The arthrosis of the knee joint combines two processes: the destruction of cartilage and the growth of osteophytes or bone spurs.The stadium of the process is determined by the X -ray.Arthosis is believed to be the destruction of the knee joints with age, the natural aging process.The causes are muscle weakening and poor blood supply to the fabrics.How to treat you without surgery?Delete the factors that have reduced muscle tone.
Causes
The causes of arthrosis are not yet determined by medicine,Only risk factors are appointed:Over 45 years of age, knee injuries and overweight.Almost 50% of the adult population never complained about the knee joint.
With arthrosis, the cartilage that lines the edges of the bones is abrasion or completely absent.The damaged tissue is not a source of pain, because it has no receptors.Inflammation in nearby structures causes characteristic symptoms.
The body continues the regeneration of damaged tissues, but the cartilage grows in a non -uniform way.Consequently, irregularities are formed that damage other elements of the joint.The nature of osteophytes is explained by the compensation of smooth joint cartilage.Another version indicates that the growth of "spurs"It is associated with an attempt to stabilize the medialy or lateral joint due to muscle hip.
What is the chronic arthrosis of the knee joint?Pain occurs in tendons and ligaments only when muscle forces cease to retain bones and control them.Therefore, the biomechanical causes of pain and arthrosis are distinguished:
- On the background of a long placeThere is a compression between the inguinal ligament and the iliac muscle of the femoral artery and the nerve, which weakens the strength of the front of the thigh and leads to the appearance of tension in the knee cup.
- Sitting in the long term tightens the buttock musclesWeakening them.Instead, the pear -shaped muscles begin to work, according to which the sciatic nerve passes.During its compression, the double head muscle weakens, the corner of the thigh and the lower part of the leg changes.The knee is injured.
- Walking with heelCause tension of the calf muscles, the pelvis takes place, weakens the medium buttock muscles.The femoral bone turns inside, the ligaments are loaded along the inside of the knee, a medial meniscus, the osteophytes grow.
- Flat feetAssociated with the use of uncomfortable shoes, weakening of the main muscles and increased lordosis, the tibial bone towards the outside takes place, which leads to knee pain due to the violation of biomechanics, the development of the cyst of a baker.
The pathological chains that affect the knee are associated with a fall on the coccyx during childhood, scoliosis caused by diseases of the internal organs.People who have a different shoulder height,Over time, they begin to complain about the knee, since the fascial chains on the front of the body include the extensor of this articulation: the muscle of the rectum of the thigh.
Symptoms
The degenerative process interrupts the function of the joint, leads to pain and rigidity.It is believed that it isFrom cartilage and bone, the effect begins on the muscles.The practice shows the opposite -The pain in the knee joint occurs in places of tendon- Fixing of the weakened muscles of extensors, flexors and knee stabilizers.
The main signs of the threat of the wear of the cartilage:
- From time to time, the discomfort associated with the path, the feeling of "not so to set up the leg".
- The appearance of the pain with a direct load on the joint and the muscles, bending and extending it - Tozzo, climb the stairs.
- Knee pain and stiffness after prolonged inaction or rest, for example, when the bed is raised in the morning, which is associated with the stagnation of venous blood.
The main signs of arthrosis are caused by the load on the weakened muscles:
- The knees in the knees are linked to the fact that the buttock muscle and double that extends the thigh does not work and the muscle of the right thigh is excessively extended, creating discomfort in the knee.
- The pain when bending the articulation is associated with the weakness of the flexors: the double head muscle and the tension of the quadriceps tendon.
The swelling is caused by lesions to soft tissues, inflammation of the tendons and joint bag.The appearance of heat in the knee, the swelling indicates the accumulation of inflammatory exudate -Arthosis is often accompanied by Borsite, Sinoviti, tendonitis.
The creak on the knees is painless and traumatic.Clinkles and other sounds do not say that the bones are abrasion.Signs of violation of knee stability -The weakness of one of the controls of the muscles.
The creation caused by the friction of the bone on bone does not occur at the beginning and at the end of the amplitude of the movement, but in the middle,Also with passive flexion of the joint.The blocking of the joint is caused by the wear of the cartilage and tendons, which creates a feeling of fixation.The bones with any movement are controlled by the muscles.Their premature reduction leads to a changed direction of the bone movement, the block.
1 degree
The determination of the degree of arthrosis occurs by radius xrevealing participation in the pathological process of bone structures.Their change indicates that the muscle system has been in an imbalance for 5-10 years.As a rule, peopleFor several years they experience painful pains.
