How to treat arthrosis of the knee joint( gonarthrosis)?

Osteoarthritis of the knee joint( gonarthrosis) is a progressive degenerative disease, which is based on thinning and damage to the cartilages covering the articular surfaces of bones.Due to such pathological changes, the joint loses its functionality and gradually deforms, and in the started cases it becomes completely immobile.

To prevent the development of serious consequences of gonarthrosis( limb deformities and ankylosis - joint immobilization), when a patient can only be helped by a joint replacement operation, the disease must be identified and treated in a timely manner.And to treat not independently by popular methods and advertised means, but under the supervision of qualified doctors.

Table of contents: Methods for the treatment of arthrosis of the knee joints Conservative methods for treatment of gonarthrosis

Methods for treating knee arthrosis

All methods of treating this disease can be divided into two large groups: conservative and operational.

Conservative methods include:

• Treatment with medicines.
• Physiotherapy.
• Manual therapy.
• Therapeutic physical training.
• Special diet.

It is possible to treat gonarthrosis with strictly conservative methods only at the initial stage of its development, when pathological changes in the joint are limited to dystrophic changes in the cartilage, disturbances in the functioning of the synovium and inflammation.If the disease goes to the second stage, accompanied by the destruction of the cartilaginous tissue, the formation of osteophytes( bone growths), and even greater deterioration of the synovial membrane, doctors have to resort to intraarticular injections and minimally invasive surgical interventions performed by the arthroscope.

In the case of diagnosing the disease in the third stage, it is impossible to fully restore motion in the joint with conservative and minimally invasive surgical methods. The only way out for such patients is arthroplasty of articular surfaces - a complex and expensive operation.

Conservative methods of treatment of gonarthrosis

The complex of therapeutic measures for gonarthrosis should solve the following tasks:

• eliminate pain;
• to reduce inflammation if present;
• to improve the trophism of cartilaginous tissue and thereby contribute to its recovery;
• activate blood circulation in the affected area;
• strengthen the muscles surrounding the joint.

All these tasks are completely solved if we correctly combine medical treatment with manual therapy, physiotherapy procedures, exercise therapy and nutrition, which provides the body with the necessary substances for the restoration of cartilage.Let us consider in detail each of these methods of treatment of gonarthrosis.

Diet for arthrosis of knee joints

In the diet of patients with arthrosis, products useful for joints should be present daily:

• sources of amino acids - lean meat and dairy products;
• sources of collagen - gelatin and meals from it;
• sources of essential fatty acids - vegetable oils, some varieties of fish( herring, mackerel, etc.);
• sources of sulfur and selenium - beef and chicken, eggs, legumes, cereals, apples, cabbage.

In addition, it is important to observe several more rules:

• Limit the intake of salt to 1 teaspoon per day.
• Drink enough fluids.
• Take food 4-5 times a day.
• Completely abandon semi-finished products, sausages, sausages, etc.

In addition, gonarthrosis of the knee joint very often occurs against the background of obesity, so an important component of the treatment of such patients is a reduction in body weight, which can only be achieved by dieting( sports do not help, because excessive physical activity is harmful to the unhealthy joint). To lose weight, you must stop eating foods that contain harmful fats and "fast" carbohydrates:

• sweets and confectionery;
• mayonnaise and all kinds of shop sauces;
• fatty meat;
• cream and sour cream of high fat content;
• margarine, spread;
• sweet drinks;
• chips, salted nuts and crackers;
• fast food.

Medications for arthrosis of the knee

The main complaint of patients with gonarthrosis is pain, which people tend to seek medical help for. Therefore, at the first stage of treatment, doctors prescribe such non-steroidal anti-inflammatory drugs to such patients, which allow reducing pain and inflammation( if any). Physiotherapy, manual therapy and exercise therapy are prescribed after the patient feels better.

Because of the mass of side effects, it is allowed to take non-steroid preparations inside only in short courses.But painkillers and anti-inflammatory drugs for external action( ointments and creams) can be used for a longer time.

The non-steroidal anti-inflammatory drugs recommended for gonarthrosis include:

• diclofenac;
• indomethacin;
• meloxicam;
• piroxicam;
• ketoprofen and others.

