Knee osteoarthritis is divided into four stages from mild to severe, each stage has a corresponding ** method, usually in the first and second stages, patients can try to be conservative**, although the cartilage is damaged to a certain extent, bone spurs grow, and the joint space narrows, but due to the presence of synovial fluid, there will be no friction between bones, and the overall symptoms of most patients are relatively mild.
In the third stage, the joint space continues to narrow, the cartilage undergoes a serious breakdown, and daily life begins to be significantly affected, such as squatting, kneeling, walking, going up and down stairs, which may cause discomfort, and the symptoms worsen with the intensity of exercise, and obvious symptoms such as knee swelling, joint stiffness, popping sounds, and locking may occur. Imaging tests may show that the bones are getting rougher and the bone spurs are getting worse. Some patients have moderate pain, others have severe pain that makes it difficult to perform basic daily living, and surgery should be considered**.
The fourth stage is the late stage of osteoarthritis, where the cartilage is almost worn out, the joint space is barely visible, and the bone spurs multiply and have progressed to"Bone to bone".Stage, which is the most severe stage of osteoarthritis, can cause unbearable pain and lasts for a long time and does not relieve it at rest. Walking and using stairs are difficult, and synovial fluid is rarely available to lubricate joints.
Thus, the vast majority of patients in stage 4 (bone to bone is an important indication), the majority of patients in stage 3 may face conservative ineffectiveness.
Medications,Most patients with osteoarthritis take non-steroidal anti-inflammatory drugs, such as ibuprofen, celecoxib, meloxicam, etc., which are anti-inflammatory analgesics that relieve symptoms by inhibiting the enzymes that cause pain in the body, not directly acting on the bones and joints, but affecting the secretion of prostaglandins in the body, so ibuprofen and other drugs can also be used to relieve joint pain and fever caused by colds. However, once osteoarthritis occurs irreversibly, the effect of drugs is to relieve the symptoms, but not to regenerate the cartilage, even if it can be done in the future, osteoarthritis is not only a problem of cartilage, but also the destruction of other tissues of the joint, such as the meniscus, synovium and subchondral bone.
The drug is mainly effective for patients with osteoarthritis in the early stage, and the cartilage of patients in the middle and late stages is worn out a lot, and the direct physical friction between the bones and bones is difficult to guarantee. Non-steroidal anti-inflammatory drugs also have their own negative effects on gastrointestinal function, such as constipation, nausea, vomiting, dizziness, drowsiness, dependence, etc., some non-steroidal anti-inflammatory drugs have a smaller gastrointestinal tract, but long-term use cannot avoid the cardiovascular impact.
Injection**,It mainly includes injections of sodium hyaluronate to lubricate joints, steroid injections to reduce inflammation and analgesia, for patients with more severe joint symptoms, steroid injections are more effective, commonly known as blocking, but it can only relieve symptoms and cannot improve knee joint function. And after a period of time, the effect of the injection may be weakened or disappeared, and the patient can only get occlusive injections up to three times a year, and excessive or too many times will cause cartilage damage, degeneration of muscle tissue, ligament tissue, and even tendon rupture, so it is not a long-term solution.
However, it is not excluded that the condition of some patients will stabilize, and osteoarthritis will no longer develop or become very slow, and conservative ** may have an effect on some early patients.
Most patients develop mild to severe stenosis of the knee space, which takes about 12 to 18 years. The symptoms of osteoarthritis are produced by structures other than cartilage, and even if future techniques can reverse cartilage degeneration, osteoarthritis destroys other tissues in the joint. Therefore, surgery is generally recommended for patients with advanced imaging findings and significant symptoms**. There are osteotomy and knee arthroplasty, osteotomy can correct knee problems such as looped legs and varus knee, which is usually suitable for young people with mild arthritis, and because artificial joints have a useful life, the replacement should be postponed as much as possible. Older people have poor bone quality and are generally not suitable for this type of surgery, and knee arthroplasty is often used to reduce pain and restore function.
Medical science, for reference only.