With the growth of the aging human population and the improvement of people’s standard of living, the number of patients with knee pain and osteophytes is increasing and has become the main group of people attending orthopedic clinics in hospitals. In order to make such patients understand knee pain and actively prevent and treat osteoarthrosis, we are here to explain the early, middle and late treatment of osteoarthrosis of the knee: Osteoarthrosis Osteoarthrosis of the knee is a disease formed by cartilage degeneration causing subchondral bone proliferation and ossification, which is characterized by chronic onset, no obvious history of trauma, mostly seen in middle-aged and elderly people, mostly women, also known as degenerative arthritis It is also known as degenerative arthritis, osteophytes, bone spurs, etc. Cartilage degeneration Cartilage degeneration is not osteoporosis, not calcium deficiency, but a layer of white cartilage (commonly known as “brittle bone”) that covers the joints, just like the white brittle bone you see when you eat chicken legs. There is no vascular nerve in the cartilage, so when people walk, the friction between the cartilage and cartilage does not feel pain, but with age or trauma, the cartilage is destroyed, the subchondral bone will be revealed, the subchondral bone is rich in vascular nerve, sensory acuity, the friction when walking will directly lead to pain, the more powerful the destruction of cartilage, the more pain when walking. The greater the damage to the cartilage, the more painful it will be when walking. Another characteristic of cartilage is that it cannot be regenerated or repaired after destruction, so care should be taken to protect it. The main cause of osteoarthrosis is the increase in the aging population, the improvement in the standard of living, the increase in the number of obese people, inappropriate sports activities, the additional weight on the weight-bearing joints, accelerating the wear and tear of the cartilage, some studies have proved that an increase in weight of one kilogram, the weight added to the joints will be 3 kg! Secondly, mainly engaged in heavy physical labor, commonly known as “hate work”, there are many people disregard the body’s ability to bear, once to do the work, will not rest. Three is too little activity, often sitting in the office, to the car instead of walking, not to waste, the joints are like the door shaft, also need to appropriate activities exercise. In addition, there are traumatic injuries that cause damage to the cartilage surface of the joints, etc. Treatment of osteoarthrosis The treatment of osteoarthrosis is mainly divided into early, middle and late treatment. (1) Early stage The main symptom is pain on the front side of the knee when going up and down stairs, especially obvious when going downstairs, squatting, or even squatting when unable to stand, the bone joint gap is not significantly narrowed from the X-ray film, there is only mild osteophytes in the patellar axial film, the patella can be seen to the lateral tilt, the medial joint gap is slightly narrowed, treatment methods are Chinese medicine fumigation, with blood circulation, relaxation of tendons and channels Chinese medicine fumigation joint, to reduce swelling and pain, improve function. To reduce swelling and pain and improve function. Massage to activate the tendons can achieve the purpose of activating blood, relieving pain and relaxing tendons. Oral administration of joint pills and other herbal preparations. If the patella is significantly displaced to the lateral side, lateral support band release is feasible. (2), medium-term The main symptoms are pain in the joint along with pain in going up and down stairs, sometimes the joint may pop, and the pain increases when walking far or after exertion, and is related to weather changes. In patients with narrowing of the medial joint space, the cartilage surface of the medial condyle can be destroyed and the bone exposed. The treatment in the middle stage is conservative and surgical. Conservative treatment includes traction and manipulation, which can effectively move the soft tissues around the joint and restore the range of motion of the joint; changing the line of negative gravity so that the knee joint is evenly stressed; medication fumigation and physical therapy to reduce swelling and pain; and internal medication Joint Pill No. 2. Surgical treatment is mainly knee joint cleaning and wedge osteotomy, which can effectively increase the medial joint gap and change the negative gravity line of the knee joint. (3) Late stage The main symptoms of late stage are severe deformation of the knee joint, bending of the lower leg into an “O” leg, inability to walk far, or walking in a sedentary position, accompanied by pain at night, limited extension and flexion of the knee joint, and pain in the back of the leg, or even up to the neck of the foot. X-rays showed destruction of the medial and lateral joint surfaces, hyperplasia of both knees, and an “O” shaped leg. The main treatment is surgery, total knee arthroplasty, which is a new surgical treatment in recent years and can greatly improve the quality of life of the patient, freeing him from walking pain and allowing him to take care of himself. Artificial joint surface replacement, as the name suggests, is to get rid of the necrotic cartilage on the surface of the joint, wrapped in a layer of metal, just like tooth