In the first phase of osteoarthritis, which is detected by chance, a slight increase in bone spurs occurs.The growths appear in the places of the maximum instability of the joint.Generally, patients rarely experience pain or discomfort during movement.
The weakness of some muscles is compensated by the function of others, without causing serious spasms and overloads.Running and weight training cause symptoms, since weakened muscles are loaded.The weakness (hypotension) of the muscles is associated with the intake of blood and compromised innervation.
2 degrees
The second phase of arthrosis is considered easy.The X -ray reveals significant bone spurs, but cartilage is not influenced.The amount of synovial fluid is reduced, but the symptoms of pain appear after long walks and running, rigidity in the articulation and pain during bending and position on the knees.
Features x -early arrival of the second phase of knee illegal:
- The pointed edges of the Inter -Scrip tubercles on the tibia, where the cross -shaped ligament is attached;
- narrowing of the joint gap on the medial side;
- The pointed edges of bones condyli on the medial sides, less often in lateral, depending on the development of the Valgus or Varor joint deformation.
For the second phase of LarsenThe narrowing of the joint gap of over 50% is characteristic, but this can only be controlled in dynamics or comparison with a different joint.
3 degrees
In the third phase of osteoarthritisThe pain during the flexion and extension of the joint become constant.During the exacerbation, the articulation blushes and swells, the painful pains do not stop at rest.Around the knee, the swelling appears, an evident deformation of the articulation joints.
Signs of moderate arthrosis of the knee joint in the third phase:
- The joint gap is significantly restricted;
- the presence of subcontracting sclerosis in the loaded sections;
- numerous osteophytes at the edges;
- a rare aspect of subcontracting cysts;
- Sinoviti, the appearance of the cyst of a baker under the knee;
- Irregular surfaces of the femoral and tibia, the loss of the joint joints;
- change in the shape of the patella;
- Focal of calcification and chondro;
The fourth phase is rarely completed by necrotic lesions.Why is arthrosis dangerous?Disease violates the ability to move, it creates dependence on others.
Diagnostics
Orthopedist studies signs of edema, palpa the articulation for pain, studies the active and passive range of movement.Necessarily inspects the lumbar column, becauseIt is there that the nerves pass, which provide the function of the thigh muscles.
The X -ray shows the presence of osteophytes, a change in the space between the femoral bones and tibia, which indicates the loss of cartilage in the knee.Sometimes radius X of the knee joints shows significant signs of cartilage wear, but patients do not feel significant pain.On the contrary, the arthrosis of the first stadium can stop the function of the knee, since the cause of pain are the hypotonic muscles.
If a radius X does not show great changes, thenThe doctor prescribes a magnetic resonance of the knee and lumbar articulation.The diagnostics displays ligaments, tendons and muscles, meniscus to find other sources of pain.
Laboratory diagnostics is necessaryIf you suspect infectious damage to the joint or gout.
Treatment
Arthrosis therapy should be completeaimed at the cause of the disease.With endocrine dysfunctions capable of affecting connective tissues, adequate treatment is performed.Overweight patients are recommendedGo to proper nutrition.The exacerbations are removed with medicines.
Pharmacological treatment
The pharmacological treatment of pain consists inprescription of anti -inflammatory drugs.Non -pounded anti -inflammatory drugs with prolonged useIt negatively affects the function of the stomach.
The treatment regime includes chondroprotectors, which help only when you follow long courses during3-6 months.Pharmacies represent a large number of drugs in this group.
The components of these drugs is believed to help to regenerate the structure of the cartilage, have an analgesic effect.
Controlled studies have recently been conductedAnd they concerned a complex treatment: arthroplasty, physiotherapy, diet.
Attention!The chondroprotectors are drunk in the courses - you can drink a course of a drug and the second course - the other and compare the effect.However, the uncontrolled drug is not the best idea.Before starting to take drugs, consult your doctor.
How and what to relieve pain and swelling?Intra -articular injections are more popular:
- Steroid drugsInhibit inflammatory reactions in terms of immune cells, removing acute pain, articulation joints and swelling.
- Hyaluronic acidIt increases the viscosity of the joint fluid, reducing the friction of the joint surfaces.
Important!The effect of drugs is sufficient for 6-12 months, but at the same time the degenerative processes do not stop.
Surgical treatment
With low efficacy of drugs, patients are offered arthroscopy- A minimally invasive procedure for removing bone growth, articulation audit.If necessary, surgeons perform ligaments and plastic of the cartilage, remove the focals of the worn fabric.
