I. What is osteoarthritis
Osteoarthritis is one of the most common joint lesions. There are many names for osteoarthritis, such as osteophytes, proliferative knee arthritis, senile knee arthritis, hypertrophic osteoarthritis, degenerative arthritis, degenerative arthritis, and osteoarthrosis, and osteoarthritis is used uniformly in China. Its prevalence increases with age, mostly in middle-aged and elderly people, more women than men; it is more likely to occur in the joints that bear more weight: the knee joint.
Second, what can cause osteoarthritis
1, age: osteoarthritis is a degenerative change in the joints, preferably in the elderly, the older the age, the higher the incidence.
2, chronic strain: long-term poor posture, weight-bearing force, excessive weight, resulting in soft tissue damage to the knee joint.
3, obesity: the increase in weight and the onset of knee osteoarthritis is proportional. Obesity is an aggravating factor for the condition.
4, bone density: When the subchondral bone trabeculae become thin and stiff, their tolerance to pressure is reduced, so the chances of osteoarthritis increase in osteoporotic people.
5, trauma: frequent knee injuries, such as fractures, cartilage, ligament injuries are not treated correctly and in a timely manner.
6, genetic factors: osteoarthritis is also related to family genetic factors.
Three, the pathogenesis of osteoarthritis
The main pathological changes of osteoarthritis are degenerative degeneration and loss of cartilage, as well as reactive hyperplasia of the joint marginal ligament attachments and subchondral bone to form bone superfluities, which cause joint pain, swelling, stiffness deformity and functional impairment. Osteoarthritis can be divided into two categories: primary and secondary.
Four, clinical manifestations
1. Slow onset, mostly in middle-aged and elderly obese women, often with a history of exertion.
2. The pain in the knee joint is aggravated by activities, characterized by paroxysmal pain at first, then persistent pain, more so during exertion and at night, and obvious pain when going up and down stairs. The limb is difficult to change from one position to another, and the pain and stiffness are quickly relieved by a little activity: for example, stiffness and pain appear in the morning when getting up or when standing up after sitting for a long time, and the symptoms are obvious, and the joint symptoms are reduced or disappear after activity.
3. Knee joint movement is limited, or even limping. Very few patients may develop interlocking phenomenon or knee joint effusion.
4. There may be popping and grinding sounds when the joint moves, and some patients have swollen joints, and joint deformity can be seen over time.
5. Knee pain is a common complaint of patients with this disease. The early symptoms are pain when going up and down stairs, unilateral or bilateral, joint cavity effusion, free body formation, and in severe cases, knee valgus deformity.
6. X-ray examination: joint hyperplasia is predominant, joint surface is rough, and joint space is narrowed.
V. Treatment methods
1.Non-pharmacological treatment
Including massage, acupuncture, health education, self-training, weight loss, aerobics, joint mobility training, muscle strength training, the use of walking aids, wedge walking insoles for internal knee rollover, occupational therapy and joint protection, aids to daily life, etc.
2.Osteoarthritis drug treatment
(1) Sodium hyaluronate: It is the main component of the synovial fluid of the joint cavity and one of the components of the cartilage matrix. It plays a lubricating role in the joint and reduces friction between tissues, and can significantly improve the inflammatory response of synovial tissue after injection into the joint cavity, enhance the viscosity and lubricating function of the joint fluid, protect the joint cartilage, promote the healing and regeneration of the joint cartilage, relieve pain and increase the mobility of the joint.
(2) Glucosamine: the most important monosaccharide constituting the cartilage matrix of joints, glucosamine can block the pathogenesis of osteoarthritis, promote the synthesis of proteoglycans with normal structure by chondrocytes, and inhibit the production of enzymes that damage tissues and cartilage, reduce the damage of chondrocytes, improve joint activity, relieve joint pain and delay the course of osteoarthritis inflammation.
(3) Non-steroidal analgesic and anti-inflammatory drugs: they can counteract inflammatory reactions and relieve joint edema and pain.
(4) Topical medication: external application of Chinese herbal medicine, Chinese herbal hot amenity pack treatment, Chinese herbal medicine fumigation, etc.