enamel badly wrapped teeth, can completely solve the problem of pain and flexion and extension activities. Osteoarthrosis is often accompanied by symptoms (1) First of all, synovitis caused by swelling of the knee joint, which is caused by the destruction of lyso-fibrous protein on the cartilage, coupled with the protrusion of exposed bone tissue, which stimulates the synovial membrane. It occurs mostly in the early and middle stages of osteoarthrosis. (2) Free body, also known as joint rat, is caused by cartilage degeneration and formation of bone superfluous, which is dislodged by friction or trauma, and gradually increases in size due to the nutritional effect of joint fluid and gradually affects joint function. The main symptom is “impingement”, that is, walking, the knee joint suddenly will not move, and pain, after slowly moving and can walk again, and even in some cases can be directly in the knee joint to feel the moving bone block. (3) Meniscus damage, especially the medial meniscus, is mainly due to the narrowing of the medial space, which causes meniscus degeneration, wear and tear, and fracture. The normal function of the meniscus is to carry the load and cushion the pressure, but once the rupture occurs, it will form an impingement with the same symptoms as a free body: sudden knee pain and inability to move, relieved by slow movement. Free bodies and meniscal injuries can be differentiated by x-ray. Differentiation of osteoarthrosis from rheumatoid disease Systemic osteoarthrosis may also present with pyknosis of the fingers, but that is not rheumatism or rheumatoid, because after the degeneration of the cartilage of the hand joints, deformation also occurs like the knee joints, and it should be noted that: the finger deformation in osteoarthrosis mostly occurs in the interphalangeal joints of the hand, not the metacarpophalangeal joints; secondly, osteoarthrosis may also present with early finger stiffness, but usually not more than half an hour. Third, the rheumatoid factor z check Y results for positive may not be rheumatoid, according to statistics rheumatoid factor z check Y results for positive only 12% of the final diagnosis of rheumatism. The diagnostic criteria for rheumatic diseases are now internationally adopted by the American Rheumatism Association’s 1987 revised classification criteria for rheumatoid arthritis (RA): (1) morning stiffness of at least one hour, lasting at least 6 weeks. (2) Swelling of 3 or more joints lasting at least 6 weeks. (3) Swelling of the wrist joint and swelling of the metacarpophalangeal or proximal interphalangeal joints lasting at least 6 weeks. (4) Symmetrical joint swelling lasting at least 6 weeks. (5) X-rays of the hand with typical RA changes, which must include bone erosion or definite bone decalcification. (6) Rheumatoid nodules. (7) Positive serum rheumatoid factor. The diagnosis is confirmed when four of the above seven items are met. Misconceptions in the treatment of osteoarthrosis The following issues should be noted in the treatment of osteoarthrosis: First of all, do not misdiagnose the disease, which is more common in the vast rural areas, but primary care doctors do not know enough about the disease, and are prone to misdiagnose it as osteoporosis, joint inflammation, osteophytes and so on. Then do not play closed injection, generally closed injection contain hormonal drugs, easy to stimulate the synovial membrane, causing crystalline synovitis, long-term multiple injections of closed injection can cause the destruction of cartilage, can also cause changes in the systemic situation, the most common such as hormones can cause obesity, osteoporosis and so on. Third, do not eat no national approval number, no drug registration, especially marketing drugs, some drugs contain a lot of hormones, the patient ate the pain relief effect is good, but a discontinuation of symptoms aggravated, over time, the joints are completely broken. Fourth, the disease is treated early, do not nurse the disease as a problem, the best treatment at the beginning of the symptoms. Some patients, when the first onset of fear of spending money, thought to endure a little on the good, did not receive formal treatment, when the disease is serious can not walk, only after examination found to have reached the advanced stage of osteoarthritis, had to make artificial joint replacement surgery, would have been early to see a few hundred dollars to get good results, the results not only suffered, and spent tens of thousands of dollars, the loss is not worth it! Osteoarthrosis patients daily life considerations (1) reduce the burden on the knee joint. Pay attention to weight loss to prevent weight imbalance. (2) Avoid activities that cause pain, such as going up and down more than 4 flights of stairs, climbing, hiking, long-distance walking and running, etc., but you can ride a bicycle. (3) Pay attention to the warmth of the joint, promote blood flow, do not squat for a long time, etc. (4) To strengthen functional exercises to increase muscle strength, which can effectively improve the stability of the knee joint and control the development of the disease. If you practice knee hyperextension, hook your foot straight, straighten your leg, lift it up, stabilize it in the air for 5 seconds, and repeat the exercise. Put a pillow under the knee joint and press down hard on the knee joint. Cycling, insisting on half an hour a day, etc. are good exercises.