Drug treatment
1.Sodium hyaluronate: It is the main component of synovial fluid of joint cavity and one of the components of cartilage matrix. It plays a lubricating role in joints and reduces friction between tissues, and can significantly improve the inflammatory reaction of synovial tissue after intra-articular injection, enhance the viscosity and lubricating function of joint fluid, protect joint cartilage, promote the healing and regeneration of joint cartilage, relieve pain and increase the mobility of joints. It is often injected intra-articularly, once a week for 5 weeks, and must be operated strictly aseptically.
2.Glucosamine: It is the most important monosaccharide that constitutes polyglucosamine (GS) and proteoglycan in articular cartilage matrix. Normal people can synthesize GS by amination of glucose, but in osteoarthritis, the synthesis of GS in chondrocytes is blocked or insufficient, resulting in softening of cartilage matrix and loss of elasticity, destruction of collagen fiber structure, and increase of cartilage surface lumen to make bone wear and tear. Glucosamine can block the pathogenesis of osteoarthritis, promote the synthesis of proteoglycans with normal structure in chondrocytes, and inhibit the production of enzymes (such as collagenase and phospholipase A2) that damage tissue and cartilage, reduce damage to chondrocytes, improve joint movement, relieve joint pain, and delay the course of osteoarthritis. Take 250-500mg orally once, 3 times a day, best taken with meals.
3, non-steroidal analgesic anti-inflammatory drugs: can inhibit the synthesis of cyclooxygenase and prostaglandin, counteract the inflammatory response, relieve joint edema and pain.
Surgical treatment
If the symptoms of osteoarthritis are very severe, medication is ineffective, and it affects the patient’s daily life, surgical intervention should be considered.
For osteoarthritis of the knee, some people advocate arthroscopic arthroscopic debridement first. This type of surgery is effective for some patients in the near future, but the long-term effect is not certain.
2, joint replacement surgery for most patients with osteoarthritis, femoral head necrosis, rheumatoid arthritis, has significant effects in relieving pain and restoring joint function, but a small percentage of patients with joint replacement surgery have certain immediate and long-term complications, such as loosening and wear of components and osteolysis.
The goals of joint replacement surgery are to.
1. To relieve pain so that the patient has a pain-free joint.
2. To maximize joint function and improve the patient’s quality of life based on pain relief.
Surgical indications for joint replacement include.
1. Radiological evidence of joint damage;
2. The presence of moderate to severe persistent pain or disability;
3. Patients who have failed to respond to various non-surgical treatments.
Since the outcome of artificial joint replacement is closely related to the length of surgery, the experience of the surgeon, the patient’s preoperative physical condition, perioperative management and rehabilitation. Therefore, a good joint surgeon should be knowledgeable, well-trained, and skilled in order to be able to perform artificial joint replacement surgery independently.
Currently, the most commonly used surgeries are knee surface replacement, hip replacement and ankle replacement.
Non-pharmacological treatment
These include patient health education, self-training, weight loss, aerobic exercises, joint mobility training, muscle strength training, use of mobility aids, wedge inserts for internal knee rolls, occupational therapy and joint protection, aids to daily life, etc. A significant proportion of patients in Europe and the United States can reduce their symptoms and return to normal life and work through the above treatments.
Patients with osteoarthritis of the knee often have reduced quadriceps muscle strength, which was previously thought to be caused by disuse atrophy, but recent studies abroad have concluded that quadriceps muscle atrophy is not entirely caused by osteoarthritis, and that reduced quadriceps muscle strength may be one of the risk factors for osteoarthritis of the knee. As a result, the stability of the knee joint is affected and the normal muscle cushioning capacity is reduced, so strengthening the quadriceps muscle strength and aerobic training is beneficial for patients with osteoarthritis.