Can synovitis of the knee be completely cured?
Synovitis of the knee, these words are familiar to many friends, every time the knee swelling to the hospital examination, finally get these words.
The symptoms are not relieved at all when you go home to rest, and the symptoms are aggravated when you exercise a lot, and the pain is so unbearable that you wonder if you have a fake knee.
What is synovitis of the knee?
Synovitis of the knee is a sterile inflammatory disease that is caused by sprains and a variety of intra-articular injuries to the knee. Abnormalities in the synovial membrane can result in the normal production and absorption of joint fluid, and fluid buildup in the knee joint. Changes in the morphology of the synovium also attack the cartilage of the knee, which can lead to osteoarthritis of the knee if left untreated, with a high risk of disability.
Causes
1. Acute trauma and chronic injury are the most common causes in young adults. Acute trauma includes: knee sprain, meniscal injury, lateral collateral ligament or cruciate ligament injury, intra-articular fluid or sometimes blood accumulation, manifested as acute traumatic synovitis of the knee.
2. Synovitis occurs more frequently in the elderly, mainly due to mechanical biochemical irritation from cartilage degeneration and bone proliferation, secondary to synovial edema, exudation and effusion.
3, Sometimes it can also be caused by simple knee synovial injury or long-term chronic knee strain, which can lead to gradual swelling and dysfunction of the knee joint, and then form chronic knee synovitis.
4, infection, of which the common is synovial tuberculosis infection, generally speaking, the synovial membrane is rich in blood vessels, good blood circulation, strong resistance to bacteria, but in the case of infection with tuberculosis bacteria, the disease progresses more slowly, and its symptom performance is sometimes good and sometimes bad.
Clinical manifestations
Synovitis of the knee is not age specific, but can occur at any age. In young people, they usually have a greater amount of exercise and are therefore prone to swelling, pain, difficulty moving, walking with a limp, high local skin temperature, swollen and tense skin, or joint puncture with bleeding fluid after a blow, twisting, or excessive movement of the knee joint during exercise.
So, how should synovitis of the knee be treated? What are the treatment modalities?
About treatment: In the early stage when the symptoms are mild, you can observe temporarily, pay attention to rest and avoid straining. Treatment is based on medication, physical therapy, drug therapy and surgery. Drug treatment mainly includes non-steroidal anti-inflammatory drugs, painkillers, topical anti-inflammatory and analgesic drugs, etc.
1.Acute treatment
The main purpose of acute treatment is to relieve pain, reduce swelling and improve joint function. Crutches or canes can be used to assist activities and reduce weight-bearing on the joints, while excessive and substantial activities should be avoided.
The use of anti-inflammatory and analgesic drugs can quickly reduce or control the symptoms, but should not be taken for a long time.
2.General treatment
Fix the affected area for 2~3 weeks, reduce the activities and weight-bearing of the affected joints, and avoid large activities of the joints to rest in bed and elevate the affected limbs to reduce the burden on the joints and accelerate the recovery;
Physiotherapy and joint rehabilitation exercises should be carried out appropriately to prevent muscle atrophy and joint decompensation. For patients with obvious swelling of the joint, puncture and aspiration are feasible to reduce the pressure on the synovial membrane.
Drug treatment
Patients can be treated with the following medications under the guidance of a doctor.
1.Non-steroidal anti-inflammatory drugs
Their effect is to control inflammation and relieve pain.
Non-selective NSAIDs are not recommended because of the risk of gastrointestinal bleeding and perforation;
Selective NSAIDs (such as celecoxib, etoricoxib) have less gastrointestinal adverse effects, but patients with cardiovascular disease should be noted that their use is prohibited.
2.Anti-inflammatory and analgesic drugs
Before using oral drugs, it is recommended to choose local topical drugs in the early stage, especially for the elderly, they can use various anti-inflammatory and pain-relieving drugs such as gel plasters.
Local topical drugs can effectively relieve mild to moderate pain in joints, and their gastrointestinal adverse reactions are mild, but attention should be paid to the occurrence of local skin adverse reactions.
For patients with significant pain, oral pain medication can be used as appropriate.
3.Methotrexate
For moderate to severe knee osteoarthritis secondary to synovitis, some studies have shown that the application of methotrexate can reduce pain and improve the functional status of the knee joint. However, there is no clinical evidence of widespread use.
4.Biological response modifiers
With the in-depth study of various histopathologies of osteoarthritis more therapeutic targets have been identified. Biological response modifiers may be used to treat synovitis secondary to osteoarthritis of the knee.
5. Joint cavity drug injection
This method requires joint cavity puncture for injection of drugs, commonly injected drugs include glucocorticoids, sodium glacial, etc.
Injected drugs have the functions of lubrication, anti-infection and cartilage repair, which can effectively relieve pain and improve joint function in the short term. However, this method is an invasive treatment and may increase the risk of joint infection.
Surgical treatment
Surgery should be considered for those who are unable to get relief after more than 2 months of conservative treatment. The primary surgical procedure is arthroscopic debridement of the lesion, including inflammatory synovium, exudate, deposits, and neoplastic material.
The procedure should be combined with drainage with the addition of medications (e.g., epinephrine) to help control bleeding and reduce the incidence of postoperative adhesions. For synovitis secondary to severe knee osteoarthritis, aggressive step therapy for knee osteoarthritis should be performed.