Joints are important structural tissues for people to perform various life and social activities. Meeting the needs of various activities depends on the physiological characteristics of the constituent tissues of the joints being intact and structurally sound. In general, a well-functioning joint must have effective stability (including the morphological integrity of bones and the functional integrity of soft tissues such as ligaments), smoothness of joint surface structures (including bone tissue structures adjacent to the joint surface and cartilage tissue structures on the joint surface), no abnormal structures in the joint cavity (such as abnormal hyperplasia, free bodies, incomplete evolution, etc.), a perfect physiological range of motion, correct trajectory of motion and The conditions include a well-developed physiological range of motion, correct trajectory and axis of force, and coordinated and powerful motor muscles. Pathological changes in any of these conditions can cause joint dysfunction (e.g., reduced range of motion, painful sensation, fear, etc.). Trauma, infection, deformity, chronic age-related damage, vascular neuropathy, tumors, rheumatoid and other immune diseases, osteoporosis, long-term fixation, and other factors can cause pathological changes in these conditions. In many cases, it is difficult or even impossible to recover from pathological changes in joint structure or constituent tissues once they occur, which, combined with lack of patient awareness and inappropriate activities, results in progressively severe joint dysfunction.
When the joint becomes severely dysfunctional, besides bringing physical displeasure or pain to the patient due to pain and fear, more importantly: the inconvenience in mobility makes the patient reduce or even lose the ability to participate in social activities, unable to interact with others, unable to enjoy a better life, unable to better demonstrate personal abilities and values. At the same time, they may have to rely on the help of others to perform basic physical activities because of the reduced or lost ability to take care of themselves, which not only sometimes does not preserve their self-esteem, but also brings additional human burden to their families or society. In addition, in order to resist the pain, patients have to seek medical help and prescriptions for a long time, thus causing an excessive financial burden. All of these have caused great mental suffering to the patients.
Therefore, it is necessary to pay attention to the protection of joint function, reasonable choice of exercise methods, and correct understanding of the value of treatment.
First, joint disease, early diagnosis and early treatment
In China, there are more than 100 million patients with various types of joint damage, and there is a trend of youth, the most common of which are osteoarthritis and rheumatoid arthritis. There are 355 million arthritis patients worldwide, of which 190 million suffer from osteoarthritis and more than 16.5 million from rheumatoid arthritis. As the world’s number one disabling disease, osteoarthritis can cause total loss of mobility in severe cases, while rheumatoid arthritis has a 50% bone destruction rate in those with a two-year disease course, shortening life expectancy by about 10-15 years in severe cases. In response to the reality that people are not sufficiently alert to this, experts have long issued a call for early prevention, early diagnosis and early treatment to prevent disability.
Since there is no specific treatment that can completely cure joint lesions that have undergone structural changes. Therefore, it is important to make a clear diagnosis as early as possible and to receive the right interventional treatment as soon as possible to control the progression of the disease, protect the function of the joint and minimize the degree of disability.
The current interventional treatment for joint lesions mainly includes surgical and non-surgical treatments. The purpose of surgery is to repair the trauma, correct the deformity, remove the lesion, rebuild the mobility and stability of the joint, and eliminate intractable pain. There are many non-surgical treatments, the main purposes of which are anti-inflammatory, analgesic, blood circulation and blood stasis, regulation of immunity, and promotion of metabolism.
Among the non-surgical treatments, Chinese herbal medicine shows stronger advantages. Many herbal medicines have the efficacy of activating blood stasis, regulating immunity, supporting the righteousness and driving away evil, regulating qi, promoting metabolism, and supplementing trace elements. At the same time, TCM emphasizes the combination of internal and external treatment, and the combination of drug and non-drug treatment, including diet therapy, massage therapy, exercise therapy, traction therapy, fumigation therapy, hot compress therapy, bath therapy, steam therapy, wet mud therapy, acupuncture point therapy and so on. Not only the variety of treatment, suitable for different diseases, different people’s choice, the treatment effect is remarkable, but also to avoid the possible toxic side effects due to long-term use of chemical synthetic drugs.
