Arthrosis of the knee joint is a disease that causes discomfort and discomfort in life. Severe pathology occurs in every fifth person, but much more often the disease affects the body of women. This is due to the peculiarities of changes in their body after forty years. Having discovered that you have a knee disease (gonarthrosis), you must immediately contact a specialist so that he can prescribe the right medications for the unpleasant arthrosis of the knee joint. Let’s take a closer look at what medications an experienced doctor can prescribe.
A person experiencing pain associated with gonarthrosis for the first time may not even understand that this disease is present in the body. If unpleasant sensations occur after a long stay in one position or immediately after waking up, and pass during the day, this is the first stage of the development of pathology. At the second stage, the pain comes more often, becomes more intense, while walking a man or woman may feel discomfort or even severe pain, and a peculiar sound is often heard in the knee - a creaking sound. During palpation, a person feels pain.
The third stage is the final stage of the disease, when the knee joint can no longer be fully restored. In this case, the patient experiences constant excruciating pain, his temperature may rise, it becomes difficult to move, and lameness appears. To avoid serious consequences, you need to diagnose it in time and see a specialist. In addition to medications, there are other options for reducing pain and treating gonarthrosis:
The range of drugs is extensive during the treatment of gonarthrosis. Doctors prescribe special compresses, ointments, tablets, and intramuscular injections to their patients. There are two main effective groups of remedies that help get rid of an unpleasant pathology; they differ in the method of action. It is necessary to take medications according to the stated dosage, after the recommendation of the attending physician. If you are sick, you should never self-medicate.
A non-steroidal group of anti-inflammatory drugs are drugs that do not contain hormonal substances. These medications are the first aid for illness. Various non-steroidal medications can remove the symptoms of the disease: cope with pain much faster, relieve tissue inflammation. The effect also differs in significance from the type of drug: some have a more anti-inflammatory effect (ibuprofen, aspirin, amidopyrine), others have an analgesic effect (diclofenac, ketoprofen, indomethacin).
The peculiarity of the action of non-steroidal drugs is that they only help relieve the main symptoms of the disease, but do not contribute to a complete cure of the knee. As soon as the inflammation subsides, the person should stop taking these medications. The absence of obvious symptoms may be mistakenly perceived by a sick patient as recovery, and non-steroidal medications have unpleasant side effects for the body:
The second main group of drugs in the treatment of arthrosis are chondroprotectors. Unlike non-steroidal anti-inflammatory drugs, they not only help to significantly reduce the unpleasant manifestations of gonarthrosis, but also help to effectively treat the pathology. Such drugs are considered relatively safe and do not have serious side effects, but they must be taken with caution and after a doctor has written a prescription. They are an essential part of effective treatment of gonarthrosis.
The principle of action of the drug is to help the body's recovery processes. Thanks to the use of these medications, blood circulation in the area of the affected knee joint improves, joint fluid begins to be produced in normal quantities, and its lubricating properties return to normal. Subtleties of treating arthrosis with chondroprotective drugs:
After consultation with a specialist, it is necessary to purchase medications for painful gonarthrosis. The cost of drugs varies depending on the manufacturer, the quality of the substances in the composition, and the pharmacy. There are products both at a high price and their inexpensive analogues, differing only in name. Let's consider the best effective non-steroidal anti-inflammatory drugs and chondroprotectors.
Any disease cannot be cured without the use of medications. Each category of medicines is intended for specific purposes. In the article we will talk about tablets for arthrosis of the knee joint, their categories, and purpose.
When diagnosing arthrosis of the joints of the extremities, traditional treatment (a course of medications in combination with physiotherapy) or surgical intervention (for an advanced stage of the disease) can be prescribed. The doctor decides which treatment method to use after diagnostic studies.
Regardless of the degree of development of arthrosis, initial therapy, or in the postoperative period, begins with taking tablets for the treatment of the knee joint. All drugs prescribed for the pathology of an injured limb are divided into the following categories:
In this article we will talk about tablet medications and touch on other forms of medications (injection solutions, ointments, gels).
