Common symptoms
Initially, slow onset knee pain is not serious, there is sustainable vague pain, the pain increases when the temperature decreases, related to climate change, morning after starting to move, walking for a long time, strenuous exercise or sedentary starting to walk when the knee pain stiffness, a little activity after the improvement, up and down the stairs difficult, down the stairs when the knee is weak, easy to fall. Pain and stiffness when squatting, in severe cases, joint pain and swelling, limp walking, combined with rheumatism, joint redness, deformity, functional limitations, stretching and flexion activities have a popping sound, some patients can be seen in the joint effusion, local obvious swelling, compression phenomenon.
Clinical manifestations
The disease is mostly seen in middle-aged and elderly people, with a higher incidence in women than in men. It is characterized by joint discomfort, pain and swelling on one or both sides. Initially, the pain is more likely to occur during prolonged walking or going up and down stairs, but improves after rest or bed rest. As the disease progresses, it becomes painful even when walking on a flat road, and the joint becomes unstable and painful when walking without paying attention; at the same time, there is a sound like twisting hair when the knee joint moves. In severe cases, the knee joint may suddenly “lock” in a certain position, and when it is unlocked, there is an obvious popping sound. In the early stages of prevention, there is only mild osteophytes on x-rays, but in the later stages, osteophytes in the bones of the joint are obvious and can even be seen as free bodies. To pay attention to the prevention of.
1, avoid sleeping in wet places, do not sweat when the wind, do not sweat, that is, take a cool bath or wash your feet, in order to prevent the wind, moisture, cold three evil qi on the knee joint. The knee joint is not overworked or overloaded.
2, the most critical treatment for early patients is to stabilize the joint, insist on doing the static training of double quadriceps contraction, i.e., take a lying or sitting position, straighten both lower limbs, tense the muscle groups in front of the thigh with force for 10-20 seconds, relax for 5-10 seconds; repeat 20-30 times; 4-5 times a day. Do it for three weeks effectively. Adhere to 0.5 to 1 hour of walking daily, self-massage legs.
3, joint swelling, pain should be rested when aggravated. Avoid deep squatting, weight-bearing, going up and down stairs and other activities, and ask your doctor to cooperate with physical therapy treatment. Stop the medication after the symptoms improve, and adhere to the above training mainly.
Surgery may be considered in the following cases
1. Free bodies (also called joint rats) are already visible in the knee joint on X-ray.
2.Severe osteophytes in the knee joint have formed bone superfluous, which seriously affects its function.
3, Combined meniscal damage or the presence of disc-shaped cartilage.
4.The knee joint is overly hyperplastic, with narrowing of the joint cavity, obvious bone destruction or joint deformity, resulting in painful walking, which is ineffective after many months of conservative treatment.
Maintenance of osteophytes of the knee joint
Knee joint hyperplasia often takes a long time to treat and the effect is slow, so the usual maintenance is more important than drug treatment.
What medical exercises should be done for osteophyte knee symptoms?
1. Stand and hold the Dantian for a moment. With both feet together, bend over and hold both knees with both hands, with the Laogong point facing the Blood Sea point, with the intention of holding the Laogong point in both hands. Both knees at the same time to make the knee joint straight back from the flexion position to stretch straight position, while whistling, and then recover, inhale, repeat 8 times.
2, posture with 1, both hands hold the knee so that the knee joint clockwise for a week (whistle), and then counterclockwise rotation for a week (whistle). Then both knees open, respectively, rotate a week from the inside to the outside (inhale), and then rotate a week from the outside to the inside (whistle). Repeat 8 times.
3, sitting position, the intention of the Dantian for a moment, the Dantian Qi to the spring, the use of muscle contraction force to straighten the lower leg, while inhaling. Then use the gravity of the lower limbs, so that the knee joint flexion, while whistling, repeat 8 times. Finally, draw Qi back to the Dantian point.
4, supine position, intention to guard the Dantian for a moment, and then both hands on the side of the body, the whole body relaxation. Use muscle contraction force to raise the lower limbs straight leg, while inhaling. Whistle when recovering. Repeat 8 times, then lie on your back and do 16 repetitions of the lower limb according to the cycling action, whistling naturally.
