The onset and development of OA is a long-term progressive degenerative process, and the clinical manifestations of patients vary at different stages of the disease. There are many treatment methods available,
Different treatment measures can be taken according to the severity of the disease, the patient’s age and activity level. The maintenance of bone mass is largely dependent on the proper intake of nutrients and minerals, so it is important to eat more calcium-rich foods. Weight control: Overweight increases the local load on the knee cartilage, making it more prone to wear and damage, so weight control for patients with knee OA can help reduce symptoms and slow down the disease process. ③ Exercise and rest: Exercise appropriately, avoid strenuous exercise, and reduce the weight on the knee joint; do not go up and down stairs or squat frequently to reduce the pressure on the articular cartilage;
The use of knee braces, canes and crutches can reduce the pressure on the affected joint and improve joint function; shock-absorbing shoes can also reduce the stress on the lower limb joints and pain during walking, and may slow down the degeneration process of the joint;
Early quadriceps exercise to maintain knee stability and reduce quadriceps atrophy. Manual therapy can increase the blood flow rate and flow of the knee joint, improve the blood circulation in the joint, promote the absorption of inflammatory substances, reduce the intraosseous pressure, and facilitate the penetration and diffusion of synovial fluid into the articular cartilage,
This will improve the nutrition and metabolism of joint cartilage and enhance the regeneration and repair ability of cartilage. Physical therapy Heat, ultrashort wave and hydrotherapy, acupuncture, electro-acupuncture and other physical therapy measures can improve human blood and lymph circulation, strengthen the local tissue oxygen supply and nutrient supply, accelerate the removal of pathological products,
It is conducive to the dissipation and absorption of inflammatory lesions, and has a good pain relief effect. However, these methods can only relieve the symptoms, and do not affect the process of the disease. 4, drug treatment 1, Western medicine ① analgesic and non-steroidal anti-inflammatory analgesic: analgesic drugs do not have anti-infective effect, but has a good antipyretic, analgesic effect, can relieve moderate pain below, for more serious pain effect is not good, if the amount is too much,
If too much is used, there is a risk of gastrointestinal bleeding. Non-steroidal anti-inflammatory drugs are commonly used in the clinical treatment of osteoarthritis,
They are especially suitable for people with prolonged stiffness, swelling, localized fever and other inflammatory manifestations. Traditional NSAIDs include aspirin, ibuprofen, diclofenac and indomethacin. The mechanism of action is to inhibit the synthesis of prostaglandins, which are inflammatory substances in the body,
The mechanism of action is to inhibit the synthesis of prostaglandins, the inflammatory substance in the body, by binding to the enzyme cyclooxygenase, blocking the enzyme catalyzing the conversion of arachidonic acid into prostaglandins, thus exerting pain relief and anti-inflammatory effects. The new generation of non-steroidal drugs such as celecoxib are highly selective cyclooxygenase-2 inhibitors,
It has good anti-infective and analgesic effects and low gastrointestinal adverse effects. Glucosamine hydrochloride: Glucosamine hydrochloride can reduce the symptoms of joint pain and slow down and change the pathological process of OA. The mechanism of action of this drug is the formation of proteoglycan colloid complexes attached to the matrix collagen reticulum,
Together with the collagen meshwork, it forms an elastomer that acts as a load-bearing, stress-conducting and cushioning agent, and protects the cartilage structure and subchondral bone. Glucosamine hydrochloride inhibits the degradation of proteoglycans caused by immune factors,
It repairs damaged articular cartilage and restores the function of damaged joints in a comprehensive manner. Chondroitin sulfate: Chondroitin sulfate can promote cartilage repair and maintain synovial fluid viscosity. Studies have shown that,
Chondroitin sulfate can stimulate the synthesis of hyaluronic acid, proteoglycan and collagen by chondrocytes, thus promoting the formation of new cartilage tissue. In vitro chondrocyte culture experiments showed that,
Chondroitin sulfate enhanced the expression of type II collagen mRNA and cartilage regeneration in porcine chondrocyte cultures. In addition, some in vivo studies have also shown that,
Chondroitin sulfate has been shown to have therapeutic effects on OA. When chondroitin sulfate was administered to a mouse model of type II collagen inflammation, it was found to significantly inhibit joint edema, synovitis and articular cartilage destruction. ④ Antioxidants: Reactive oxidative metabolites produced in normal metabolic and pathological states can damage hyaluronic acid, proteoglycans and collagen, and affect the mechanical properties of articular cartilage,
This is an important factor in the occurrence and development of OA. Some antioxidants, such as vitamin C, β-carotene and vitamin E, have a wide range of antioxidant activities, which can not only eliminate free radicals and reactive oxygen species produced during cellular metabolism, but also may play a role in cartilage repair,
They may also play a special role in cartilage repair process. ⑤ Deer melon peptide: Deer melon peptide is an osteoinductive peptide biologic made from the bone extract of the northeastern deer and the extract of sweet melon seeds from the local Cucurbitaceae family,
The main pharmacological effects include promoting cell mitosis, differentiation and osteolytic activity, among which bone morphogenetic proteins are a group of acidic low molecular weight glycoproteins, as a highly effective osteoinductive substance,
As a highly effective osteoinductive substance, it can induce the conversion of perivascular mobile mesenchymal cells into irreversible chondrocytes and osteoblasts, thus exerting a regulatory effect on the differentiation of osteoblasts and chondrogenic cells. Melon seeds can reduce inflammatory exudation,
It also inhibited the release of prostaglandins and achieved pain-relieving effects. Melon seed extract has a synergistic effect with the supplemented osteoinductive peptide biokines,
It can jointly promote the synthesis of osteoinductive growth factors. (6) Sodium vitrate: At present, the main clinical intra-articular injections include corticosteroids, vitamin B, lidocaine and sodium vitrate. Intra-articular injection of corticosteroids can reduce the inflammatory response and have pain-relieving effects,
However, they cannot change cartilage degeneration, and steroid-induced osteoarthropathy may occur if used in excessive amounts. In addition, corticosteroids can inhibit protein synthesis in the joint and reduce cartilage matrix content,
In addition, corticosteroids can inhibit protein synthesis in the joint, resulting in a decrease in cartilage matrix and aggravating cartilage damage. Intra-articular injection of sodium vitreous acid has been widely used in recent years. It covers the cartilage surface, enters the cartilage matrix when the cartilage degenerates and cracks, and forms a polymer with the proteoglycans in the matrix,
It prevents proteoglycans from spilling out of cartilage, increases the viscosity of joint fluid, increases its lubricating ability, and inhibits chondrocyte apoptosis. (7) Gene therapy: With the continuous understanding of the pathogenesis of OA and the development of gene therapy technology, more and more target genes have been used in the experimental and clinical research of gene therapy for OA cartilage degeneration. Currently,
Gene therapy for OA can be achieved by modulating the expression of genes related to cartilage degradation factors and/or promoting the expression of genes related to cartilage repair factors.
