Step 1: Rest and Physical Therapy
Follow the With the increase of age, the pathological process of knee joint hyperplasia and degeneration is basically irreversible. Early treatment can reduce symptoms, relieve pain, stop the vicious cycle, increase joint mobility, and slow its progression.
Rest is an important part of the treatment of knee osteoarthritis, throughout each treatment process. In daily life, we should pay attention to protecting the joints and avoid excessive movement or damage of the joints. One thing I often say to patients in outpatient clinics is: From now on, take a car or bike when you go out, find a stool to sit down wherever you go, and don’t stand there to watch.
Physical therapy, including infrared and microwave therapy, can also relieve symptoms to a certain extent.
Step Two: Oral Medication
Western medicine treatment: anti-inflammatory and analgesic drugs (oral or topical); cartilage nutrients.
Traditional Chinese medicine treatment: Chinese patent medicines, decoctions, etc. External hot compress, fumigation, soaking, and sticking of traditional Chinese medicine can also be used.
Step 3: Intraarticular injection
Intraarticular injection refers to the injection of nutritious cartilage, anti-inflammatory and analgesic drugs into the joint cavity, using its rheological properties to lubricate the joint and protect the articular cartilage. We use the “triple needle” injection into the knee joint, which can relieve the symptoms of some patients for a period of time.
Step Four: Minimally Invasive Surgery
(1) Arthroscopic surgery:
Arthroscopic surgery can perform joint irrigation and cleaning, remove osteochondral debris, Free bodies and various inflammatory and pain-causing factors; dilute cartilage-degrading enzymes in the joints, clear collagen antibodies, slow down autoimmune reactions, reduce synovial inflammation, eliminate synovial edema, and reduce knee internal pressure to exert physical effects.
Arthroscopy is now widely used, but it still cannot fundamentally cure osteoarthritis. Early and mid-fifties patients with joint effusion. For older patients, the cartilage in the joint is severely damaged, the hyperplasia is obvious, and the joint space almost disappears, and the postoperative effect is poor.
(2) Proximal fibula osteotomy:
< span> In clinical practice, the subsidence of the medial tibial plateau significantly lower than the lateral plateau is commonly found on the X-ray and CT images of patients with osteoarthritis of the medial compartment of the knee. Studies have shown that bone loss and osteoporosis are the main culprits in the pathogenesis of knee osteoarthritis. The uneven settlement of the tibial plateau caused by fibular support is an important factor in the occurrence and development of medial compartment osteoarthritis of the knee joint. It is the latest theory of uneven settlement of the knee joint, and the use of proximal fibula osteotomy for the treatment of patients with osteoarthritis in the medial compartment of the knee joint is based on this theory. At present, it has been widely carried out all over the country, and Asian countries such as South Korea and Japan have also begun to carry out. The procedure is streamlined, less costly, less traumatic, and quicker to heal. It does not require arduous rehabilitation training, and it can also be performed by elderly patients with underlying diseases.
Step 5: Joint Replacement
for the following patients:
(1) Serious destruction of articular surface bone and cartilage;
(2) Moderate to severe persistent pain;
(3) Severe joint deformity;
(4) severely limited joint function.
Osteoarthritis develops to the middle and late stages, and there will be persistent joint pain, joint deformity, and even the inability to take care of yourself. At this time, artificial joint replacement must be accepted.