Knee arthrosis is a chronic (long -term) degenerative disease that causes the cartilage to be destroyed in the joints.Symptoms include pain, stiffness and swelling.Treatment opportunities to reduce pain and damage include changes in lifestyle (diet, exercise), physical and professional methods of treatment, medicines and surgery.
Knee osteoarthrosis becomes
Knee joint osteoarthrosis is a common disease accompanied by chronic, exhausting pain.Recent clinical data show that central sensitization stimulates deforming osteoarthrosis of the knee joint.Improved understanding of how knee arthrosis affects central pain treatment is crucial to identifying new analgesic goals/new therapeutic strategies.
Inhibitory receptors weaken the function of peripheral immune cells and modulate central neuro-immune responses.The systemic introduction of the receptor agonist weakens the behavior of the pain caused by the OA, and in this model there are changes in circulating and anti -inflammatory cytokines.
Deformation of arthrosis
Deformative arthrosis of the knee joint is inflammation and wear of the cartilage on the bones that form the knee joint (osteo = bone, artro = joint, itis = inflammation).The diagnosis of osteoarthritis of the knee joint is based on two main results: X-ray data on changes in bone health (using medical images such as X-ray and magnetic resonance imaging) and human symptoms.About 14 million people have symptomatic knee arthrosis.Although the more common in the elderly, 2 million of 14 million people with symptomatic knee OA were younger than 45 years during the diagnosis, and more than half were younger than 65 years.
Osteoarthritis (OA knee) is a progressive disease caused by inflammation and degeneration of the knee joint, which worsens over time.
This affects the whole joint, including bones, cartilage, ties and muscles.Its development is influenced by age, body mass index (BMI), bone structure, genetics, muscle strength and level of activity.The knee of the OA can also develop as a secondary condition after injury to the knee.Depending on the stage of the disease and the presence of injuries or conditions associated with it, the knee of the OA can be controlled with the help of physical therapy.Severe or extended cases may require surgery.
Symptoms
People who develop the Knee OA may experience a wide range of symptoms and restrictions based on the development of the disease.The pain occurs when the cartilage covering the bones of the knee joint.The areas in which the cartilage wears out or damage exposes the bone at the base.The effect of the bone allows you to increase the stress and compression of the cartilage, and sometimes to contact the bones when moving, which can cause pain.Because the knee is the joint, the level of activity, the level of activity, and the type and duration of actions, as a rule, have a direct effect on the symptoms.Symptoms can worsen with weight activity, for example, when you walk with a heavy object.
Symptoms of knee joint may include:
- Worsening of pain during or after surgery, especially when walking, climbing, getting down the stairs or passing from sitting in an upright position.
- Pain or stiffness after sitting with a bent or straight knee for a long period of time.Pain is the most common symptom of osteoarthritis.As the disease develops and inflammation, the pain can become constant.
- Jumping, cracks or grinding when knee movement.
- Swelling after action.
- The hardness of the affected joint is often observed first in the morning and after rest.
- The swelling, which is sometimes warm to the touch, can be noticeable in the joint with arthritis.
- Deformation can occur with osteoarthritis due to bone growth and cartilage loss.Bone growth in the end joints of the fingers is called Hyberden nodes.Bouchard nodes are bone growth in the middle joints of the fingers.The degeneration of the cartilage of the knee joint can lead to the outer curvature of the knees (onion leg).
- A cracker sound or a grille sensation can be noticed when arthritis moves.This is caused by bone wiping against bone or coarse cartilage.
Usually these symptoms do not occur suddenly and all at once, but gradually develop over time.Sometimes people do not admit that they have osteoarthritis because they cannot recall a certain time or injury that caused their symptoms.If knee pain worsens for several months, which does not respond to rest or change in activity, it is better to seek the advice of a medical professional.
Diagnostics
Osteoarthritis can often be diagnosed by its characteristic symptoms of pain, decreased movement and/or deformity.Osteoarthritis can be confirmed by X -ray or MRI scanning.General data include narrowing the joint space between bones, cartilage loss and bone spurs or bone growth.Blood tests can be used to exclude other possible conditions, but they cannot diagnose osteoarthritis.
In the knee, a 2 primary process is diagnosed.The first is based on a report on symptoms and clinical examination.The physiotherapist will ask questions about medical history and activity.The therapist will perform a physical examination to measure knee movement (range of motion), strength, mobility and flexibility.They can also request different movements to see, increase or reduce pain.
