Natalia SANDROVICH, “FACTS”
The trouble is, when people due to joint pain can not climb on a moving bus. Or when it is difficult to get out of bed to walk around the room, pour a Cup of tea, cut a slice of bread. The doctor who came in a direct line of “FACTS” — orthopedist-traumatologist, head of the scientific Department of reparative and reconstructive orthopedics and rehabilitation center of innovative medical technologies of NAS of Ukraine, candidate of medical Sciences Eugene Skobenko, emphasizes: “one should Never ignore the pain, thinking that it will go away. If the time to diagnosis and prescribe treatment, the affected joints can be braked”. How to confirm the diagnosis of osteoarthritis and to treat this disease? Is it possible to move the surgery to replace the joint? What to do when you break the cords? To these and other questions from our readers — answers in a straight line “FACTS”.
See also: How to get rid of knee pain: the advice of a doctor
“The cause of articular pain syndrome is a tick bite”
*— Hello, Evgeny! Are you worried about Irina from Kiev, 46. I was diagnosed with primary osteoarthritis of the knee. Why so early? Mom’s knees began to ache after 60 years.
Have osteoarthritis several reasons. In addition to hereditary predisposition, are important features of the anatomy. The knee joint wears more on the side which is stronger, as it happens, for example, when you have flat feet. Due to the deformity and malposition of the ankle joint and knee suffering. Osteoarthritis often occurs as a result of injury, for example, damage to the meniscus. Especially if it is incorrectly treated or removed.
* Is Oksana from the city of Kagarlyk of Kiev region. My husband (he’s 51) long-standing gout. And now add another osteoarthritis. There are days when she can hardly walk even around the yard. These two diseases are somehow connected?
— Yes, gout is like rheumatoid arthritis, causes the development of osteoarthritis. The people are of the opinion that the gout is an inflammation of the joint of the big toe. Actually gouty arthritis affects all the joints.
The basis of gout — a metabolic disorders. Treatment involved rheumatology. In the patient accumulates a large amount of uric acid which is deposited crystals inside the joint.
*— Calling Galina from Transcarpathia. Started to hurt my knees, and the doctor suspected osteoarthritis, sent for an MRI. They found fibrosis, synovitis. What to do?
— In-depth examined. The fibrous tissue is formed in the area of overload of the joint, and may be due to the fact that in osteoarthritis the cartilage has become thin and lost its damping properties. Sometimes arthritis accompanies chronic inflammation (rheumatoid arthritis, chondroplasia).
It is important to find the cause of the inflammation of the synovial fluid. Normal her in the joint for about two to four milliliters, but because of the inflammatory process, the quantity increases. Excess fluid can be removed. However, if you do not establish a cause of synovitis (rheumatoid arthritis, inflammatory connective tissue diseases, Lyme disease), the fluid will appear again.
*— Are you concerned about Valentina from Kiev, 80 years. I am absolutely healthy person, while… lying on a hard orthopaedic mattress. As soon as I get up, immediately there is a sharp pain in the lower back radiating to the legs. When I disagree, pain is reduced. What to do?
The cause of the pain may be due to the instability of the spine in the lumbosacral region. It is necessary to be surveyed: to make MRT a lumbar Department of a backbone, and a functional x-ray sample.
— While I take nonsteroidal anti-inflammatory drug. Is this correct?
— Yes, but be careful. All painkillers nonsteroidal anti-inflammatory drugs increase the secretion of gastric juice. They need to drink after a meal or under the guise of drugs that slow the production of gastric juices and reduces the aggressive environment in the stomach. But uncontrolled nonsteroidal anti-inflammatory drugs can cause gastritis, stomach ulcers and even bleeding.
See also: the Joint can hurt and destroy because of the old injury, which people have forgotten, — the doctor
* My name is Neal, I’m calling from Kiev. Question for my sister, who is 72 years old. She had two strokes and surgery to replace the hip joint (a hip fracture). Now the sisters have a really sore foot and has difficulty walking, knee not bend, turned foot, heel touching the ground. How to help her?
I think the knee bend is not due to a lack of rehabilitation after strokes. Apparently, in the developed joint contractures limiting mobility. And what are the pain, you need to understand. They can be caused as defeats of the joints and spasticity — involuntary muscle contractions resulting from disorders of cerebral circulation. Your sister needs help experts good rehabilitation center.
If one leg is shorter, it is desirable to select orthopedic shoes. To also fix the orthosis knee joint.
Causes of osteoarthritis
- Genetic predisposition.
- Variations in the structure of the joints.
- Excessive load.
- Inflammatory diseases and infection.
“With the help of cell therapy will be able to push arthroplasty”
* Is a straight line? Calling Olga from the city of Irpin, Kyiv region, 51. Start whining to the knee, and examination revealed osteoarthritis of 2-3 degrees. How to treat this disease?
— Tell, how we act. First, we examine the patient to get a correct history. Pain can be in the region of the knee joint, and in fact the affected hip. So often we take x-rays of the pelvis. Also check the lower back, where it can be a source of pain that radiates to the joint, for example, a small hernia in the lumbar. It compresses the nerve root, causing pain.
In addition to x-rays, sometimes MRI is assigned. It happens that the person suffers from severe pain, and x-ray changes are not showing. With the help of magnetic resonance imaging possible in the early stages to see circulatory disorders in the bone (called avascular necrosis).
