What is the best way to treat a swollen arthritic knee?
The most common symptom of knee arthritis is swelling, in addition to pain.
One of the most important reasons for the swelling of the knee joint is that there is “fluid” in the joint!
When you go to an orthopedic clinic, some doctors will tell the patient that the disease is called “synovitis” and that several large tubes of “water” will be extracted from the joint. The pain is really unbearable.
What is synovitis all about? The “water” in the joints where did it come from? And how to completely cure it?
To understand what synovitis is, we must first understand what synovium is.
The human body consists of 3 major parts of a functioning joint
1.Joint surface
Each joint has at least two corresponding articular surfaces, which are covered with articular cartilage, or “cartilage synovium” as a few people call it, which is 3-7 mm thick.
2.Joint capsule
It is a fibrous tissue attached to the bone surface around the joint surface. It has two layers, the outer layer is called the fibrous layer, which has the role of wrapping and stabilizing the joint. The inner layer is called the synovial layer, which is normally very thin and can secrete and absorb synovial fluid.
3.Joint cavity
It is a closed cavity composed of articular cartilage and synovial layer, which contains a small amount of synovial fluid under normal circumstances, about 3~5ml. It serves to lubricate the joint and protect the articular cartilage.
But in pathological conditions, this function of secreting lubricating fluid is disturbed, mainly in the following ways.
1, the secretion of lubricating fluid has become thin, secretion of more water;
2. The amount of lubricating fluid secreted increases greatly, and the knee joint becomes “swollen”.
Why does the synovial membrane become diseased?
The reasons for this are complex, and can be caused by any of the following
Infectious synovitis: various infections such as bacterial infections, tuberculosis infections, etc. Most pediatric synovitis are viral infectious synovitis.
Primary synovitis: rheumatoid arthritis, pigmented villous nodular synovitis, etc.
Secondary synovitis.
Meniscal injury, bleeding, etc., can also cause synovitis.
Accidental injury such as trauma, long-term chronic strain on the joint, surgery, etc.
Joint instability such as fresh or old ligament injury causing joint instability, or bony compression of the synovium, which stimulates the formation of synovitis.
In addition, joint aging, degeneration, osteophytes, and gout also tend to induce synovitis.
The first point in treating synovitis or finding swollen joints is to go to the hospital and have the doctor determine the cause first before treating the symptoms. Synovitis can often be cured by treating the cause of synovitis.
Treatment of synovitis
1. less activity and more rest during the acute phase
The most important treatment for the acute phase of synovitis is rest. The rest mentioned here is to require the patient to do as little as possible in addition to going to the bathroom, but pay attention to exercising the muscle strength of the quadriceps (thigh muscles), which generally requires 1-2 weeks or 3-4 weeks of rest, during which ice can be applied to the swollen area.
2.Should the fluid be pumped or not?
It is a controversial issue whether the fluid inside the joint should be pumped or not, but in most cases it is not necessary. We recommend that if the joint effusion is particularly large and the joint swells uncomfortably, it can be pumped, but when pumping joint effusion, it is important to pay attention to sterility, preferably in a better sterilized environment, to prevent infection of the joint cavity caused by pumping joint effusion.
3.Does synovitis require sodium vitreous acid?
Sodium vitrate is a kind of joint lubricant drug, many doctors are used to using this drug in the joint cavity injection. However, synovitis itself is not a decrease in joint lubricating fluid, but an increase in joint fluid, so sodium vitreous injection is not significant for the treatment of synovitis, and it can easily cause joint cavity infection.
4.Use of anti-inflammatory and analgesic drugs and physical therapy
(1) Drug therapy: In the acute phase of synovitis, if the pain is particularly severe, you can take some oral non-steroidal anti-inflammatory drugs for analgesic treatment.
(2) Physical therapy: for example, some Chinese herbal heat, ultra-short wave, low and medium frequency electrotherapy, wax therapy, etc., are more effective ways to promote the absorption of joint effusion.
Surgical treatment
In the case of treatment by other methods for more than 2 months and unsatisfactory results, surgery should be considered.
Surgery is mainly performed under the arthroscope, and the removal of the lesion is performed through the arthroscope. The removal includes inflammatory synovial membrane, exudate, deposits and neoplastic material.
Postoperatively, a tube should be placed to flush and drain the area, and medications (e.g., epinephrine) may be added to the flushing solution to help control bleeding and reduce the incidence of postoperative adhesions.