I. What exactly is osteophyte
When it comes to degenerative knee osteoarthritis, it is important to first talk about what osteophytes are, as they are closely related. Osteomalacia is a very general term that is simply a manifestation of degenerative changes in the bone on an x-ray. It is a sign of bone formation and a manifestation of bone aging. It is systemic, just as wrinkles appear when the skin ages. There is no real treatment for osteophytes yet, only targeted treatment of its consequences, i.e. there are no drugs to treat osteophytes.
Second, the cause of osteoarthritis of the knee
The etiology of this disease is not very clear, but it is closely related to age, gender, occupation, metabolism, and injury. The pathological change is a joint lesion caused by degenerative changes in the articular cartilage, mainly osteophytes, and the inflammation of the synovial membrane is a secondary lesion.
1, chronic strain: long-term poor posture, weight-bearing force, excessive weight, resulting in soft tissue damage to the knee joint.
2, trauma: frequent knee injuries, such as fractures, damage to cartilage and ligaments.
3, imbalance of forces on the joint surface: certain factors such as trauma, strain or poor posture.
Third, what are the signals of degenerative knee osteoarthritis?
1, joint pain: manifested as a dull pain, early pain is light, mostly occurs during activities, after rest to relieve, later is also pain at rest, and often occur at night pain. The pain is most pronounced in the morning or when the joint is in a certain position for too long. Usually the earliest symptom of knee degeneration is pain in front of the knee when walking upstairs, but it is not affected when walking.
2, inconvenience of movement: such as morning, a posture after a long stay can not immediately move, a stiff state, only after a period of time to feel comfortable, and in the joint activities can also hear a variety of joint surfaces rub against each other and make different sounds, such as creaking or clicking sound.
3.Joint instability: such as playing soft leg, mainly caused by knee pain, more obvious when walking on uneven roads.
4. Joint dysfunction: Joint function can be partially or completely lost due to pain, muscle spasm, and destruction of joint structure. For example, the knee cannot bend, cannot squat, or cannot be fully straightened. In addition, localized joint swelling, oozing, muscle atrophy, and even joint deformation can occur in later stages. In short, if the joints feel sore, painful, sometimes swollen, aggravated by cloudy weather, cold, overwork and exertion, and such symptoms are more obvious or persist without relief, you should seek medical attention because these may be early manifestations of osteoarthritis.
Physical signs and examination
1. There is obvious pressure pain at the knee patella and atrophy of the quadriceps muscle is visible.
2, X-ray radiographs show hyperplasia of the inner and outer condyles of the tibia and femur, intercondylar spine and calcification of the patellar ligament.
3.Patellar grinding test was positive.
Laboratory tests: normal blood and urine, normal blood sedimentation, negative anti-O and rheumatoid factor, non-inflammatory joint fluid.
V. How to treat degenerative knee osteoarthritis
Degenerative knee osteoarthritis has a slow onset and is dominated by degenerative changes in the knee cartilage, most of which can improve joint function with active treatment. In acute attacks of degenerative arthritis, the main treatment is rest. Special emphasis is placed on adequate rest of the affected joint. The pressure on the joint or excessive activity often aggravates the wear and tear of the articular cartilage. Appropriate limitation of the activity of the affected joint not only reduces pain but also prevents aggravation of the disease, but bed rest is not advisable. Once the symptoms of arthritis are eliminated, exercise of the affected joint should be resumed as soon as possible. Prolonged bed rest or braking can aggravate bone calcium loss, muscle atrophy, and contribute to increased osteophytes.
In general, the treatment of degenerative knee osteoarthritis is based on different treatment options for different periods of the disease.
1. Conservative treatment
In the early stage of symptoms, the main focus is on prevention, regulating the amount of exercise, avoiding strenuous activities, and taking oral medications to repair joint cartilage. Physical therapy is used to reduce pain in the affected area by using cold compresses, heat therapy and exercise, while strengthening the muscles around the joint and expanding the range of motion to restore joint function. Physiotherapy is very effective in relieving the patient’s pain and controlling the disease in a timely manner, and is very effective when combined with medication. However, it is important to note that physical therapy must be performed under the guidance of a professional physician, and not blindly massage or massage. Chinese herbal medicine has a pain-relieving effect on degenerative arthritis, but the mechanism of treatment has yet to be further studied.
2.Arthroscopic cleanup
Suitable for the middle stage. In addition to the above treatment, arthroscopic cleanup can be performed at this stage to effectively delay joint degeneration; at the same time, a large amount of saline flushing can remove inflammatory pain-causing substances, which can effectively relieve pain, and if intra-articular injection of artificial lubricants such as gibberellic acid and sodium vitrate to protect the joint at the same time, the effect is very good.
3.Tibial high osteotomy and artificial joint replacement
In the late stage of degenerative arthritis, the joint degeneration is serious, that is, the narrowing of the joint space is obvious on X-ray, suggesting the destruction of articular cartilage. Once damaged, joint cartilage, like teeth, cannot be regenerated. At this point, surgical treatment is an option on a case-by-case basis. Even at this level, there is no need to be discouraged, as the technology for total knee replacement is now very mature, and successful artificial knee replacements are painless, functional, and can basically restore normal knee function. We have successfully completed hundreds of such surgeries with good results.
VI. How to prevent degenerative knee arthritis
Once degenerative arthritis occurs, it is difficult to reverse the lesions. Therefore, how to prevent it is very important.
1, appropriate physical activity
It helps to improve joint cartilage nutrition and prevent muscle and cartilage atrophy. Exercise should be gradual, it is important to adhere to. Pay attention to the protection of the joints. There are various methods of physical exercise, it is appropriate to move the joints without weight. Dancing and stair climbing, mountain climbing, running, etc. are harmful exercises. Swimming, jogging on flat ground, tai chi, bicycles and other beneficial exercises.
2, muscle training.
As we age, the skeletal muscle decreases year by year, affecting joint stability and promoting joint degeneration. Therefore, increasing the muscle strength around the joints can improve joint stability, protect the normal mechanical conduction of the joints, buffer the impact of sports on the joints, so that the joints are evenly stressed, which is conducive to maintaining joint proprioception, protecting the joints and preventing degeneration. The main methods of training are: isometric and isometric training and resistance exercises. Hip osteoarthritis should pay attention to the training of the abductor muscle group, etc.
3, joint function training.
Such as knee flexion and extension exercises under non-weight-bearing conditions to maintain the maximum mobility of the joint. Correct poor posture, more aerobic exercise, etc. to control weight and reduce the pressure on the joint and adverse stimulation. Avoid prolonged running, jumping, squatting and other poor postures. Reduce or avoid climbing stairs. Obese people should also pay attention to weight loss and do more aerobic exercises such as swimming and cycling. In short, a normal amount of activity is an essential physiological stimulus for bone, cartilage and muscle metabolism, the lack of this stimulus will result in osteoporosis of bones, disuse muscle atrophy, and accelerated degenerative disease of cartilage.