Injections are different: what injections are given in joints for arthrosis

Joint pathologies require a comprehensive course of treatment using different methods - medication and physiotherapy, exercise therapy and special diets. All this allows you to relieve exacerbation and reduce the risk of relapse to the maximum. But sometimes joint pain is difficult or slow to relieve, and then intra-articular injections come to the rescue. Such procedures ensure the delivery of the drug directly to the inflammatory focus, resulting in rapid relief.

Injections for joints are prescribed for arthralgia - joint pain - of various origins and impaired mobility. They are used in the treatment of arthrosis and arthritis, gout, synovitis and bursitis. Thanks to the injection of drugs, damage to ligaments, tendons, knee menisci and cartilage is successfully treated.

Glucocorticosteroids (hormonal)

Hormones have a strong anti-inflammatory effect, due to which pain goes away and swelling subsides. Such drugs are prescribed in tablets and ointments, and are also injected intramuscularly. But intra-articular injections work much faster and better. An additional advantage of steroids is the low risk of systemic adverse reactions, since they enter the blood in a negligibly small volume. Painkilling injections for joint pain are given with medications such as:

• flosterone;
• diprospan;
• kenalog;
• hydrocortisone;
• celeston.

Hormones are administered either individually or in combination with vitamins and local anesthetics (Lidocaine).

Attention! Steroids are useless and even dangerous for septic – infectious – arthritis. It is treated with antibiotics, which are administered only after the joint has been washed.

Chondroprotectors

Such drugs are taken for degenerative-dystrophic diseases of the joints and spine to protect hyaline cartilage. The process of destruction of cartilage tissue during arthrosis and arthritis is progressive and irreversible. It can be slowed down with the help of chondroprotectors, which are especially effective when they “directly hit” the joint cavity. They improve local metabolism and nutrition of intra-articular tissues, and most importantly, stimulate the synthesis of their own collagen.

Collagen is the main component of cartilage, which performs a protective function. Thanks to the cartilage coating, the articular surfaces of the bones slide rather than rub, and movement does not cause pain. Most often, doctors prescribe Alflutop; the frequency and duration of the course is determined individually. The minimum number of injections is 5.

Prevention of arthrosis of the hip joint

The development of arthrosis of the hip joint can be prevented in various ways. Sufficient and regular exercise stimulates the supply of nutrients to cartilage tissue and helps reduce the risk of disease. Another important prevention of arthrosis is to minimize the risk of injury - blows, falls, excessive physical activity. It is also important to monitor your body weight; excess weight is a provocateur of joint pathologies. Numerous studies have found that reducing a patient’s weight by 10-15% reduces the risk of developing arthrosis lesions by 50%.

Hyaluronic acid

It is also called a “synovial fluid prosthesis”, since hyaluronic acid acts as a lubricant that protects the joint from injury. It normalizes the composition of the synovium, which becomes denser and more viscous. Hyaluronic acid perfectly relieves pain and inflammation, activates the processes of self-regeneration of cartilage. Its most common use is in patients with arthrosis. With this remedy, injections are often made into the hip joint and knees. The standard course of treatment consists of 3-5 procedures with a week interval between them. The effect lasts for a long time, up to 1 year. The most frequently prescribed drugs with “natural lubrication” are Gialgan, Hi-Flex, Gialsin.

Carbon dioxide (carboxytherapy)

The effect of carboxytherapy is based on the property of carbon dioxide to cause oxygen starvation in tissues. Gas injections are given through a special device, and after the injection the body strives to enrich the joint with oxygen, increasing its blood supply. Metabolism accelerates sharply, and much more nutrients are supplied to damaged structures. In a matter of minutes, carbon dioxide leaves the joint cavity, and the effect remains for a long time.

Attention! The advantage of this unique technique is the absence of side effects, since CO2 is a natural element, a product of metabolic processes.

Carbon dioxide treatment was developed by Czech specialists from the city of Karlovy Vary, where the famous sanatorium is located. It has been successfully treating diseases of the musculoskeletal system for more than a century.

Causes of knee arthritis

Gonarthritis develops after an injury, so it mainly affects children, adolescents and young people. Athletes are at risk. After an open injury, an infection can enter the joint cavity, resulting in an acute inflammatory process.