Second, the need for exercise, pay attention to the way
The function of the joint is closely related to the movement. Any patient who refuses or is unable to move for a long time, or whose activity is too little, can cause osteoporosis, atrophy of limb muscles, slowing down of local blood circulation in the joint, slowing down of tissue metabolism, degeneration of joint cartilage, etc., which will then lead to stiffness of the joint and change of tissue structure, etc. Some studies have proved that joint fixation for more than three months may cause irreversible dysfunction. Therefore, exercise is very important. However, improper exercise can aggravate joint wear and tear, destroy cartilage structures, and even damage tendon ligaments, further aggravating joint pain, destroying the stability and smoothness of joints, and also causing irreversible joint dysfunction.
For patients who already have joint damage, the following issues should be noted in the exercise process.
1, reducing weight can relieve the compression and ligament muscle strain load on the spine, knees, hips, ankles and feet to reduce further wear and tear of the joints and strains.
2, relaxation, mental attitude is essential to reduce joint pain, any rigid movements may cause new injuries.
3, avoid persistent standing, sitting, squatting, often changing posture helps to promote blood circulation and promote the metabolism of joint cartilage.
4, avoid excessive semi-squatting fatigue, such as long climbing, stair climbing, tai chi, etc., because semi-squatting force on the knee cartilage damage the most.
5, do not fatigue exercise, such as forced leg press, long time walking, repeated squatting and standing up, fast running, long time dancing, etc., these conditions are aggravated by joint damage.
6, do not exercise in the acute phase, joint redness, swelling, heat, pain is obvious, because the acute phase of the joint tissue due to the inflammatory response is obvious and become very fragile, normal activities are likely to produce tissue damage.
7.Select exercises that are less wear and tear on the joints, such as swimming, bicycling on flat ground, joint extension and flexion activities in the prone position, easy walking, jogging, etc.
8, pay attention to the combination of static and dynamic, exercise for a continuous period of time should not be too long, the interval rest time between two exercises should exceed the time of the previous exercise.
9, the way and time of exercise, also according to different ages, different causes, different degrees, different periods of lesions easy.
10. Exercise should be performed under the guidance of an experienced doctor if necessary.
Third, minimally invasive surgery, safe and effective
Arthroscopic technology is the fastest growing orthopedic surgery technology in China in recent years. Arthroscopy uses delicate and meticulous instruments, and through video imaging magnification, changes and lesions of various parts inside the joint can be observed under direct vision in both static and dynamic. The arthroscopic surgery is done through 2-3 skin incisions of about 0.5cm, inserting observation lenses and operating instruments, etc., respectively, which minimizes the interference with normal tissue structures and causes almost no additional damage or impact on joint function. Therefore, it has the advantages of less damage, high safety, less bleeding, accurate and comprehensive observation, and quick recovery after surgery. At present, the scope of application of arthroscopic technology includes almost all large joints of the knee, hip, shoulder, ankle, elbow, wrist and other extremities, and has become an important method of examination and diagnosis and means of treatment in joint surgery. In particular, most diseases in the knee and shoulder joints can be examined and treated by arthroscopy, such as knee meniscus injury or deformity, knee cruciate ligament injury, intra-articular free body, articular cartilage lesion, synovial lesion, abnormal intra-articular bone growth, joint capsule contracture, frozen shoulder, rotator cuff injury, habitual dislocation, septic infection, etc. In general, there are few serious complications associated with arthroscopic surgery, and the only possible complication is wound infection, making it a very safe surgical procedure.
