Methods of treatment of osteoarthritis

Knee osteoarthritis is a chronic (long-term) degenerative disease, which causes destruction of the cartilage in the joints. Symptoms include pain, stiffness and swelling. Treatment and options to reduce the pain disability lifestyle changes are (diet, exercise), physical and occupational therapies, medications and surgery.

Osteoarthritis of the knee

Knee osteoarthritis is a common disease, which is accompanied by chronic, debilitating pain. Recent clinical data have shown that Central sensitization stimulates the deforming arthrosis of the knee. To improve the understanding of how to affect the osteoarthritis of the knee the Central processing of pain is important to identify new analgesic targets/new therapeutic strategies.

Inhibitory receptors impairs the function of peripheral immune cells to modulate and Central neuro-immune responses. Systemic administration of receptor agonist, reduced the OA-induced behavior of the pain and changes and circulating anti-inflammatory cytokines shown were in this model.

Deforming osteoarthritis

Deforming arthrosis of the knee joint is inflammation and deterioration of cartilage, the bones that form the knee joint (osteo = bone, rheumatoid arthritis for = joint, itis = inflammation). The diagnosis of osteoarthritis of the knee joint based on two main results: radiographic changes in bone health (using medical images, such as x-ray and image magnetic resonance imaging MRI), the symptoms and the person. Approximately 14 million people have symptomatic osteoarthritis of the knee. Although more common in older people, 2 million of the 14 million people with symptomatic OSTEOARTHRITIS of the knee was like a younger diagnosis of 45 years, and more than half were less than 65 years.

Osteoarthritis (knee OA) a progressive disease caused by inflammation and degeneration of the knee joint, which over time will deteriorate.

This affects the entire joint, including bone, cartilage, ligaments and muscles. Its development is influenced by age, body mass index (BMI), bone structure, genetics, muscle strength level and activity. Knee OSTEOARTHRITIS can also develop as a secondary condition in the knee after injury. Depending on the stage of the disease and is associated with the English injuries or conditions, the management of OSTEOARTHRITIS of the knee can be occupational therapy. Serious More or advanced cases may require surgical intervention.

Symptoms

Individuals who develop OA of the knee, may experience a wide range of symptoms and limitations, which are based on the development of the disease. Pain occurs when the cartilage that covers the bones in the knee joint wears out. The area where the cartilage wears pois or has been damaged, to expose the underlying bone. The effect of the dice allows you to add and stress the compression of the cartilage, and sometimes bone contact during movement, which can cause pain. Because the knee is the weight-bearing joints, the level and type of activity and duration, as a rule, is a nun effect symptoms. Symptoms may be exacerbated by weight activity, for example, when walking between the heavy Object.

osteoarthritis of the knee

Symptoms of the knee may include:

  • Exacerbation of pain during or after surgery, especially when walking, climbing, walking, unfortunately, the stairs or moving from a sitting and standing position.
  • Pain stiffness or when sitting bent, or nun's knee for a long, long time. Pain is the most common symptom of osteoarthritis. With the development of the disease and the occurrence of inflammation, the pain can become constant.
  • Feeling that the point of popping, or cracking of the grinding when moving the knee.
  • Swelling after activity.
  • Stiffness of the affected joint is often noticed first in the asian morning and after rest.
  • Swelling, which is still warm, sometimes can be noticeable in the context of arthritis.
  • Deformation can occur in osteoarthritis is due to bone growth and cartilage loss. The growth of bones in the terminal joints of the fingers are called Heberden's nodes. Nodes Bouchard's bone growth in the middle-joints of the fingers. The degeneration of knee cartilage can lead to the outer curvature of the knees (bow-legs).
  • Annoying Crackling sound or can be noticed the feeling when the joint moving arthritic. This is due to bone rubbing against bone or roughened cartilage.

These are Usually symptoms happen suddenly and all at once, but gradually develops over time. People do not recognize Sometimes that they have osteoarthritis, since he can not remember the time or a specific injury, which is causing their symptoms. The knee worsened pain If for several months, which does not respond to rest or other activities, it is better to seek the advice of the doctor.

Diagnosis

Osteoarthritis often it can be diagnosed by the characteristic symptoms of pain, decreased movement and/or deformation. Osteoarthritis can be confirmed by x-ray or MRI. Shared data includes narrowing of the joint space between the bones, cartilage loss and bone spurs or bone growth. Blood tests can be used possible to close the poi other conditions, but he can not diagnose osteoarthritis.

the diagnosis of osteoarthritis of the knee

Is knee OA diagnosed 2 primary process. The first is based on the opinion of the symptoms and clinical research. The physiotherapist will ask medical historian and activities. The therapist will perform a physical examination to measure knee movement (range of motion), strength-by song, movement and flexibility. Also Can be different will be asked to perform movements seen in increase or decrease pain.