Bone osteotomy aims to change the loading axis on the joint.The doctor cuts the femoral or caps to change the areas of contact of the joint surfaces.The operation is often conducted in young patients.
Total replacement of the knee or arthroplasty articulationIt is required in the serious phase of osteoarthritis (third or fourth degree).Surgical treatment does not always solve the problem, since it requires diligent and daily rehabilitation, muscle strengthening.
Changes in the knee can be compensatory in relation to the basin, therefore, without restoring muscle balance, the hip joint suffers later.
Physiotherapy treatment
In the environment of physiotherapy, mud applications, sounds and magnetic therapy are used.The action of the external factors is addressedStimulation of the blood supply and regeneration of fabrics, relief of inflammation and swelling.
Treatment with folk and non -traditional methods
Recipes of popular remedies for the treatment of arthrosis of the knee joints at home usuallyaimed at removing swelling and eliminating pain.Very often the horseradish leaves and potato are used, sometimes they mix and the vodka for the compressions.
It is impossible to completely stop degeneration.You can influence the exchange in the kidneys using celery juice.The kidneys are associated with the iliac-luxury muscle, which is associated with pathologies of the hip joint.The normalization of the function of the gallbladder and the liver improves the conditions of the knees.
The methods for the treatment of the initial stage of the initial phase of illegal knee include the decoctions of anti -inflammatory herbs:Chamomile, must of San Giovanni, immortality.Mated garbage, sea salt and kerosene are used.Bathrooms with magnesium salts, pine infusions are used.
Manual therapy and massage
Manual therapy for osteoarthritis of the knee joint helps, if a specialist includes unique muscle imbalances.Muscle tests help to find weakened muscles that stabilize the knee, determine the cause of dysfunction and eliminate.
The source can be not only the joint block in the lumbar region,but also dysfunctions at the level of blood supply, internal organs, endocrine and biochemical failures.Therefore, manual therapist must have osteopathy skills, kinesiology applied to influence many factors.
Massage is an auxiliary tool for manual therapy, car -help.A patient with arthrosis of the knee joint can knead independently the tendons of the muscles that control the movement of the limb:
- the area around the large buttock muscle;
- lines on the front surface of the thigh - from the pelvis to the patella;
- The lateral surface of the thigh with a large oscillation to the condensals of the thigh;
- The inguinal area along the inguinal ligament;
- The internal surface of the thigh (along the main channel line).
The massage is performed in point, without very press.
Therapeutic gymnastics
The cause of arthrosis is the weakening of the muscles caused by problems in the lower back, pelvis, abdominal cavity.Perform exercises for the prevention of arthritis and arthrosis of the knee joints for the elderlyIt is possible to increase strength, but not the tone.
Without working on the factors of their weakening with the help of manual therapy, it is difficult to obtain a complete restoration of biomechanics.Yoga further deprives the joints of stability.Among the treatment methods, it is better to preferPilates and Scandinavi walking.
Diet
The food is adapted, first of all, to fight overweight.It is important to abandon sugar and simple carbohydrates, Add products with fiber, magnesium, vitamins of group B and calcium with arthrosis of the knee joint, which are important for muscle activity.AttemptExclude lactiero -caseari products, since almost 80% of the population has lactose intolerance.
Prevention of illegal knee joints
Attempts to strengthen muscles do not always help, since the innervation and the blood supply are not restored.The function of the hip muscles depends on the lumbar plexus.
The changes in the lower part of the back associated with the weakness of the abdominal muscles also influence the knees.Therefore, in men with a "belly of beer", arthrosis is more common, as in women after multi -guide, different genres with diastasis - a weakening of the muscles of the abdominal wall.
The operations in the pelvis and in the internal organs form adhesions that affect the vertebrae of the lumbar region, violating the innervation of the muscles around the knee.
Which doctor to contact with the arthrosis of the knee joint?Diagnosis will help make an orthopedistwhich will insist on the operation.The best results are given by the work of multidisciplinary teams in rehabilitation centers.
The best that can be made for the joints:Eat well, monitor the weight, walk more, visit a masseur or osteopath once every three months.
Reviews on treatment
Positive reviews can only provide complete treatment of the clarification of the knee joint or gonartrosis.Anesthesia, intra -articular injections act temporarily, suppressing a natural inflammatory reaction.
Conclusion
The problem of arthrosis is that drug therapy temporarily eliminates only pain syndromes.The reasons are left without identification and influence.Ergotherapists who teach how to live with the arthrosis of the knee joint can come to help and how to use a stick correctly.But the service is available only in private clinics that lead rehabilitation.