In severe cases, intra-articular hormone injections can be used to relieve pain and reduce inflammation.

Chondroprotectors and hyaluronic acid for arthrosis of the knee

Anti-inflammatory and analgesic agents are only symptomatic therapy, they do not affect the cartilage state( they even contribute to their destruction during prolonged use). The main component of gonarthrosis treatment should be the use of drugs that contain substances that restore the structure of cartilaginous tissue and protect it from further damage.These drugs include chondroprotectors and hyaluronic acid.

The main components of chondroprotectors are glucosamine and chondroitin sulfate - the structural elements of cartilage. Chondroprotectors are produced in tableted and injectable forms( for intra-articular administration).To obtain a real result of the treatment, these drugs must be taken for 3-5 months( with mandatory interruptions).Such courses should be passed a minimum of 2-3.When using injection chondroprotectors, the course of treatment should consist of 12 injections, it is recommended to repeat it 2-3 times a year.Wait for the first improvement is only a few months after the start of therapy.

Another modern treatment for arthrosis is hyaluronic acid, , which when inserted into the knee envelops the articular surfaces of bones, increases the elasticity of the cartilage and protects them from further destruction.Thanks to therapy with preparations containing sodium hyaluronate( another name for acid), the friction of the joint surfaces decreases one another, the intensity of pain sensation decreases, and as a result, the mobility of the joint increases.

Applied hyaluronic acid courses of 3-4 intra-articular pricks with an interval of 10-14 days.Patients, as a rule, tolerate such procedures well and do not notice any side effects of the drug.However, the disadvantages of hyaluronic acid are - this is a high cost, although it can not be compared with the cost of arthroplasty.

Physiotherapy and chiropractic therapy in the treatment of gonarthrosis

Among the physiotherapeutic methods of treatment of arthrosis of the knee joint, the following are preferred:

• laser therapy;
• ozokeritotherapy;
• paraffin therapy;
• sonication;
• cryotherapy;
• mud procedures.

All these physiotherapeutic methods activate blood circulation in the joint area and thereby improve cartilage nutrition.

Manual therapy is of no small importance in the treatment of gonarthrosis. Manual therapists are used for knee arthrosis with two techniques:

• mobilization( smooth stretching of the affected joint and the release of articular surfaces);
• manipulation( joint adjustment).

If the procedure of manual treatment is carried out by an experienced specialist, the patient practically does not feel any discomfort and soreness.In addition, after the first treatment session, many patients notice significant improvements - pain is reduced, the joint becomes more mobile.Strengthens and potentiates the results of manual therapy with the use of chondroprotectors and intra-articular injections of hyaluronic acid.

Knee joint arthrosis

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Patients with gonarthrosis usually spare the affected knee, try to walk less, and generally move, from which the muscles and ligaments weaken.Such hypodynamia negatively affects the state of the cartilage itself, because during movements it absorbs nutrients in the synovial fluid like a sponge.If there are no movements, dystrophic changes in the cartilaginous tissue progress.Therefore, dosed physical exertion is extremely necessary for gonarthrosis.They help to strengthen the muscles, increase blood flow in the knee and restore joint mobility.

The complex of exercises for the treatment of arthrosis of the knee joint for each patient is selected individually. In this case, the doctor takes into account the depth of the pathological changes in the joint and the functional state of the person. In addition, the following requirements are necessarily taken into account:

• in the complex should not include exercises that strain the joint( the knee should not bend strongly and unbend);
• to increase the volume of movements in the joint should be gradual;
• movements should not be sharp;
• performing exercises should not be accompanied by pain in the knee.

One of the sets of exercises for arthrosis of the knee joint is presented below:

It is possible to begin exercises of exercise therapy only when the joint is not inflamed and painful .During periods of exacerbation of the disease, the knee needs rest, and the patient - analgesic and anti-inflammatory treatment.

It is best to practice physical exercise in a specially equipped hall under the supervision of an instructor.In the future, you can train yourself at home, but to do this, the specialist must teach the patient the correct exercise.

Zubkova Olga Sergeevna, medical reviewer, epidemiologist