Another tool used for diagnosis of the knee joint represents a diagnostic visualization. Physical therapist your doctor may refer you, which the amount of x-rays of the knee in different positions to check for damage and bone cartilage of the knee joint.

If you suspect more serious damage to the joints, you can order an MRI more closely the joint state of the whole and the surrounding tissues.

Blood tests can also helps in order to close the poi other conditions that may cause similar symptoms of osteoarthritis of the knee.

Treatment

Depending on the severity of arthritis and the patient's age, how to deal with osteoarthritis of the knee. The treatment can be or surgical conservative methods or a combination of them.

The first line of treatment for arthritis of the knee joint includes activity modification, anti-inflammatory medicines and weight loss.

The rejection of the action, which can make the pain worse to make this condition acceptable to some people. Anti-inflammatory drugs to relieve inflammation, which can contribute to pain.

Occupational therapy to strengthen the muscles around the knee can help to absorb part of the shock attached to the joint. Particularly This is true of arthritis from the kneecap (patello-femoral). Special types of braces are designed to transfer the load of the knee joint, which is less than the arthritis, can also ease the pain. Injections of medication in the knee joint can help temporarily.

Also, a walking stick with a hand on the opposite side as the painful knee may help to distribute the load, reduce the pain. Finally, weight loss helps reduce the force, less through which the knee joint. A combination of conservative measures, these can help to relieve pain and prevent disability.

If these methods do not allow to make the condition bearable, surgery may be the best option for treatment of arthritis of the knee joint. The exact type of surgery depends on age, region, state and country. Some of the options examples of the surgical treatment of arthritis include osteotomy, which involves cutting the bone to align the joint.

Modern methods of treatment of osteoarthritis are osteotomy, which is a good option if the patient is young and one of the arthritis is limited to the area of the knee joint. This allows the surgeon to straighten the knee unloaded area of arthritis to keep ny-the load relatively with part of the knee joint. For example, the patient may re-organize to balance the load across the joint. The advantage of this type of surgery is that your knee joint of the patient is to maintain and could possibly provide pain relief without the year the disadvantages of a prosthetic knee. Disadvantages are taking advantage of the possibility of longer and develop arthritis in the newly aligned knee.

Surgery to replace the knee joint involves cutting of bone and joint arthritis for adding prosthesis. All of the arthritic surfaces are replaced, such as the femur, tibia and patella. Arthritic surface is removed and the bone ends are replaced by prosthetic. The prosthesis portion is typically of metal and made of plastic surface, which is designed for smooth sliding against each other.

Knee replacement surgery

Joint surgery knee replacement surgery was first performed in 1968 and over the years has developed a reliable and effective way to get rid of the pain, when you disconnect and patients can resume an active life. Improvements and surgical techniques implants have helped one of the most successful orthopaedic procedures today. Kun and the population is ageing is more active, the need for the knee to continue to grow. Many of the functions of the replacement knee joint was kept at the hospital for special surgery. Improvements in surgical technique and the design of the new implant are some of the charges that were made surgeons.

People wonder often, and when they why he had to replace the knee. Is This a unique issue, which depends on the level of functional activities and needs. Many people with arthritis pain to live with it, which prevents them from participating in activities; weak others are so that they are difficult to wear shoes and socks. The knee offers Total joint replacement surgery solution to the problem of osteoarthritis pain and functioning and again. Rehabilitation Kun completely successful knee replacement, patients can expect to surgery, without pain. Total knee arthroplasty significantly improves patient's condition and significantly reduce long-term costs of treatment. This study showed that not in vain the knee cost-effective, but also offers more functions and better quality of life.

Total knee replacement is considered major surgery, the decision, and is not trivial. Usually people decide to be activity when he or she feel they cannot live anymore the pain of his arthritis.

The implant consists of 4 parts: the tibia, femur parts, plastic insert, and the patella. And parts of the tibia the femur is made of metal, usually cobalt-chromium is used for closing the ends of the femur, the tibia after removal of the and bone arthritis. The plastic part is made of polyethylene ultra-high molecular weight tibial part and will fit so that the shiny surface of the femur sliding on plastic. Also Part of the patella to slide against the front part of the femoral component. They are Usually attached to the bones with cement.

