Osteoarthritis of the knee joint Osteoarthritis is a chronic joint disease whose main changes are degeneration of the cartilage surfaces of the joint and secondary osteophytes. The main manifestations are joint pain and inflexibility. X-rays show narrowing of the joint space, dense subchondral bone, broken trabeculae, sclerosis and cystic changes. There is lip-like hyperplasia at the edge of the joint. In the later stage, the bone ends are deformed and the joint surface is uneven. The cartilage in the joint peels off and the bone fragments into the joint, forming an intra-articular free body. Osteoarthritis, also known as degenerative arthritis, is not actually an inflammatory condition, but is primarily a degenerative condition that involves premature aging of the joints, particularly the articular cartilage. Osteoarthritis represents the aging of the joints and is therefore called age-related arthritis. The broader term osteoarthritis also includes a number of other aseptic arthritic disorders. The basic introduction of the disease description treatment plan Chinese medicine point of view self-preventive care and treatment to expand the basic introduction of the disease description treatment plan Chinese medicine point of view self-preventive care and treatment to expand the basic introduction [disease family] orthopedics knee osteoarthritis is a chronic bone and joint disorder caused by the degeneration of knee cartilage, bone proliferation, also known as knee proliferative arthritis, degenerative arthritis and osteoarthrosis. arthrosis, etc. The disease occurs mostly in middle-aged and elderly people, but can also occur in young people; it can develop unilaterally or bilaterally.
According to statistics, 50% of people over 50 years of age suffer from arthritis; osteoarthritis of the knee is a common disease of the middle-aged and elderly in which extensive degenerative changes occur in the bone and joint structure, including the exfoliation of articular cartilage, osteophytes, meniscal damage, synovitis, and a series of other changes. It is also known as proliferative arthritis, degenerative arthritis and osteoarthrosis of the knee.
Knee anatomy diagram disease description disease examination osteoarthritis (os disease name teoarthritis, OA) is a chronic joint disease characterized by degeneration and destruction of joint cartilage and osteophytes. It is also known as proliferative knee osteoarthritis and age-related knee osteoarthritis.
The clinical onset is most common in middle-aged and elderly people, with more women than men. The pathology is characterized by focal degeneration of articular cartilage, subchondral bone densification (sclerosis), marginal osteochondral redundancy formation and joint deformity.
Chronic strain: Long-term poor posture, weight bearing and overweight, resulting in soft tissue damage to the knee joint.
Obesity: The increase in body weight is proportional to the onset of osteoarthritis of the knee. Obesity is also a factor in aggravating the disease. Weight loss in obese people can reduce the onset of osteoarthritis of the knee.
Bone density: When the subchondral bone trabeculae become thin and stiff, their tolerance to pressure decreases, so the chances of osteoarthritis increase in people with osteoporosis.
4. Trauma and force tolerance: Frequent knee injuries, such as fractures, cartilage, and ligament injuries. Abnormally shaped knee anatomical diagrams in the joint, such as when the link is in an unstable state after patellar resection, degenerative changes in cartilage can occur when the joint is subjected to muscle imbalance and combined with local stress. Normal joints and activities or even after strenuous exercise is not osteoarthritis.
5. Genetic factors: The involvement of joints varies from race to race, such as osteoarthritis of the hip and carpometacarpal joints is common in Caucasians, but rare in people of color and nationalities, and gender also has an impact, and the disease is more common in women. Data show that the incidence of osteoarthritis in mothers and sisters of women with Heberden’s nodes is 2-3 times higher than in family members without the disease.
Symptoms Pain: Characterized by pain that increases with activity, decreases with rest, and can still be painful or worse with re-activity. It is especially difficult to go up and down the stairs, and can only ascend and descend the stairs with the good leg or the leg with light symptoms, rather than alternating between the two legs like normal people, often making it more difficult to descend the stairs than to ascend them. Joint pain can be triggered or aggravated by joint sprain, cold, or overwork. If the pain is severe, the leg cannot move and sleep is affected.
Joint swelling: Joint swelling is caused by synovial hyperplasia and intra-articular fluid accumulation. There is a rubbing sensation or a popping sound when the joint is moved.
Knee tenderness: also known as weak leg. It is the phenomenon of sudden weakness of the knee joint during walking and the desire to kneel or fall, which may be accompanied by severe pain. The “gluing” phenomenon: After the joint has been stationary for a long time in a certain position, it is very painful when moving again and cannot be flexed or extended, and must be moved slowly and gradually for a while before the “gluing” phenomenon disappears and the knee joint can be flexed or extended. For example, when riding a bus, the patient has to stand up and move the joint before getting off the bus.
Strangulation: This is when the knee joint is suddenly locked in a certain position during walking and other movements, as if something is “stuck” in the joint, often requiring the joint to be swayed and flexed and extended, often after feeling a “thump” before the joint resumes its original movement. The joint often resumes its original motion only after a “thump” is felt. Free bodies and ruptured menisci are common causes of joint locking due to articular cartilage exfoliation.