Any medications for joint arthrosis can only be used as prescribed by a doctor. Painkillers for arthrosis of the knee joint are usually prescribed for a short course. The short-term use is explained by the fact that the drugs have many contraindications, do not cure the pathology, but only eliminate the pain syndrome.
Common pain relievers for knee arthrosis include the following:
The dosage of medications is prescribed depending on the stage of the disease and the general well-being of the patient. The individual characteristics of the body with concomitant diseases are also taken into account.
Pain relief for arthrosis of the knee joint is performed not only with the help of tablets. If it is necessary to get rid of pain faster, then painkillers, intra-articular or intramuscular injections are given. Solutions for injections into the muscle include the following drugs:
Injectable anesthetic solutions that are placed directly into the joint include:
Anesthetic ointments, like other forms of drugs, are not able to eliminate the disease itself. With their help you can only temporarily relieve pain. But, compared to tablets, ointments do not have a negative effect on internal organs during use. Ointments only affect the specific area to which they are applied. This is their advantage.
The following ointments are mainly prescribed to relieve pain due to arthrosis:
How to treat arthrosis of the knee joint and what pills to prescribe is decided by the doctor in each specific case. There is no single template according to which the pathological process is treated for such a serious disease as arthrosis. Each case is individual.
Sometimes in combination with traditional drug treatment, home treatments are additionally used for treatment. These are all kinds of compresses, homemade ointments, decoctions and infusions from herbal preparations. Before using a home remedy for knee arthrosis, you should consult your doctor. Even if permission is received, you cannot stop taking the medications prescribed by your doctor.
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Now answer the question: are you satisfied with this? Can such pain be tolerated? How much money have you already spent on ineffective treatment? That's right - it's time to end this! Do you agree? That is why we decided to publish an exclusive interview in which the secrets of getting rid of joint and back pain are revealed. Read more.
Osteoarthritis of the knee joint often occurs in elderly patients. Degenerative-dystrophic changes worsen the condition of cartilage and bone tissue, limit the mobility of the affected knee, and change the usual rhythm of life.
Drugs of various dosage forms help eliminate negative symptoms and slow down the destruction of cartilage: tablets, gels and ointments, injections. For arthrosis of the knee joint, the doctor will select effective medications with the most beneficial effect on the problem area.
Aseptic damage to joints occurs against the background of natural aging of the body. High loads, heavy lifting, and injuries of various types have a negative effect on cartilage tissue.
The gradual destruction of cartilage increases friction of the articular heads, the process of synovial fluid production is disrupted, and the risk of inflammation increases. With severe damage to the knee joint, the patient loses the ability to move independently and constantly experiences severe pain.
Factors that provoke the destruction of articular tissues in the knee area:
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Injections are the optimal form of using medicinal compounds for severe pain in the knee joint. Delivery of drugs occurs almost instantly, the harmful effects on the gastrointestinal tract are minimized.
Injections into the joint area are a rather unpleasant procedure. The benefits of administering potent anti-inflammatory compounds, painkillers and chondroprotectors are much greater than the discomfort.
Various groups of medications help restore the health of the affected joint:
Injectable medications have a positive effect on the affected joint tissue:
Despite the high effectiveness of intra-articular injections, there are restrictions, in the presence of which it is prohibited to give injections to the knee for arthrosis. The patient is obliged to tell the doctor about chronic diseases and answer questions regarding their health status.
The use of a medicinal solution in the area of a problem joint requires a highly qualified doctor. Incorrect needle insertion and ignoring contraindications often provoke complications and worsen the course of joint pathology.
Not all drugs reduce pain in the affected area. Rheumatologists and orthopedists use several groups of medications that alleviate the pathological process of arthrosis.