Total knee replacement surgery throughout the surgery in a special laminar airflow system, which helps to reduce the risk of infection. The surgeon will be wearing a "space suit", the purpose is also to reduce the likelihood of infection. The entire surgical team consists of your surgeon, two to three, and nurses assistants.

Anesthesia will be given epidural catheter, which is a small tube is inserted into the back. During surgery, the patient can be awake, sleepy.

After the introduction about epidural anesthesia in the pelvis is placed the tourniquet or cuff. The bar is too during surgery to reduce blood of the son of loss. Domestic and foreign tourists throughout the knee replacement is made along the front of the knee. Surgery is the measured 4 to 10 inches, and depending on the area.

Arthritic surface of the femur, tibia patella exposed, and are and disable protection tools. This corrected, deformation of the knee and the knee becomes more direct. The bone is prepared to accept the artificial knee joint, and then set the prosthesis. During the closure of about two drainage installed in the work area to help the evacuation of blood. Brackets are used close to the skin.

surgery knee replacement surgery

The operation lasts the Whole 1-2 hours. After the patient taken to the recovery room where they tested the tests. Most patients can be submitted to an ordinary room in a few hours; others need to stay for the night room for recovery, as determined by the surgeon and the anesthesiologist.

Patients usually remain in the hospital for 3-4 days after total knee arthroplasty

Risks during the operation

Some of the risks of surgical treatments include blood loss, clot formation in the legs and the risk of infection. The overall incidence of these risks is very small. Should discuss with my surgeon before surgery.

Some of the risks of the availability of the prosthetic knee are the possibility that the parts may loosen or wear out over time, or the prosthesis may become infected. Again these issues are discussed with my surgeon.

During surgery

Immediately after the whole surgery to replace the knee joint of the patient to achieve recovery. Most patients can regularly get a few hours in the room when the feeling returns to the legs. Given a pain pump, which is associated with the epidural catheter, which allows you to control when given medication for the pain.

The day after surgery, you can do some exercises, such as a physiotherapist, including the reduction of quads moving and the legs and up unfortunately. Depending on the preference of the surgeon can begin immediately Flex your new knee after surgery or his first day. The patient takes a stabilisation and association agreement remains after surgery, mouth wet, but drinking fluids or eating can cause nausea. The patient has a catheter in the bladder, so no need to worry about urinating. As soon as I can recover movement in his legs, allowed to sit, unfortunately, the nose up and take a few steps with a walker and a therapist.

The first day after surgery is the active, designed to help you become more mobile.

The patients meet a physiotherapist, which controls the other exercises. In addition, they help lift the legs and take a few steps Walker. As a rule, patient stabilisation and association agreement, to drink clean fluids.

In the next few days it is easier and easier to move. The patient is free and the pain of urinary catheters. Pain management is given in the form of tablets. On the second day after surgery, if signs of the intestines showed some recovery, get to eat regular food.

Depending on the age, preoperative status, insurance coverage physical, and the patient may be a candidate for a short-term placement rehabilitation facility. Otherwise, the patient is discharged, a physiotherapist and came to his home to continue rehabilitation. The director will discuss these options with the patient and help him to plan his return to the state.

Return to ny-activities controlled by the surgeon therapists. Patients can Usually walk as much as you want to 6 weeks after surgery. Patients can continue movement after 6 weeks. After 8 weeks patients can resume and play Golf swimming i; at 12 weeks, he can play tennis. The surgeon will help decide what activities can be continued.

What the physical therapist needs

rehabilitation after knee replacement surgery

All are ready to physical therapists education and clinical experience in the treatment of a variety of conditions or injuries:

  1. A physical therapist who has experience treating people with osteoarthritis of the knee after surgery to replace the knee joint. Some physical therapists is a practice with an orthopedic focus.
  2. Physical therapist who is a certified orthopedic clinical specialist. This is the therapist advanced knowledge, experience and skills that can be applied to the condition.
  3. You can find physical therapists who have and these other identifiers, using MRI, an online tool to help find physical therapists with specific clinical expertise.

General advice, when you can find a physical therapist (or other provider):

  • Get recommendations from family and friends or other health care providers;
  • Turning clinic occupational therapy appointment, a man must ask the physical therapists experience in helping people with arthritis.

During the first visit with the physical therapist, the symptoms will be ready to be described in as much detail as possible, and to report on its activities, which aggravate the condition.