The second tool used to diagnose the knee joint is a diagnostic visualization.The physiotherapist may send to the doctor who will prescribe X -beams of the knee in different positions to check the damage to the bone and cartilage of the knee joint.
If you suspect more serious joint damage, you can order MRI to more carefully examine the overall status of the joints and surrounding tissues.
Blood tests can also be arranged to help exclude other conditions that can cause symptoms similar to osteoarthritis of the knee joints.
Treatment
Depending on the severity of arthritis and the age of the patient, it will be chosen how to treat arthrosis of the knee joints.Treatment may consist of surgical or conservative methods or their combinations.
The first line of treatment for knee arthritis includes an activity modification, anti -inflammatory drugs and weight loss.
Rejecting actions that increase pain can make this condition acceptable to some people.Anti -inflammatory drugs help to relieve inflammation, which can contribute to pain.
Physical therapy to strengthen the muscles around the knee can help to absorb some of the shock given to the joint.This is especially true for arthritis with a knee glass (patelo-femoral).Special types of braces designed to transfer the load to the part of the knee joint, which is less than arthritis, can also relieve pain.Injections of drugs inside the knee joint can also help temporarily.
In addition, walking with a cane in the arm on the opposite side, as the painful knee can help distribute some of the load, reduces pain.Finally, weight loss helps to reduce the strength that passes through the knee joint.The combination of these conservative measures can help relieve pain and prevent damage.
If these methods do not allow you to make the condition tolerant, the surgery can be the best option for treating arthritis of the knee joint.The exact type of work depends on age, anatomy and basic condition.Some examples of surgical options for treating arthritis include osteotomy, which consists in cutting bone to align the joint.
Modern methods of treating knee arthrosis include an osteotomy, which is a good alternative if the patient is young and arthritis is limited by one area of the knee joint.This allows the surgeon to restore the knee to unload the arthritis zone and to perform the load, does not relatively include parts of the knee joint.For example, the patient may be recovered to redistribute the load through the joint.The advantage of this type of surgery is that the patient's own knee joint is preserved and can potentially guarantee many years of relieving pain without the disadvantages of the prosthetic knee.The disadvantages include a longer course of rehabilitation and the possibility of developing arthritis in a recently leveled knee.
The surgery to replace the knee joint involves cutting an arthritic bone and the placement of the prosthetic joint.All arthritic surfaces are replaced, including the femur, the lower leg and the knee glass.The arthritic surfaces are removed and the ends of the bone are replaced by a prosthesis.The prosthetic component is usually made of metal and plastic surfaces, which are designed for smooth sliding against each other.
Replacement of the knee joint
The overall surgery for replacement of the knee joint was performed for the first time in 1968 and over the years developed in a reliable and effective way to get rid of the pain of exclusion and allows patients to resume their active lives.Improvements in the field of surgical methods and implants have helped to do this one of the most successful orthopedic procedures today.As the population becomes older and remains more active, the need for general knee replacement continues to grow.Many of the knee replacement operations were performed at the hospital for a special surgery.Improvements in surgical technology and the design of new implants are some of the contributions that surgeons made.
People often wonder when and why they should replace their knee.This is an individual question that depends on the level of human activity and functional needs.Many people with arthrosis live with pain, which prevents them from participating in activities;Others are so weakened that they find it difficult to wear shoes and socks.The complete replacement of the knee joint offers the solution to the problem of arthrosis and is done to relieve the pain and resumption of activity.After rehabilitation from the successful complete replacement of the knee joint, the patient can expect surgery without pain.Complete replacement of the knee joint significantly improves the patient's condition and significantly reduces his long -term treatment costs.This study showed that not only the overall replacement of the knee joint is cost -effective, but also provides more functionality and the best quality of life.
Complete replacement of the knee joint is considered a major surgery and the solution is not trivial.Usually, people decide to undergo surgery when they feel that they can no longer live with arthritis.
The implant consists of 4 parts: shin, femur parts, plastic insert and pattern.The components of the shin and femur are made of metal, usually cobalt chrome, are used to close the ends of the thigh and lower legs after removal of the arthritic bone.The plastic insert is made of polyethylene of ultra high molecular mass and fits into the component of the tibia so that the polished surface of the thigh slides along the plastic.The knee cup component also slides to the front of the femur component.They are usually attached to bone cement.