Gene therapy for OA can be achieved by regulating the gene expression of factors related to cartilage degradation and/or promoting the gene expression of cartilage repair factors. 2.Chinese medicine treatment: ①Chinese medicine internal treatment: Chinese medicine internal treatment method by activating blood and relieving pain, warming the meridians, dispelling cold and dampness, tonifying liver and kidney, strengthening tendons and bones, and relieving clinical symptoms,
To achieve the effect of both primary and secondary treatment. The most commonly used treatments are Palsy Capsules, Xian Ling Bone Depot, and various herbal tonics. External treatment with Chinese medicine: External treatment with Chinese medicine follows the principle of “no pain if it passes through”, and generally uses drugs with warming effect to fumigate the affected area with decoction water or hot iron or compress on the affected area after processing, so that the medicinal power can directly reach the lesion to improve local circulation,
To promote the absorption of pathological exudates, to achieve the purpose of anti-infection and pain relief. 5, surgical treatment 1, small needle knife: according to the pressure and pain area to choose 3 ~ 5 points of local closure, and then to perform longitudinal and transverse sparing, shoveling and cutting of the pain area around the knee joint. On the one hand, small needle treatment can loosen tissue adhesions,
On the other hand, it can improve blood circulation and eliminate the stimulation of inflammatory factors such as metabolites,
On the other hand, it can improve blood circulation, eliminate the stimulation of metabolic products and other inflammatory factors, so that inflammation and edema disappear. 2, arthroscopy: including joint lavage and intra-articular cleaning, arthroscopic surgery for OA has been controversial whether the effective,
The focus is mainly on the physiological mechanism of the treatment method is unclear, and the lack of strong evidence of the effectiveness of the treatment. The traditional view is that arthroscopic debridement for OA is less invasive, more intuitive, simpler to perform, and has less impact on joint function,
It can be repeated if necessary, and the pathological changes of the internal structures of the joint can be visualized under the microscope and treated accordingly,
It is also possible to directly visualize the pathological changes of the internal structures of the joint under the microscope and perform the corresponding treatment, such as repair of the worn joint surface, meniscus repair, adhesion release, and removal of pathological articular cartilage to regenerate and repair the cartilage surface. During the operation, the joint cavity was irrigated with a large amount of 0.9% sodium chloride injection at a certain pressure,
This not only removes cartilage, necrotic tissue debris and inflammatory media, but also improves the internal environment of the joint, causing rapid reduction of synovial inflammation and restoration of normal synovial fluid secretion, which has a positive effect on the treatment of mild to moderate knee OA.
has a positive effect. 3, osteotomy: OA patients with internal knee and medial knee OA or with knee subluxation, severe pain, affecting the activities, non-surgical treatment is not effective,
Osteotomy can be considered. The most common type of osteotomy is a high tibial osteotomy. This procedure allows partial repair of the degenerating joint by reconstructing the force lines of the lower extremity and making full use of the favorable conditions of healthy articular cartilage,
At the same time, it reduces the intraosseous pressure in the upper tibia, and the distal end of the tibial osteotomy is lightly internally rotated to elevate the tibial tuberosity, loosening the patellar ligament and reducing the pressure on the patellofemoral joint, thus reducing symptoms,
Improve the function of the joint. 4.Artificial knee joint replacement: For people with severe pain, deformation and dysfunction, artificial knee joint replacement has good effect, but this surgery requires high requirements for surgeons and is expensive,
Therefore, the indications for surgery should be strictly controlled. In conclusion, the etiology and pathogenesis of knee OA are not well understood and need to be further investigated and targeted for prevention and treatment. The current treatment methods should be integrated, and early diagnosis should be made before the disease develops into severe OA.
The early diagnosis should be made before the disease develops into severe OA, and the appropriate treatment plan should be selected according to the disease, which can effectively delay the degeneration of the knee joint, reduce the pain of patients and improve the quality of life.