Potent drugs are “first aid” for acute pain. Injection solutions do not treat arthrosis, they only relieve severe pain. Glucocorticosteroids combine well with medications for the complex treatment of degenerative changes. The compositions have many side effects, injections are carried out in short courses, sometimes only 2-3 injections per month. Medicines have a wide range of prices.
Effective medications with a positive effect on the affected knee joint. Chondroprotectors nourish weakened tissues, stop the destruction of intra-articular structures, and stimulate the process of cartilage regeneration.
Injections into the knee with chondroitin sulfate and glucosamine are carried out in courses. Depending on the severity of the pathology, from 4 to 15 injections are required. There are practically no side effects; sometimes there is an allergy to the components of the medicinal solution.
The following drugs received positive reviews:
The natural remedy has virtually no restrictions on its use and rarely causes side effects. Hyaluronic acid actively nourishes cartilage, envelops joint structures with a thin film, and prevents excess friction. A positive property is maintaining water balance.
Injections are used to restore neurohumoral regulation. The complex of vitamins B1, B6 and B12 has a positive effect on cartilage tissue and reduces pain in the manifestations of arthrosis. Medicinal solutions are administered intramuscularly, but without the use of these drugs it is impossible to relieve patients from severe pain or prevent convulsions and spasms of tense tissues.
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In some cases, doctors prescribe intramuscular injections of essential vitamins. The drugs are administered according to a special scheme: the first day - vitamins B12 and B1, the second day - vitamins B12 and B6.
The disadvantage of many modern drugs with glucosamine, hyaluronic acid and chondroitin is their high cost. Lower-priced drugs often have more side effects.
Injections of chondroprotectors are also not cheap. Considering the duration of the course of treatment, the need to repeat therapeutic procedures throughout the year, the price for some patients turns out to be unaffordable, many interrupt treatment. Glucocorticosteroids are used infrequently, but the cost of some drugs is also quite high.
More detailed information about intra-articular injections for arthrosis can be found in the following video:
Arthrosis is called degenerative-dystrophic changes in the joints due to damage to the cartilage tissue that covers the articular surfaces of the bones. The most vulnerable are the knee and hip joints, which are more often susceptible to this pathology than others.
Arthrosis of the knee joint is a localized form of the disease and is called gonarthrosis. Its leading symptom is aching pain and discomfort that occurs after walking. Most often, knee arthrosis develops against the background of an injury that disrupts the internal structure of the joint.
As a result of the loose connection of bones to each other, individual sections of cartilage experience increased stress, which leads to their rapid and premature wear. The destructive process goes through 3 stages, the manifestations of which can differ significantly.
Pain in the initial stages is transient, and no other symptoms are observed yet. However, when gonarthrosis moves to the next stage, the situation changes sharply for the worse: the pain syndrome does not go away even after a long rest and bothers the person almost constantly. The functionality of the joint also decreases - mobility is limited, muscles weaken, and a crunching sound is clearly heard when bending the leg.
According to statistics, it is at the second stage that patients most often consult a doctor, since the quality of life noticeably decreases. Treatment during this period in most cases allows one to achieve good results with the help of injections or tablets for arthrosis of the knee joint.
Lasting positive dynamics are ensured only under the condition of an integrated therapeutic approach, when physiotherapy, exercise therapy, and a therapeutic diet are prescribed in combination with medications. The most important aspect of recovery is to reduce the load on the diseased joint, as well as the use of special orthopedic devices and normalization of body weight.
Treatment with conservative methods should solve several problems at once, the primary of which is the reduction or complete elimination of pain. In parallel or after acute symptoms are relieved, medications are prescribed to restore articular cartilage and activate local blood circulation.
For arthrosis of the knee joint, non-steroidal anti-inflammatory drugs are traditionally used:
Diclofenac is one of the best representatives of the NSAID class and combines anti-inflammatory and analgesic effects with good tolerance by patients
However, we must remember that painkillers create a deceptive impression of cure, “masking” the manifestations of the disease. In other words, NSAIDs do not treat the disease, but stop its manifestations. In addition, recent studies have provided evidence of a negative effect of NSAIDs on the production of proteoglycans.