Complete knee replacement is performed in the operating room with a special laminar airflow system, which helps to reduce the likelihood of infection.Your surgeon will wear a space suit, and is also intended to reduce the likelihood of infection.The whole surgical team will consist of your surgeon, two to three assistants and nannies.
Anesthesia is given through an epidural catheter, which is a small tube placed in the back.During the surgery, the patient can be both awake and sleepy.
After the introduction of the epidural block, a turnstile or cuff will be placed around your thigh.The horizontal band will be overestimated during the surgery to reduce blood loss.Declared for the complete replacement of the knee was made on the front knee.The incision will be measured from 4 to 10 inches depending on the anatomy.
The arthritic surfaces of the femur, the lower legs and the patella are exposed and removed with the help of power tools.At the same time, knee deformities are adjusted and after surgery the knee becomes right.The bone is ready to take an artificial knee joint and then a prosthesis is placed.During the closure, two drains are installed around the work area to help with blood evacuation.Sapers are used to close the skin.
The whole operation will take 1 to 2 hours.The patient will then be taken to the recovery room where the tests will be checked.Most patients can be taken to a regular room for several hours;Others will have to stay in the recovery room, as defined by a surgeon and anesthesiologist.
Patients usually stay in the hospital 3-4 days after full knee change surgery
Risks during surgery
Some of the risks of the surgical procedure include blood loss, the formation of clot in the legs and the likelihood of infection.The overall spread of these risks is very low.They must be discussed with the surgeon before the start of the operation.
Some of the risks of the presence of a prosthetic knee include the likelihood of parts to weaken or wear out over time or the prosthesis may become infected.Again, these issues will be discussed with the surgeon.
Postoperative course
Immediately after a complete surgery to replace the knee joint, the patient will fall into the recovery room.Most patients may enter a regular compartment in a few hours when the sensation returns to the legs.A pain pump will be given associated with an epidural catheter, which will allow you to control when given a cure for pain.
On the day of the surgery, you can perform some exercises, as indicated by the physiotherapist, including reduction of quadriceps and moving your feet up and down.Depending on the surgeon's preference, you can start bending your new knee immediately after surgery or on the first day of it.The patient will be left to take ice after surgery to wet his mouth, but drink fluids or you can cause nausea.The patient will have a catheter in the bladder, so you do not have to worry about urination.Once the movement in the legs is restored, it will be allowed to sit, become and take a few steps with a walker and a therapist.
The first day after the operation will be active, designed to help become more mobile.
The patient will meet with physiotherapists who will instruct additional exercises.They will also help to get to their feet and take a few steps with a walk.As a rule, the patient will be allowed to drink clean fluid.
In the next few days it will be easier and easier to move.The patient will be released from pain and urinary catheter.Pain treatment will be given in the form of tablets.On the second day after surgery, if signs of recovery in the intestine are found, it will be allowed to eat ordinary food.
Depending on your age, preoperative physical condition and insurance coverage, the patient may be a candidate for short -term accommodation in a rehabilitation institution.Otherwise, the patient will be discharged at home and the physiotherapist will come to his house to continue rehab.The dispatcher will discuss these opportunities with the patient and help him plan his return home.
The return to the activity will be led by a surgeon and therapists.As a rule, patients can walk as much as they want 6 weeks after surgery.Patients can resume traffic after 6 weeks.After 8 weeks, patients can resume play in golf and swimming;At 12 weeks, they can play tennis.The surgeon will help to decide what actions can be resumed.
What kind of physiotherapist is needed
All physical therapists are prepared through education and clinical experience to treat different conditions or injuries:
- A physiotherapist who has experience in the treatment of people with osteoarthritis on the knee joint after surgery to replace the knee joint.Some physiotherapists have a practice with orthopedic focus.
- Physiotherapist who is a certified orthopedic clinical specialist.This physiotherapist will have sophisticated knowledge, experiences and skills that can be applied to a country.
- You can find physiotherapists who have these and other accounting data using an MRI, an online tool to help find physiotherapists with specific clinical knowledge.
General Tip when you can find a physiotherapist (or other medical service provider):
- Get recommendations from family and friends or other medical service providers;
- As you turn to the physiotherapy clinic for admission, you should ask about the experience of physiotherapists in helping people with arthritis.
During the first visit with the physiotherapist, you should be ready to describe the symptoms, both more detailed and report activities that worsen the condition.