Joint dysfunction: Due to the destruction of cartilage, formation of bone fragments, and synovial hyperplasia, the knee joint cannot be fully extended and flexed, and cannot squat or hold weight, and it is even difficult to sit and defecate. Joint deformity: As the disease progresses, the knee joint becomes thicker and more deformed, such as “O” shaped leg.
The onset of the disease is slow, mostly in middle-aged and elderly obese women, often with a history of exertion.
2. The pain in the knee joint increases with activity, characterized by paroxysmal pain at first, then persistent pain, more so at night and during exertion, and obvious pain when walking up and down stairs.
3. Restriction of knee movement, 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.
5. Knee pain is a common complaint of patients with this disease. The early symptoms are pain when going up and down stairs, especially when descending stairs, either unilaterally or bilaterally, and joint enlargement, mostly due to bony hypertrophy, or joint effusion. Synovial hypertrophy is rare. In severe cases, the knee is deformed.
Diagnosis 1. History of repeated strain or trauma.
2. Knee pain and stiffness, more pronounced when waking up in the morning, relieved by activity, aggravated by more activity, and relieved by rest.
3. Late pain persists, joint activity is significantly limited, quadriceps muscle atrophy, joint effusion, and even deformity and intra-articular free bodies.
4. Friction sounds can be detected during knee flexion and extension activities.
5. Frontal and lateral photographs of the knee joint show lip-like osteophytes on the joint edges of the patella, femoral condyles, and tibial plateau, with the tibial intercondylar bulge becoming sharp, the joint space narrowing, and dense subchondral bone, and sometimes intra-articular free bodies are seen.
Treatment options conservative therapy non-surgical treatment (conservative therapy) include physiotherapy, drugs, injection therapy and Chinese herbal medicine treatment. For example, commonly used physical therapy includes Chinese acupuncture, fumigation, and medical magnetic therapy for knee brace magnetism.
Acupuncture and cupping therapy Acupuncture is more effective in the treatment of knee osteoarthritis. According to research, acupuncture has the effect of anti-inflammatory and pain relief, swelling reduction, and promotion of blood circulation, etc. By changing the blood flow and blood flow rate in the affected area, some pathogenic inflammatory factors are taken away to improve the symptoms. Commonly used acupuncture points are: Yanglingquan point, Yinlingquan point, the nasal point, the foot three li point, Liangqiu point, the sea of blood point, the commission point, Chengshan point, etc. Electric acupuncture can be used, or moxibustion can be added, or cupping can be added. According to research, electro-acupuncture and warm moxibustion are the most effective and can generally relieve symptoms after several treatments, and can be used as an adjunctive therapy for osteoarthritis of the knee.
Medication is currently the best treatment for arthritis, medication includes oral medication and topical medication, currently oral medication still does not achieve the purpose of treating arthritis, topical herbal patches, direct action, the effect will be better, from the outer skin penetration, drug penetration into the bone, there are no side effects. The medicine completely replaces the drawbacks of surgery and traction treatment, using advanced RGS bio-extraction technology, its drug components can easily penetrate into the cartilage end plate, the treatment of arthritis can be completely cured, and not easy to relapse, basically no side effects.
The dietary approach to arthritis in the knee should be light in the diet, with less food containing high oxalic acid. This is because salty foods are too high in sodium, which can easily combine with calcium to eliminate it from the body, leading to calcium loss. And foods high in oxalic acid also try to eat less, such as spinach, tomatoes, sweet potatoes, celery, etc., oxalic acid can combine with calcium to form calcium oxalate, reducing the absorption of calcium. Experts also specifically reminded that it is best to eat fruit half an hour after a meal, if eaten immediately, is also detrimental to the absorption of calcium.
Arthroscopic techniques for surgical treatment Arthroscopic exploration and cleaning of the knee This procedure is a new and safe technique for the diagnosis and treatment of knee diseases, resulting in less pain, fewer complications, faster recovery and significant results.
Knee replacement is the surgical replacement of the diseased knee joint, either partially or completely, with an artificially manufactured joint component. The worn and damaged joint surface is removed and implanted like a brace to restore a normal smooth joint surface.
The minimally invasive technique uses a hair-thin puncture needle to inject safe and side-effect-free medical trioxane into the lesion under the precise guidance of CT. The triple oxygen enters the lesion and exerts its strong oxidizing property to completely remove the inflammatory factors from the lesion, which has significant oxidizing tissue, anti-inflammatory and relaxing effects; the triple oxygen generates oxygen after oxidation, which improves blood oxygen saturation, increases cellular oxygen content, activates metabolism, and promotes the growth and recovery of the body; then it helps bone repair and growth to achieve the purpose of treatment [1].
