, but also during rest. Pain at night can disrupt sleep. It is difficult to lie on the bed without pain in the knee. Swollen joints indicate inflammation. The knee joint range of motion is reduced to a minimum.
The joints are obviously deformed and the legs become O-shaped or X-shaped. In severe cases, the joints will be completely destroyed as the ankylosis develops (immobility).
There are four types of pain in knee arthritis:
- Mechanical pain is produced under the influence of physical activity during the day and subsides during the night rest period. These knee pains are related to the reduced shock absorption capacity of cartilage and bone structure. Knee pain is usually located in the front and internal areas of the knee joint and the upper part of the lower leg.
- Nocturnal pain is related to venous blood stagnation, increased intra-articular intraosseous pressure and inflammation.
- After a period of "rest", the "start" pain appears and disappears 15-20 minutes after joint movement. These knee pains are caused by friction on the joint surface, where cartilage attenuated debris is deposited on the joint surface.
- Persistent knee pain is caused by muscle spasms and the development of synovitis.
Complications of the knee joint.Synovitis is inflammation of the synovial membrane, which covers the joint cavity from the inside. Signs of inflammation: swelling, fever, redness, pain, joint dysfunction.
Usually, the knee joint contains 3-5 ml of synovial fluid. As joint disease occurs, the production of inflammatory fluid increases. The amount of effusion (pathological fluid) can reach 30-70, or even more than 100 ml. Knee fluid first fills the cavity inside the bone (medial fossa). As the volume increases, the upper bowel volvulus fills up, and a huge swelling appears above the bone ("saddle").
The occurrence of Baker's cyst is related to a significant increase in the amount of fluid in the joint cavity. Round elastic protrusions are formed in the upper jaw area. This is not a tumor, nor is it an oncology, and does not require surgery. Baker's cyst can cause knee discomfort, pressure and pain when moving. The diameter of the cyst is 2 to 6 cm or even larger. The cyst can squeeze the nearby peroneal nerve, causing weakness and numbness in the foot.
Diagnose the knee joint.Laboratory tests are not helpful for diagnosis, but can be used to rule out other conditions of knee pain. When suffering from arthritis, there is no inflammatory change, and the blood cell counts of white blood cells and ESR are within the normal range. The rheumatism test was negative. Uric acid levels are within the normal range.
X-rays show bone changes in the joints, excluding the traumatic cause of joint pain. In our country, X-ray classification of arthritis by stage is used.
Stage 1-The marginal bone growth exists, and the joint space is slightly reduced;
Stage 2-The joint space becomes narrower and subchondral sclerosis occurs;
The third stage-the joint space narrows sharply, the joint surface becomes flat, and the cyst develops;
MRI of the knee refers to the early stage of the disease. Radiological changes are not visible at this time, but the patient will have typical knee pain. With MRI, you can assess the condition of cartilage, meniscus, ligaments, and tendons. Ultrasonography of the knee joint helps to visualize the soft tissues (meniscus, muscles, ligaments) to assess the amount of fluid accumulation.
Arthroscopy is the most accurate way to diagnose knee arthritis. A special probe is inserted into the joint cavity, and the doctor evaluates the extent of cartilage destruction under a microscope.
Knee joint disease treatmentA daunting task was presented. In each case, you must choose a separate treatment program.
When you start to say something plain during the consultation, the patient will look surprised at the first moment. Is this our purpose? Give a magical injection so that my knee won't hurt again. We must explain that there is no single way to eliminate joint disease. To regain health, you need to move, lose weight, and register for the swimming pool. A person wants to lie on the sofa, grow a "beer belly", use a pile of drugs to catch the problem and stay healthy. What a pity!!! In this case, medicine is powerless.
Analgesics cannot cure, but only relieve pain. Anti-inflammatory drugs are prescribed only when knee joint pain gets worse. Some non-steroid drugs help to further destroy cartilage by relieving pain. Healing ointment cannot cure knee joint disease, but it does help slightly reduce knee pain. For edema, redness of the joints, ointments and hot compresses are contraindicated; it is best to use topical therapy together with non-steroidal anti-inflammatory drugs.