In order to properly prescribe treatment, it is important to determine the degree of osteoarthritis. Increasingly widely used cell therapy, using plasma and stem cells. In the first case, taking blood from a vein and in a special vial to be processed using a centrifuge, separating the upper layer of plasma containing cells and growth factors. Cells work as building material, and growth factors triggers the repair their own tissues.
Even more effective in the early stages of the disease, injection of stem cells into the joint. Through punctures recruited from the abdomen or thighs of the patient fat, as do plastic surgeons for liposuction, processed and secreted from stem cells. 30 milliliters of fat we get about four ounces of finished cellular substance.
See also: “the Knee I had cured, using a “cocktail” of my own stem cells and blood plasma”
*— It refers you to Tamara from Kiev, age 79. By arthritis very sore big toe. Will the injections of hyaluronic acid? Previously, I did them in the knee, and the pain was gone.
— Alas, for the small joints of the foot, this treatment can be ineffective. It is often used for joints carrying axial load: knee, hip, ankle. But if they change the deep, the hyaluronic acid is also ineffective.
How then to ease the pain?
— With the help of physiotherapy, orthotics or surgery. The insole can be purchased in orthopedic stores or available individually. And to make other appointments, you need to see your x-rays. Can contact our Center for innovative medical technologies (Kyiv, descent Voznesensky, 22). Pre-call by phones: (044) 272-22-05 or (044) 272-34-03.
*— Could I speak to the doctor? Taras from Lviv, 54. Due to old injuries I have pronounced osteoarthritis of the knee. Bad leg flexion and extension: contracture of more than 40 years. I read that sometimes replacing the joint completely, and only his head — set so-called cap prosthesis. Is this possible?
— Only if you allow the bone quality and the degree of osteoarthritis. You have a contracture, which will complicate the work of the surgeon, impede the development of the feet. A complete total prosthesis, which was adopted worldwide, will provide an opportunity after recovery to move normally.
— I’m afraid that changes the length of the legs of my friend.
— Sometimes leg really extended or shortened, as we will warn patients. So there are no surprises, for surgery you need to prepare carefully, not only the doctor but the patient. You can not go to intervene, not cure, for example, rotten tooth. Any infection can harm implants, because it is, in fact, the weak link in the body.
What studies clarify the diagnosis
- An x-ray.
- Magnetic resonance imaging.
- If necessary, computed tomography.
“To reduce abrasion of the cartilage, you need to drink more fluid”
*— “The FACTS”? Worried about Alexander from Odessa, 50 years. I have a few years ago, discovered the trichinosis — parasitic infection. After the treatment complications at the joints of the legs: they occasionally get sick, especially in the morning. How to avoid further deterioration?
— To answer your question, you need to clearly understand what kind of complication you have experienced after the treatment. You should monitor the condition of the joints using x-rays, MRI. To support the hyaluronic acid preparations, which are prescribed by a doctor. It creates in the joint of the gel layer that reduces the blurring of the cartilage and improves glide in the joint.
But General recommendations are reduced to a few simple rules. It is impossible to gain weight, overloading the joints. To maintain the condition of the cartilage of funds to help with substances, life-prolonging cartilage, warning her wear — chondroitin, glucosamine and collagen.
It is important to drink plenty of fluids, because cartilage consists mostly of water. It is also advisable to avoid heavy physical exertion, trauma. Try to lead a healthy lifestyle. Any systemic diseases, such as diabetes, can lead to deterioration of health.
* Is a straight line? Calling Maria from the city of Ternopil. Son played football and has damaged the anterior cruciate ligament. Inflammation doctors removed, but insist on surgery. Is it necessary?
Yes. Plastic anterior cruciate ligament — the most common operation that I have to do on the knee joint. Without it, an unstable joint is not resistant to excessive load. People will not be able to run, squat, even to play beach volleyball. And most importantly — later he faces early osteoarthritis.
See also: how to avoid flat feet, the child need to not go barefoot, doctor
— How to perform such operations?
With the help of the arthroscope through a small puncture go into the joint, evaluated the damage. If the ligament is completely torn, most often carried out plastic — model with tendons taken from the adductor muscles of the thigh.
*— Inna from the city of Khmelnitsky. After surgery for cruciate ligament rupture husband of six months wore a brace. How to recover?
— A rehabilitation plan is specialist. It depends a lot on equipment operation and related damage in the joint. I often, for example, recommend a week on crutches, another doctor may prescribe them for up to two weeks, or will think that you can do without them. It all depends on the damage in the joint. If, for example, a torn meniscus, it is necessary to save, because it takes some of the load, acts as a shock absorber and stabilizer. Removing it we increase the risk of developing osteoarthritis. It is important to know that not all gaps can be made.
The knee of the patient record for three weeks in a special brace. In a week you need to begin to develop the joint to bend and straighten the knee, and after a month and a half to do spinning and swimming. After three months, you can train the muscles in the gym, because the quadriceps thigh muscle atrophies greatly. When the six months are allowed to play sports.
How to help my joints
- To normalize the weight.
- To drink more water.
- Avoid heavy physical exertion and injuries.
- To control other diseases, such as hypertension or diabetes.
Previously, the orthopedic trauma Yuri Poroshenko told, what mistakes in the treatment of trauma interfere with recovery
Photo of Igor EMELYANENKO, “FACTS”