Proteoglycans are complex protein compounds that participate in the formation of connective tissue and serve as a lubricant for joints. When their synthesis is disrupted, cartilage tissue loses moisture and becomes dehydrated, and the destructive process accelerates.
Long-term use of painkillers significantly increases the risk of side effects. When prescribing them, it is necessary to take into account possible contraindications and take these drugs for a short course, discontinuing them immediately after the disappearance of painful symptoms.
Modern pharmacology has anti-inflammatory drugs of the so-called “selective action”, combining high efficiency and safety in use. Drugs such as Celecoxib (Celebrex), Rofecoxib and Etoricoxib have been successfully used to treat osteoarthritis.
In recent years, the group of coxibs has been replenished with a new drug - Lumiracoxib, the active substance of which selectively disrupts the synthesis of prostaglandins. Just like other drugs in this group, the new generation drug is able to suppress prostaglandins involved in the inflammatory process. At the same time, there is no effect on the synthesis of prostaglandins, which regulate renal blood flow and maintain the integrity of the gastrointestinal mucosa.
Celecoxib is a new generation drug that is most harmless to the stomach and intestines
Chondroprotectors are used only at stages 1-2 of arthrosis to restore the structure of damaged cartilage through additional nutrition. The tablets contain chondroitin sulfate and glucosamine - substances that improve the formation of synovial fluid and its quality.
Chondroprotective agents not only help eliminate painful symptoms, but also treat – this is their main purpose. While noting the undoubted benefits of these drugs, one cannot ignore the fact that the effect can only be achieved with long-term use of drugs from this group.
A noticeable improvement in the condition occurs no earlier than six months after the start of therapy. Usually, several courses are prescribed to slow down the development of the pathological process and achieve stable remission.
It is necessary to especially note the safety of use and the limited list of contraindications of chondroprotective drugs, which allows them to be prescribed to almost all patients. The most important condition for successful treatment is the systematic intake of adequate doses into the body: for Glucosamine this is 1000-1500 mg per day, for Chondroitin Sulfate - 800-1000 mg.
Artra contains the same amount of active ingredients - Chondroitin and Glucosamine, it is recommended to take the tablets twice a day at first, after three weeks of use the daily dose is halved
In the medical community, opinions regarding the separate or joint use of Glucosamine and Chondroitin Sulfate are divided. Some doctors are convinced of the benefits of combination drugs, while others consider monotherapy more effective. Both provide compelling arguments in defense of their views.
How to understand this issue? There cannot be a clear answer here, however, in patients taking only Glucosamine, side effects from the gastrointestinal tract occur much more often. Doctors draw up a treatment regimen individually and prescribe monotherapy in case of intolerance to Chondroitin or Glucosamine.
Structum is prescribed as an additional source of Chondroitin, the production of which is significantly reduced in osteoarthritis
The joints do not have an independent blood supply, and all nutrients are provided by synovial fluid. It is from this that cartilage tissue takes the elements necessary for normal functioning.
However, this happens only during joint movements: when the leg is bent, the fluid leaves the cartilage into the articular cavity, and when it extends, it returns to the cartilage, delivering nutrition to it. “Provision” for articular cartilage enters the synovial fluid from nearby blood vessels: when the periarticular muscle structures contract, the blood flow increases and more nutritional components enter the cartilage. Considering the features of this mechanism, recovery from arthrosis is unthinkable without therapeutic exercises.
The action of Glucosamine is as follows:
Chondroitin Sulfate complements the therapeutic effect of Glucosamine, acting in several directions:
Hodndroprotectors are available in several forms - tablets, injections and ointments. Parenteral administration (bypassing the gastrointestinal tract) is required when it is necessary to quickly relieve inflammation or in the case of diseases of the digestive organs, especially the liver. The bioavailability of the drugs is the highest. Topical products are only effective as a complementary method.