Cartilage protective agents cannot relieve pain, are expensive, and need to be taken for a long time. I think they are "dummy" and I don't actually appoint them. Currently, avocado and soy extracts have appeared in pharmacies, but I have not used this drug in my clinical practice and have no opinion on its effectiveness.
In order to treat and prevent knee joint arthritis, it is necessary to perform appropriate physical therapy exercises in a sitting or lying position. Squatting and jumping are strictly prohibited. Cycling, swimming or exercising in the water, skiing are all useful. Labor exploitation in the country often leads to increased knee pain. If the knee joint has arthropathy, it is not recommended to run, walk uphill, and do not lift weights.
The diet is knee arthritis.The knee joint bears the load in the form of its own weight. Therefore, overweight people need to lose at least 3-5 kg. Some patients need to lose more than ten kilograms. Otherwise, any treatment will be ineffective. There is no need to "sit" on a certain diet, it is harmful to the body.
You need to change your eating habits for the rest of your life, just "stop loving" all harmful products (sweet, starchy foods, beer, etc. ). Eating correctly should become a habit. In order to lose weight, you need to eat the right food every 3 hours.
In order to reduce joint inflammation, homeopathic doctors recommend eating foods that alkalize the blood and the fluid in the joint cavity. For this reason, the consumption of meat must be strictly limited, and the content of vegetables and fruits in the diet must be increased.
It is believed that sausages, sausages, smoked meat, fast food will enhance the inflammatory process of the joints. I recommend that you consume properly prepared jelly meat instead of using medicinal cartilage protective agents.
Orthopedic correction can reduce the pressure on the knee joint. If the knee joint is painful, you need your bones. In late cases, it is recommended to walk with crutches. When shortening the legs, it is recommended to use heel insoles. Recently, the use of sports tape is fashionable. These are tapes made of natural cotton and stick around the affected knee, not restricting its mobility, but helping to relieve joints and reduce muscle spasms.
I think that electrical stimulation between tissues is the most effective way to treat joint pain. Combining VTES with hirudotherapy and medical acupuncture can produce very good results. I will give a case from practice.
A 54-year-old man with stage II arthritis of his right knee asked me for help. Knee pain troubled him for 6 years. Over the years, he has been trained in many medications, physical therapy, glucocorticoid block and repetitive courses in the rehabilitation center. But the patient's condition will only worsen. He came to me to ask whether he agreed to perform joint replacement surgery or try other methods conservatively. I didn't have to persuade him for a long time, he immediately agreed to the treatment I proposed.
In the first class, I gave him 6 water ches, which helps to cope with joint swelling and eliminate night pain. The knee becomes easier to move. The man breathed a sigh of relief. Then, we performed three interstitial electrical stimulation surgeries and almost completely stopped the pain syndrome.
Since then, success has been consolidated by introducing homeopathic medicines with anti-inflammatory and chondroprotective effects in the acupoints. Three weeks after the start of treatment, the patient threw away the cane and began to move around freely, without going. Three years have passed since then. The knee pain did not recover. Once a year, we conduct a preventive VTES meeting.
In an emergency, injecting hormones into the joint cavity is very effective and can relieve severe pain, swelling and inflammation. The indication is exudate, it is forbidden to use corticosteroids to block "dry joints"! They can temporarily relieve pain, but the injection itself does not cure arthritis, and the cartilage after them is destroyed more. It should be done by specially trained doctors who should fully understand the indications, contraindications, medications and points of use. There are no more than 3 blocks per joint in total.
After the swelling and inflammation are eliminated, a hyaluronic acid preparation called a liquid prosthesis is injected into the joint. They act as natural lubricants on joints, improve the sliding of the bone surface, and restore the shock absorption function of cartilage. But hyaluronic acid preparations are expensive and can only last for 6-8 months. It is meaningless to take hyaluronic acid preparations for patients with complete loss of joint space and patients over 65 years of age.
Treat with folk remedies.You can use cture cream or water decoction together with radish, horseradish or ginger, turpentine bath.
An intra-articular prosthesis examination should only be performed if the knee joint is severely dysfunctional, because the joint must be replaced again after 10 to 15 years. Is there enough strength and health to undergo general anesthesia and subsequent rehabilitation every 10-15 years???? Therefore, do not rush to agree to the operation! Take care of your joints!