Treatment of osteophytes of the knee joint
Drug treatment.
Knee osteophytes are a manifestation of degenerative changes in the bone joints, a common chronic arthritis in middle-aged and elderly people, manifested as osteophytes at the edges of the joints. Patients often feel a stiff and tired feeling in the joint, accompanied by pain, and when the stiffness improves after activity, the pain is relieved, and the pain is heavy again after more continuous activity. The pain is relieved after rest and hot compress treatment, and the symptoms are aggravated by cold and wet weather. Sometimes the joints are mildly swollen and the edges of the joints are painful. If the pain is not heavy, there is no need to take medication, but if the pain is heavy, you can take non-steroidal anti-inflammatory painkillers, etc. To pay attention to the side effects of drugs, oral drugs are extremely damaging to the liver, kidneys, gastrointestinal damage, so choose Xiaoduo topical Chinese medicine powder package, the treatment effect will be better, from the outer skin penetration, drug penetration into the bone, also no side effects, Xiaoduo topical Chinese medicine powder package can completely solve the knee osteophytes pain.
Physical therapy.
Acupuncture can open the meridians and activate the blood and has a pain-relieving effect, which can eliminate local edema and inflammation. Physiotherapy massage can help improve local blood circulation and play an anti-inflammatory and pain-relieving role; physiotherapy methods include wax therapy, heat therapy, magnetic therapy, ultra-short wave therapy, microwave therapy, infrared therapy, etc., which can improve local microcirculation and play a role in activating blood and circulation. Traction can reduce the pressure of bone spurs on local nerves and tissues and play a role in temporary pain relief. However, for osteophytes, the above treatment methods can only play a supplementary role.
Western medicine treatment.
There is no effective treatment drug for this disease in Western medicine, and symptomatic treatment is often used. For example, in case of pain, we can take some antipyretic and analgesic drugs or inject sodium hyaluronate; in case of numbness, we can use B vitamins; in case of joint swelling and fluid accumulation, we can give local extraction of fluid or local closure therapy.
Minimally invasive arthroscopic surgery.
The principle of mini-needle knife treatment is similar. The broken meniscus is surgically removed and the tissue that hinders joint movement is removed. Artificial joint replacement surgery is performed by replacing a completely deteriorated joint with metal and plastic. Target: Patients who have not only cartilage but also bone worn out at the end of the disease; the operation is risky and expensive. It is not an option unless it is a last resort.
Home treatment method.
Osteomalacia can rub adjacent bones and nerves and blood vessels, leading to inflammation and possible formation of tiny tumors at the nerve endings, causing abnormal pain to the patient. Generally speaking, do not take surgical treatment as a last resort, because osteophytes often regenerate.
1. Choose soft-soled shoes. Choose shoes with rubber soles that are better for the feet (better than leather ones). It is more important to be comfortable than to look good in them. Jogging shoes are a good choice. Avoid walking on hard surfaces, such as concrete, wood, or non-carpeted floors. Pads can be added to the heel to reduce pain.
2. Padding with foam cushions. The soft pad can reduce the pressure around the bone growth, you can dig a hole in the corresponding part of the soft pad bone spur.
3.Heat compress. If the pain is more severe, use a hot compress.
4.Soak your feet. Take turns to soak your feet in hot and cold water, which is good for reducing the symptoms, and massaging the soles of your feet with ice is also helpful.
5, selective exercise. You can use cycling or swimming instead of walking or jogging, not only to achieve the purpose of exercise, but also will not hurt the sick feet.
6, lose weight. Being fat is one of the causes of osteophytes, so losing weight is also a matter of urgency. Knee arthroplasty
What conditions are suitable for knee replacement surgery
1, various inflammatory arthritis of the knee joint, including rheumatoid arthritis, osteoarthritis, hemophilic arthritis, Charcot arthritis, etc.
2, a few traumatic arthritis.
3, osteoarthritis after failed high tibial osteotomy.
4, patellofemoral arthritis in a few elderly people.
5, resting infectious arthritis (including tuberculosis)
6, a few primary or secondary osteochondral necrotizing diseases.
What conditions contraindicate knee joint replacement surgery
Artificial total knee arthroplasty is contraindicated in the following cases.