Chondroprotectors may contain Glucosamine or Chondroitin Sulfate, as well as their combinations. Products with an anti-inflammatory component are also produced, which can be prescribed if there are signs of inflammation - swelling, redness and severe pain.
Currently, the best known drugs are Artra, Structum, Teraflex, Chondroitin Akos. All of them are available in tablets or capsules and are intended for oral use. For injections, Dona, Chondrolon and Elbona are most often prescribed.
The intra-articular method of drug administration is used for severe pain that even powerful analgesics cannot cope with.
Artra is a combination drug that contains Chondroitin, Glucosamine, Sodium Hyaluronate and Methylsulfonylmethane. The latter component has an anti-inflammatory effect and improves the absorption capacity of cartilage tissue.
Sodium hyaluronate is produced by the body's own cells, but when the joint is damaged, its amount decreases. This element is necessary to make up for the deficiency.
Structum is a single preparation containing Chondroitin of high sulfate, which is necessary to retain the maximum permissible volume of synovial fluid in cartilage tissue. Due to the high sulfate content, the firmness and elasticity of cartilage increases.
Moreover, chondroitin in Structum has qualities close to natural and low molecular weight, which ensures rapid penetration of the drug through the membrane of the joint capsule. When taking the drug, the thickness of the cartilage is maintained and the shock-absorbing capacity of the knee joint increases. Among the analogues of Structum we can note Kartilag, Artrin, Chondrolon, Sigan, Hondrex, etc.
How and with what to treat knee arthrosis is decided by the doctor, depending on the condition and individual characteristics of the patient. Chondroprotective agents are taken daily, the duration of one course is at least three months. The course is repeated several times at intervals of approximately six months for 2 or 3 years.
It should be borne in mind that there are dietary supplements on sale that also contain Glucosamine and Chondroitin Sulfate. They are not full-fledged medicines because they have not undergone clinical trials. As an example, we can cite such dietary supplements as Chondro, Stopartrit Forte, Sustanorm Life formula.
Treatment of synovitis that has developed against the background of gonarthrosis begins with taking a puncture to remove accumulated fluid
Injections into the joint cavity are very effective and are carried out mainly in emergency situations. The indication for intra-articular administration of drugs is synovitis that occurs against the background of gonarthrosis and causes swelling of the joint due to the accumulation of fluid. This phenomenon significantly complicates or makes it impossible to perform therapeutic exercises, massage and physiotherapeutic procedures.
In order to stop the inflammatory reaction, injections with hormonal drugs are prescribed - Kenalog, Diprospan, Hydrocortisone, Flosterone. The main advantage of this tactic is the rapid relief of pain and signs of inflammation. Since the effect of glucocorticosteroids is limited only to reducing the manifestations of arthrosis, most often only one injection is performed.
If a repeated injection into the same joint is necessary, it is done no earlier than two weeks later. This approach is justified by the fact that corticosteroids have a prolonged effect, and the effect appears only after 12-14 days. The maximum number of procedures should not exceed 5, otherwise there is a high risk of developing unwanted effects.
Hyalurome is a modern synovial fluid prosthesis; after its introduction, a significant reduction in pain is observed. The drug is successfully used even in advanced forms of arthrosis
Intra-articular injections are prescribed with caution to patients with systemic diseases such as diabetes mellitus, hypertension, gastric ulcers, renal failure, and tuberculosis. Glucocorticosteroid drugs affect the entire body and can worsen the course of these pathologies.
Hyaluronic acid preparations, which are also called “liquid prosthesis” or “implants,” can also be delivered into the cavity of the knee joint through direct injections. Such procedures have become firmly established in medical practice, and have been carried out quite successfully for about 15 years.
Sodium hyaluronate acts similarly to natural joint lubrication, protecting bone surfaces from excessive friction. This slows down the destructive process in the cartilage, increasing its elasticity and flexibility.