It is especially worth mentioning that many traumatic injuries resulting in blood accumulation in the joint cavity, inflammatory fluid in the joint cavity due to various arthritis or joint infections, free debris in the joint cavity due to chronic degenerative arthritis, and hyperplasia and hypertrophy of the synovial membrane due to lesions can all cause changes in the normal joint fluid properties. The normal joint fluid is an important source of nutrient metabolism for articular cartilage, and changes in the joint fluid properties will inevitably lead to metabolic disorders of articular cartilage, resulting in cartilage degeneration and even lesions, which will then affect joint function. Current research shows that once the articular cartilage is degenerated, it cannot be repaired yet. Therefore, early improvement of joint fluid shape and maintenance of normal metabolism of articular cartilage are equally important measures to safeguard joint function. Arthroscopic surgery can effectively clean the debris and pathological joint fluid in the joint, repair the damaged area, and remove the diseased tissue for the purpose of improving and protecting the joint function. It has been compared to such arthroscopic surgery as a machine maintenance treatment, which is especially significant for patients with senile degenerative osteoarthrosis in the early and middle stages of the disease.
Fourth, joint replacement, late-stage salvation
Artificial joint replacement surgery matured in the 1960s and was one of the greatest advances in the field of surgery in the last century. Artificial joint replacement surgery is currently the most effective and mature method of treating advanced joint disease, which can achieve the good purpose of correcting joint deformity, eliminating joint pain, restoring joint function, and greatly improving the quality of life of patients.
Generally speaking, you can walk and exercise 14 days after arthroplasty, and basically resume daily activities after 3 months. If the joint prosthesis is properly designed and selected, if the surgeon is properly fitted, and if the patient uses it properly, it can be used for a longer period of time. According to a retrospective study by experts, more than 90% of patients reach 15 years of intact service life, more than 70% reach 20 years of intact service life, more than 40% reach 25 years of intact service life, and some patients reach more than 30 years of intact service life.
At present, artificial joints are stereotyped products made of metals and polymers or bioceramics that are stable in the body and do not produce toxic substances, according to the structure, morphology and functional characteristics of human joints, which do not have metabolic biological functions and depend on being embedded in the bone to achieve close contact with the bone tissue and form a fixed state, thus realizing the function of limb joint activities. Once due to osteoporosis, local infection, trauma, excessive weight bearing and strong activity, etc., is bound to cause the surface of the prosthesis and bone contact from close contact to separation and loosening, which is commonly referred to by doctors as prosthesis loosening complications, clinical symptoms will appear pain, seriously affect the joint movement function. Once loosening of the prosthesis occurs, most patients require a new replacement surgery. Therefore, patients should avoid strenuous activities, avoid excessive fatigue, maintain ideal body weight, pay attention to reasonable nutrition, increase the necessary sunshine and exercise, and eliminate various infectious diseases and correct other diseases in the body as soon as possible after the artificial joint replacement surgery.
As artificial joint replacement surgery is the most effective and mature treatment method to improve joint function, there is no other alternative. Therefore, when the joint damage is serious and seriously affects the joint function, and other treatment methods cannot improve it, artificial joint replacement surgery should be performed as soon as possible. To prevent severe joint deformation, osteoporosis, muscle atrophy and degeneration, and secondary pathological changes in other organs and tissues such as cardiovascular, cerebrovascular and respiratory due to long-term activity restriction, etc., which may affect the implementation of surgery and surgical results. To restore the patient’s physical and mental health as early as possible, and to reduce the various burdens of the family and society as much as possible.
Conclusion
With the development of human society and the process of population aging, bone and joint diseases have become a serious disorder endangering human health, and their harmful effects are receiving increasing attention from all over the world. In order to actively respond to the serious challenges of bone and joint diseases, improve human health and improve the quality of life, the international cooperation organization of the Decade of Bone and Joint was established with the support of the United Nations, which was responded by many countries and regions in the world, and China is one of the organizing countries. 2000 January World Health Organization (WHO) officially announced the implementation of the “Bone and Joint Decade Plan.
In today’s increasing attention to the prevention and treatment of bone and joint diseases, let us join hands with doctors and patients, full understanding, mutual cooperation, common resistance to the disease, to meet a better life and efforts!