1, paralysis of the muscles around the knee joint.
2. The knee has been fused in a functional position for a long time without symptoms such as pain or deformity. As a rule of thumb, severe flexion contracture deformity (greater than 60 degrees), severe osteoporosis, joint instability, severe muscle weakness, fibrous or bony fusion are not absolute contraindications to surgery.
How to choose a good artificial knee joint
When a patient decides to use artificial joint replacement as a treatment method, the question often comes up: what kind of artificial joint is the best artificial joint? It should be said that different patients should choose different artificial joints. Artificial joint prostheses have very strict requirements in terms of design, surface treatment, material selection, manufacturing process and packaging; they also require sufficient clinical practice to confirm the effectiveness of a particular artificial joint. At present, the artificial knee joint has become a very mature artificial joint, both in terms of the prosthesis itself and in terms of surgical techniques. In developed countries, artificial knee joints have been widely used in clinical practice with good clinical results. Choosing an artificial knee prosthesis is very different from choosing other commodities because once the artificial knee prosthesis is placed in the body it is not easy to “replace” it at will, and even if it is “replaced” the cost is quite high and cannot be measured in money alone. Therefore, the choice of a good artificial joint should be made carefully under the guidance of a specialist.
Post-operative examination
Three months after discharge from the hospital to review, take X-rays to understand the position and stability of the joint prosthesis is good. Another review is required six months after surgery, and every six months thereafter. If there is discomfort, such as redness, swelling, pain or difficulty moving the joint and if the hip joint is injured due to an unexpected situation, it is important to go to the hospital in time for examination.
Duration and efficacy of the artificial knee joint
The knee joint is an important joint that has various functions such as walking, running, jumping, squatting, etc. It also carries the weight of your body. Once the knee joint is diseased, the cartilage of the joint is destroyed and the surface turns from a smooth mirror-like surface to a rough or even defective surface, which further deforms the femoral condyles. This results in pain, difficulty walking, limited mobility, limping, and sometimes difficulty performing even easy movements. When the above disease has progressed to a certain point and the joint has been destroyed, surgery is required. An artificial knee joint is used to replace the damaged joint (the timing of the surgery should be decided by the surgeon) to restore function such as walking. The greatest benefit of artificial joint surgery is that it eliminates post-operative joint pain, greatly improves the function of the joint, and increases the patient’s quality of life so that he or she can work and live well during their lifetime. Nowadays, more and more patients are happy to accept the suggestion of artificial joint surgery. The longevity of the artificial knee joint is determined by two main issues: the wear and tear of the joint and the loosening of the prosthesis caused by wear particles. The strength and wear resistance of the artificial knee joint material is after hundreds of wear experiments, quality imported artificial joints, generally can meet the patient more than 20 years. The artificial joints currently used in clinical practice are much better than those used twenty years ago, and it is believed that more than 95% of the artificial joints placed now will continue to work for twenty years. A successful artificial joint replacement will allow you to live pain-free and meet your daily activities, and no other treatment can achieve the same results for a knee that has been damaged. Of course, the longevity of the artificial joint is also dependent on many factors, such as the amount of exercise the patient performs, the choice of artificial prosthesis, the surgeon’s surgical technique, and his or her condition. The orthopaedic community is currently working with engineers and material scientists, among others, to improve artificial joint materials, processes and surgical techniques. The future is bright for patients who choose joint replacement to improve their quality of life and want to be healthy and pain-free in their activities.
Management of the artificial knee after loosening
Once an artificial knee becomes infected or aseptically loosened, revision surgery is required. Special hip prostheses and surgical instruments are available for revision surgery. Revision surgery is more complex than the initial surgery and may involve bone grafting, changing the type of joint prosthesis or using a special prosthesis. After revision surgery, the vast majority of patients will have a satisfactory outcome.
Protection after Artificial Knee Arthroplasty
After an artificial knee replacement, you need to develop good habits of life and activities to maintain the stability of the joint, and learn some simple rehabilitation knowledge to perform joint rehabilitation exercises. It is important to pay attention to the prevention and treatment of infections, such as tonsillitis, skin infections, ringworm, etc. After surgery, you can do exercises such as cycling, walking, dancing and swimming, but strenuous exercises such as running and jumping, as well as long-distance walking and climbing are not encouraged. In addition, some hospitals provide post-operative rehabilitation manuals for patients to refer to.