With a closed injury, acute arthritis of the knee joint can also develop. At first, it is aseptic (without the presence of infection) in nature, and then either recovery occurs, or infection from nearby or distant foci (carious teeth, chronic tonsillitis, boils, etc.) occurs and purulent persecution develops.

The causes of arthritis of the knee joint may be associated with any general infection - gonorrhea, tuberculosis, brucellosis, etc. In such cases, the joint inflammatory process has the characteristics of the infection that caused it.

Another cause of arthritis of the knee joint and a damaging factor is an allergy to the patient’s own tissues (autoallergy). In most cases, there is a hereditary predisposition to these diseases, so people who have close relatives suffering from this pathology (rheumatoid arthritis) are at risk.

Toxic-allergic processes include reactive arthritis of the knee, which develops with certain urogenital, intestinal and nasopharyngeal infections. This arthritis of the knee joints also has genetic roots, which is why signs of knee arthritis appear after an infection. The trigger (triggering factor) in this case is infection. People who are sexually promiscuous are at risk.

PRP therapy

PRP stands for platelet-rich plasma. Platrlet rich plasma. Platelets are responsible for the formation of blood clots - blood clots that can clog damaged blood vessels. Platelets also actively participate in the processes of cleansing wounds of unnecessary proteins and stimulate the activity of fibroblasts. The latter are responsible for the production of collagen and elastin, which are the basis of connective tissue.

PRP therapy is injections for joint pain that have a number of advantages:

• do not cause allergies or side effects;
• rarely lead to the development of complications; (hormones);
• vitamins;
• do not transmit infection..

These advantages are due to the use of the patient’s own blood, which is completely compatible with body tissues. To improve the effect, plasma administration can be combined with hyaluronic acid preparations.

Treatment of knee arthritis

Crunching in joints - when to worry

Intra-articular injections of hyaluronic acid

After a complete examination, treatment for knee arthritis is prescribed. It must be comprehensive and individually selected for a specific patient. The complex treatment includes:

• regimen and diet;
• drug therapy;
• non-drug methods for treating knee arthritis;
• folk remedies;
• surgical methods of treatment.

Regime and diet

When exacerbation of gonitis occurs, bed rest with minimal physical activity is applied. In some cases (for example, with purulent gonitis), the joint is immobilized. After the acute inflammation subsides, there is a gradual increase in physical activity. It is also important to regulate sleep and wakefulness patterns.

A special diet is only necessary for gout. Offal, meat of young animals, strong broths, eggs, alcoholic drinks, strong tea and coffee, and chocolate are excluded from the diet.

For other types of arthritis of the knee joint, during the treatment of exacerbations, a nutritious diet is recommended with the exception of foods that cause tissue irritation. These are onions, garlic, radishes, hot seasonings, fried, cooked, canned foods. It is also recommended to limit sweets and confectionery.

Drug therapy

The question of how to treat arthritis of the knee joint is decided by the attending physician. The general condition of the patient, features of the course of joint pathology, the presence of concomitant diseases, individual intolerance to drugs, etc. are taken into account. In this case, the doctor must adhere to common clinical recommendations for the treatment of certain types of gonitis. Prescribed:

• medications from the group of non-steroidal anti-inflammatory drugs (NSAIDs). They relieve symptoms of exacerbation of knee arthritis well: inflammation, swelling and pain, improve the general condition of the patient (Diclofenac, Nise, Miloxicam - in the form of injections, oral tablets or ointments);
• for severe swelling and pain that cannot be relieved by NSAIDs, glucocorticoid hormones are prescribed: a course of oral prednisolone, short courses of intravenous drip infusions of methylprednisolone (pulse therapy) or intra-articular injections of Diprospan;
• reduction of tissue swelling is achieved by the use of antihistamines - Erius, Claritin;
• for reactive arthritis against the background of a urogenital infection, long-term (up to a month) courses of antibacterial therapy are prescribed;
• Antibacterial therapy and washing the knee joints with antiseptic solutions are prescribed for the treatment of purulent arthritis of the knee joint;
• in order to restore cartilage tissue, chondroprotectors are prescribed - Dona, Structum;
• to suppress autoimmune processes, basic drugs are prescribed - Sulfasalazine, Methotrexate, Leflunomide, as well as biological substances or agents (MabThera),

Drugs for the treatment of knee arthritis

Non-drug methods

These treatments for knee arthritis include:

• physiotherapy - at the acute stage of the disease these are electrophoresis procedures with medicinal solutions, then magnetic and laser therapy, mud therapy, etc.;
• physical therapy (physical therapy) with a gradual increase in active physical activity during the period of remission;
• massage – during the period of remission, it allows you to restore blood circulation and stimulate metabolic processes in the knee;
• reflexology - influencing acupuncture points on the body, reflexively associated with the knee area; allows you to relieve pain, swelling, restore biological balance in tissues.