Chinese medicine viewpoint identification analysis 1, knee osteoarthritis is divided into primary and secondary. Primary cases are caused by degeneration of articular cartilage and chronic injury to the joint, and obesity and genetic factors also have some influence, mostly occurring in middle-aged and elderly people. Secondary is due to knee trauma, strain, chronic inflammation, and internal and external knee deformity, such as femoral condyle or tibial plateau fracture, patella fracture or dislocation, articular cartilage injury, meniscal injury, patellar chondromalacia, etc., mostly occurring in young adults.
2, the liver is the main tendon, the kidney is the main bone. If the liver and kidneys are full, the tendons are strong and the joints are smooth. In middle age, the liver and kidneys gradually become deficient, the qi and blood are insufficient, the tendons and bones lose their nourishment, the tendons are soft and bones are atrophied, or they are also invaded by wind, cold and dampness, making them susceptible to this disease. If the knee is traumatized or strained, the qi and blood do not run smoothly and the meridians are obstructed, causing the tendons and bones to lose nourishment and develop.
The main lesions of this disease are damage to the articular cartilage, osteophytes at the joint ligament attachments, bone superfluous formation, dense subchondral bone, joint hypertrophy and deformity, resulting in joint movement disorders and pain.
If the pain is obvious, appropriate rest should be given and weight-bearing activities should be reduced. Treatment is mainly based on medication, together with tendon manipulation and ion introduction, etc., can achieve better results.
(1) Main formula: Tonifying Kidney and Tendon Soup (“Tonic Essentials of Injury”) Prescription: Shu Di Huang 12g, Angelica Sinensis 12g, Niubizi 10g, Cornu Cervi Pantotrichum 12g, Poria Cocos 12g, Sequoia Sinensis 12g, Du Zhong 10g, Bai Shao 10g, Qing Pi 5g, Wu Jia Pi 10g. Take with water decoction, 1 dose daily. If the pain is obvious, add 5 grams of Hosin and 10 grams of Chuanwu. For kidney yang deficiency, add Epimedium 12g, Cistanches 15g, Baji Tian 12g. For kidney yin deficiency, add 12 grams of Radix et Rhizoma Polygonati. For Qi deficiency, remove green peel and add Astragalus membranaceus 20g. In case of blood deficiency, add 15 grams of hen’s blood vine and 30 grams of shouwu.
(2) Externally applied formula: Haitongpi Tang (Wu Qian et al., “Jinjian of Medicine”) Prescription: Haitongpi 6g, Turbinicarpus 6g, Boswellia 6g, Myrrh 6g, Angelica 5g, Sichuan pepper 10g, Chuanxiong 3g, Safflower 3g, Wailingxian 3g, Licorice 3g, Fangfeng 3g, Angelica 2g. Decoction of water to fumigate the affected area.
(3) Single prescriptions.
(1) Bone Growth Pill (Traumatology) Prescription: Shu Di Huang 60g, Chicken Blood Vine 45g, Boneset 45g, Cistanches 30g, Deer Cnidium 30g, Epimedium 30g, Lycopodium 15g. Take 1 to 2 pills each time, 2 to 3 times a day with boiled water.
②Bone spur pill (Guangdong College of Traditional Chinese Medicine “Traumatology”) ③External formula: 1 part of Chuanwu, 1 part of Hesperidin, 1 part of Angelica dahurica, 1 part of Angelica sinensis, 2 parts of Dioscorea Z, 2 parts of Safflower, appropriate amount of honey. Powdered honey, 10 grams per pill, 1~2 pills each time, 2~3 times a day, with boiled water.
(4) Proprietary Chinese medicine.
1) Bone immortality tablets, taken orally, 4-6 tablets each time, 3 times a day, with boiled water.
Self-preventive care and treatment 1, try to avoid physical obesity to prevent aggravating the burden on the knee joint, once the body is overweight, we should actively lose weight and control the weight.
2, pay attention to walking and labor posture, do not twist the body to walk and work. Avoid squatting for a long time, because the weight of the knee joint when squatting is 3 to 6 times its own weight, squatting at work (such as car mechanics, sand turners) is best changed to a low sitting position (sitting on a small bench), sitting and standing for a long time, but also often change positions to prevent the knee joint fixed a posture and excessive force.
3, do not wear high heels when walking long distances, wear thick-soled and flexible soft-soled shoes to reduce the impact on the knee joint, to avoid wear and tear on the knee joint.
4, when participating in physical exercise should be well prepared activities, gently stretch the knee joint, so that the knee joint 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.
5, when riding a bicycle, to adjust the height of the seat, to sit on the seat of the two feet in the pedals, both legs can be straight or slightly bent for the appropriate, the seat is too high, too low or when riding uphill pedal hard, the knee joint have adverse effects 6, 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 knee pads, to prevent the knee joint from getting cold. Therefore, you should keep warm in cold weather and wear a knee brace if necessary to prevent the knee from getting cold.
7. 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.
8, 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.
9, 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 not only supplement protein, calcium, prevent osteoporosis, but also grow cartilage and joint lubricating fluid, but also supplement estrogen, so that bones and joints better calcium metabolism and reduce the symptoms of arthritis.