Rehabilitation after knee arthroplasty
Rehabilitation exercises are essential to the success of total knee replacement surgery. Isometric contraction of the muscles of the affected limb can be performed right after surgery. If the joint is well positioned and fixed, rehabilitation exercises, including straight leg raising for quadriceps and walking exercises, can be started under the guidance of the surgeon and rehabilitation staff. Even after full recovery, regular rehabilitation exercises are usually required.
Advantages and disadvantages of artificial knee surgery
Artificial knee surgery began in 1960, and this procedure has been established as an effective surgery. However, total knee replacement has been performed in China for a relatively short period of time, and the procedure requires a very experienced surgeon to perform it. Artificial knee surgery can turn a non-mobile joint into a mobile one. However, once the surgery fails, there are few ways to make up for it.
Its advantages are.
1. Surgery can be performed on patients with deteriorating osteoarthritis of the knee and severe deformation.
2. The surgical treatment period is relatively short, about one month.
3. The joint pain can be completely removed.
The disadvantages are as follows.
1.It has an effect on sports such as running and hiking.
2. The degree of knee flexion after surgery is usually slightly greater than a right angle, about 120°.
3. After 10-15 years after surgery, the bone and the artificial joint may loosen and need to be replaced by about 5-10%.
4.The treatment of artificial joint infection is very difficult; it often causes osteomyelitis of the femur and tibia. 3-5% of people have infection after surgery, which requires prolonged treatment, and treatment is very difficult, and even the artificial joint has to be removed, and the joint will be replaced after 1-2 years of infection control. The infection rate of the re-replaced joint is much higher than the first surgery.
5, artificial joint wear and loosening is also the cause of post-operative pain, surgery failure.
6. It is expensive and not affordable to the general public.
However, once most of the articular cartilage of the knee joint is destroyed, high tibial osteotomy cannot be performed and only artificial joint replacement or joint fixation can be performed. With the advent of aging in China, the general improvement of people’s living standard, the increase of economic income, and the implementation of social labor and medical insurance especially the rapid popularization of artificial joint technology, it is certain that the number of cases and success rate of artificial joint surgery in China will increase rapidly and the complications will become less and less.
Knee osteophytes six high-risk groups
1, overactive knee joint, such as athletes, dancers and certain types of workers whose knee joint is the main activity.
2, trauma leading to knee instability, such as repeated sprains and contusions of the knee joint ligament relaxation, trauma to the knee joint lateral collateral ligament injury without systematic treatment, cruciate ligament rupture is not strictly fixed, and knee fracture improper treatment.
3, rickets and other causes of knee deformities, such as rotundity (out called O-leg) and abduction leg (also called X-leg) deformity.
4, the elderly and frail, especially those who have age-related osteoporosis.
5.Weight significantly more than the normal standard.
6, middle-aged and elderly women significantly more than men.
Misconceptions about the treatment of osteophytes of the knee joint
1. Many people do not think they may have osteoarthrosis of the knee and do not seek medical attention in time.
2, young people do not get osteoarthritis of the knee: secondary osteophytes of the knee caused by joint trauma and joint overuse are often not related to age.
3, no pain is the “cure”: many patients with osteoarthritis of the knee after treatment, especially after joint injection “no pain” think that the purpose of treatment, in fact, is wrong.
4, lack of joint protection: usually do not pay attention to self-protection, such as often squatting or kneeling down to get things, sitting on a low stool, sleeping on a low bed, etc., which will increase the friction and weight on the joint.
Precautions for osteophytes of the knee joint
1, should not do strenuous sports: such as playing tennis or climbing mountains, etc., can do walking or swimming, etc.
2, family matters should not do squatting and scrubbing or laundry.
3, reduce weight, such as overweight people should reduce weight, reduce the pressure on the knee joint.
4.When walking with pain, use crutches or walking aids to reduce pain.
5, avoid sleeping in wet places, do not sweat when the wind, do not sweat, that is, take a cool bath or wash your feet, in order to prevent wind, moisture, cold three evil qi.