Thanks to additional infusions of Hyaluronate, cartilage tissue is restored and moisturized faster, mechanical stress is reduced, resulting in increased mobility and reduced pain in the knee.
Side effects with intra-articular injection of Hyaluronic acid almost never occur. The treatment course consists of 3-4 injections with a break of one or two weeks. If necessary, the course is repeated again after 6-12 months.
The only drawback of preparations based on Hyaluron is the rather high cost: the price of one injection ranges from 3,000 rubles. However, it should be recognized that expensive treatment is completely justified. According to doctors, many patients were literally able to “get back on their feet” precisely thanks to the additional hydration of the cartilage.
Hydrocortisone in ampoules is intended for intra- and periarticular administration, the therapeutic effect occurs within 6-24 hours and lasts for a week or more
Before the appearance of drugs containing Hyaluronic acid on the pharmaceutical market, prosthetic operations were performed much more often. Now the situation has changed, and it has become possible not only to be cured without surgery, but also to save money, since endoprosthetics is much more expensive than several injections.
It is important to know that medications based on Hyaluronic acid are quickly destroyed after administration, so their use in acute inflammatory processes will be absolutely useless. The same applies to synovitis, in which a large amount of accumulated fluid is observed.
To achieve the desired effect, you first need to stop the inflammation and achieve the resorption of excess fluid. For this purpose, either non-steroidal anti-inflammatory drugs or injections with corticosteroids are prescribed. Only then is a treatment course with Hyaluronate carried out.
A pathology such as arthrosis of the knee joint can be successfully treated in the early stages. The possibilities of modern medicine are quite wide, but not limitless. Therefore, if symptoms such as pain and stiffness in the joints appear, it is recommended to consult a doctor and undergo a diagnosis. Timely and correct treatment will protect you from many complications and ensure high physical activity for many years. Be healthy!
Arthritis is a collective term that characterizes joint damage of various etiologies. The disease is accompanied by pain and limited joint mobility.
The causes of the inflammatory process can be:
In the vast majority of cases, inflammation is aseptic in nature.
Purulent arthritis develops as a result of acute post-traumatic bursitis, accompanied by necrosis and melting of the walls of the joint capsule, with a breakthrough of its contents into the cavity of the adjacent joint.
Joint damage is bilateral. Characterized by morning stiffness in movements, the presence of rheumatoid nodules and extra-articular manifestations (vasculitis, neuropathies, pleurisy, acquired heart defects).
Causes: chlamydia, yersinia, shigella, salmonella.
Arthritis is asymmetrical, predominantly affecting the lower extremities, and is often combined with urethritis, cervicitis and conjunctivitis.
Drugs are selected taking into account the trigger infection that caused joint damage.
The most justified prescription of tetracycline drugs will be. They have high activity against chlamydial and enterococcal flora and are well distributed in bone tissue.
Tetracycline antibiotics in the treatment of rheumatoid arthritis are not etiotropic therapy. However, the use of minocycline and doxycycline (200 mg twice a day) can reduce the activity of enzymes that damage cartilage tissue, slow down degenerative processes in the joint, reduce swelling and reduce pain.
With long-term use:
Not recommended for use in children:
Prohibited for use by pregnant and lactating women, as they can accumulate in the fetal skeleton and cause congenital deformities.
It is important to remember that antibiotics for arthritis of rheumatoid etiology do not replace therapy with non-steroidal anti-inflammatory drugs, glucocorticosteroids, immunosuppressants and cytostatics.
However, the effect of taking Sulfasalazine is practically not inferior to the effect of cytostatics, which allows the use of this drug in the basic therapy of rheumatoid arthritis, especially in the presence of contraindications to the use of Methotrexate.
It is well distributed in the body, penetrates tissue barriers, accumulates in connective tissue and synovial (joint) fluid.
When carrying out therapy with sulfonamides, it is recommended to avoid ultraviolet radiation. It is also necessary to ensure sufficient drinking regime (at least two liters of water per day).