3.Surgical treatment
If the symptoms of osteoarthritis are very serious, drug treatment is ineffective, and it affects the patient’s daily life, surgery should be considered.
(1) Minimally invasive arthroscopic surgery: arthroscopic cleanup is suitable for patients with osteoarthritis with degenerative damage to the free body and meniscus of the knee joint, and is a safe and practical new technique for diagnosing and treating knee joint diseases. This type of surgery has good near-term results, but the long-term results are not certain.
(2) Joint replacement surgery: For most patients with osteoarthritis, femoral head necrosis and rheumatoid arthritis, it has significant effect in relieving pain and restoring joint function.
Indications for surgery include.
①Knee pain persists for a long time and seriously affects daily life; significant pain in the knee joint occurs within 500 meters of walking.
②X-ray shows: osteophytes and sclerosis of the knee joint, narrowing of the joint space and deformity.
③Patients for whom various conservative treatments are ineffective.
Six, how to scientifically prevent osteoarthritis
1, try to avoid physical obesity, to prevent aggravating the burden of the knee joint, once the body is overweight, we should actively lose weight and control weight.
2, pay attention to walking and labor posture, do not twist the body to walk and work. Avoid squatting for a long time, sitting and standing for a long time, and also change your posture frequently to prevent the knee joint from being fixed in one position and exerting too much force.
Do not wear high heels when walking long distances, but wear thick-soled and flexible soft-soled shoes to reduce the impact on the knee joint and avoid wear and tear on the knee joint.
3, when participating in physical exercise should do a good job of preparing activities, gently stretch the knee joint, so that the knee joint is fully active before participating in strenuous exercise. When practicing leg press, do not lift your leg too high to prevent excessive strain on the knee joint. When practicing taijiquan, do not squat too low, and do not play several sets in a row to prevent injury to the knee joint from being overburdened.
4, the knee joint encounter cold, vasoconstriction, blood circulation becomes poor, often making the pain worse, so in cold weather should pay attention to keep warm, if necessary, wear a knee brace, to prevent the knee joint from getting cold.
5. People with osteoarthritis of the knee should try to walk up and down stairs, climb less, stand less, and lift less heavy objects to avoid overloading the knee joint and aggravating the condition.
6, people with osteoarthritis of the knee, both to avoid excessive fatigue of the knee joint, but also to carry out appropriate functional exercise to increase the stability of the knee joint, to prevent muscle atrophy of the leg, which not only relieves joint pain, but also prevents the progress of the disease, do not think that only rest and inactivity to protect the diseased knee joint. According to research, people with knee osteoarthritis, swimming and walking are the best exercises that do not increase the weight-bearing capacity of the knee joint, but also allow the muscles and ligaments around the knee joint to be exercised. Secondly, sit-ups, push-ups, bridge arches and the repeated practice of raising and lowering the two retreats on the supine bed, imitating pedaling a bicycle, are the best exercises for patients.
7, in terms of diet, should eat more food containing protein, calcium, collagen, isoflavones, such as milk, dairy products, soybeans, soy products, eggs, fish and shrimp, kelp, black fungus, chicken feet, pig’s feet, leg of lamb, beef tendons, etc., these can supplement protein, calcium, prevent osteoporosis, but also to grow cartilage and joint lubricating fluid, but also supplement estrogen, so that bones and joints better calcium metabolism and reduce the symptoms of arthritis.
Avoid high-fat foods (such as beef, pork fat, etc.) and foods that are too acidic, alkaline, salty, synthetic foods, pickled foods, and fried foods. Salt should be limited to 6 grams per day. Avoid or reduce the consumption of sweet foods, such as sweet cakes, sweet snacks, candy, ice cream, chocolate, etc. Avoid or reduce the consumption of pepper, pepper, and tomatoes, spinach, amaranth, wild rice, eggplant, potatoes, etc. Avoid alcohol and carbonated beverages, drink less strong tea and coffee, shellfish, dried fruits, foods with MSG additives and preservatives.