These antibiotics for bones and joints are not used in pregnant women, due to their teratogenic effect on the fetus. Prohibited for use during lactation. Penetrates into breast milk, causing kernicterus and hemolytic anemia of newborns.
Sulfonamides are not combined with estrogen-containing contraceptives and can cause uterine bleeding.
Do not use in the presence of renal or liver failure in patients with folic acid deficiency and megaloblastic anemia.
With long-term use, they inhibit bone marrow function (agranulocytosis) and can lead to exfoliative dermatitis, infertility and reversible oligospermia.
The dose recommended for long-term therapy is 40 mg/kg (2 g per day, 1 g twice a day) starting from the fourth week of treatment.
If there are complaints of a sore throat, the appearance of ulcers on the oral mucosa, severe bleeding, weakness and fever, therapy is stopped immediately.
Third and fourth generation cephalosporins, aminoglycosides, sulfonamides, macrolides and penicillins are used.
The third generation is consumed orally:
In case of severe inflammatory process, Cefepime (4th generation) is prescribed parenterally.
These antibiotics are effective for arthritis and arthrosis of staphylo-, strepto- and gonococcal etiology.
For the treatment of arthritis of chlamydial etiology, the use of macrolides in daily dosages is effective. Antibiotics for arthritis in tablets:
With prolonged use of Erythromycin, jaundice may occur as a result of the development of cholestatic hepatitis. Characteristic appearance: abdominal pain, yellowness of the skin and mucous membranes, severe itching, increased liver transaminases in a biochemical blood test.
Rarely, the administration of high doses of Clarithromycin in patients with renal failure leads to reversible hearing impairment.
Roxithromycin is contraindicated during pregnancy. It is permissible, with caution, to use Clarithromycin and Azithromycin (strictly under the supervision of a specialist).
The use of Erythromycin and Josamycin is allowed.
For destructive joint damage associated with purulent bursitis, fluoroquinolones are used.
Treatment of purulent inflammation of the joints is carried out in a surgical hospital.
Surgical intervention, as a rule, is of an emergency nature, due to the patient’s delay in seeking medical help and prolonged self-medication.
Surgery is performed under general anesthesia.
The scope of preoperative preparation depends on the patient’s condition, the level of hemodynamics and the severity of symptoms of general intoxication.
After puncture of the affected joint, its cavity is drained and washed with solutions of antibacterial drugs.
In case of massive purulent infiltration of soft tissues, areas of necrosis are excised.
In cases of osteomyelitis, purulent-necrotic destruction and bone sequestration, surgical intervention involves radical resection of the destroyed joint.
Indications for arthrotomy are rapid deterioration of the patient's condition and lack of improvement after the puncture.
Subsequent antibiotic therapy is carried out empirically, taking into account the suspected causative agents of purulent inflammation. Upon receipt of culture data (aspirated pus), it is possible to prescribe pathogenetic, highly targeted therapy.
Treatment is prescribed only by a rheumatologist!
To reduce pain and swelling, non-steroidal anti-inflammatory drugs (hereinafter NSAIDs) are used. It is preferable to begin treatment no later than three months from diagnosis.
Use: diclofenac, ibuprofen, ketoprofen.
In severe cases, meloxicam is prescribed.
It is important to remember that NSAIDs do not affect the progression of destructive processes in the joints.
The effect of glucocorticosteroid therapy is higher, however, it has a greater number of complications and side effects. The use of hormones slows down destruction in the joints in mild arthritis.
Prescribed: methylprednisolone, dexamethasone, prednisolone.
Visual video about arthritis:
The main thing in the treatment of rheumatic joint damage is the selection of cytostatic therapy. These drugs slow down the progression of joint destruction, and in mild cases they can stop the destruction process.
The most effective use of Methotrexate, Actemra, Rituximab, Arava.
Infectious disease doctor A. L. Chernenko
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