Folk remedies

Folk remedies for the treatment of knee arthritis can only be prescribed by a doctor. You cannot use them on your own, since different arthritis requires the use of different remedies. An infusion of medicinal herbs will be beneficial to one patient, but harmful to another. Most often, doctors use folk remedies to reduce the drug load on the patient’s body and limit the side effects of drugs.

Surgical methods of treatment

The help of a surgeon is required when conservative therapy does not help:

• in the treatment of purulent arthritis of the knee joint, therapeutic arthroscopy is performed with washing the diseased joint with aseptic solutions, constant drainage of the joint;
• in case of severe swelling and severe pain, a synovectomy operation is sometimes performed - removal of the most inflamed part of the synovial membrane;
• in case of deforming arthritis, the appearance of areas of bone tissue growth, in order to increase functionality, arthroplasty is performed - partial removal of bone growths and parts of the bones; in some cases, destroyed bone structures are replaced with implants;
• endoprosthesis replacement is a surgical intervention to replace a destroyed joint with an artificial one.

Surgical treatment of knee arthritis

Advantages

• The drugs dissolve very slowly, up to 12 months.
• They have a local effect on all joint tissues.
• Almost do not enter the systemic circulation and do not affect the functioning of internal organs.
• Thanks to the previous point, they can be used in patients with severe concomitant pathologies, when treatment with other methods is unacceptable.
• Intra-articular injections help avoid surgery.
• After the procedure, no rehabilitation is required; the doctor can only apply a tight bandage and warn against excessive physical exertion.

Indications and contraindications for taking chondroprotectors

Although chondroprotectors are useful for diseases of ligaments and even periodontal tissue, their main use in medicine is the protection and restoration of joints. Chondroprotectors for joints are made from natural products that have been part of the human diet for centuries, so side effects and contraindications are very rare.

Who needs chondroprotectors for joints?

Joint damage is common among athletes, manual workers, and people who lead a sedentary lifestyle. People with age-related changes in hormonal levels and people over 45 years of age are also at risk. The presence of autoimmune and metabolic diseases (systemic lupus erythematosus, rheumatoid arthritis, diabetes mellitus, gout), excess weight is a good reason for the preventive use of chondroprotectors.

You need to start a course of glucosamine and chondroitin:

• at stages 1 and 2 of osteoarthritis and other rheumatic diseases;
• for diseases of ligaments and tendons;
• after injuries and joint surgeries;
• for diseases with a tendency to damage joints;
• in other cases as prescribed by a doctor.

Who should not take chondroprotectors?

Absolute contraindications to taking chondroprotectors for joints are phenylketonuria (a disorder of amino acid metabolism) and individual intolerance to their components. A preliminary consultation with a specialist before taking chondroprotective agents and further observation is necessary for:

• pregnant and lactating women;
• children under 12 years of age;
• asthmatics (if breathing is difficult, the drug should be discontinued);
• diabetics (glucosamine changes glucose tolerance);
• allergy sufferers (especially those with allergies to various types of protein and shellfish);
• patients with gastrointestinal diseases in the acute phase (gastritis, gastric or duodenal ulcers);
• people with kidney disease (including cholelithiasis, urolithiasis, renal failure) and liver failure;
• patients with vascular pathologies (including varicose veins, thrombosis and thrombophlebitis) and blood clotting disorders;
• persons with oxaluric diathesis;
• patients diagnosed with malignant tumors.

Indications

• osteoarthritis;
• arthritis;
• bursitis;
• synovitis;
• tendinitis.

Joint diseases are very common, especially among older people. If you are one of them, or the time has come to repeat the course of treatment, call us. Our center employs high-level specialists with extensive experience, making patients feel comfortable and confident. If necessary, you will be prescribed one or more intra-articular injection procedures and a drug will be selected based on the indications.

Diagnostics

Treatment of knee arthritis is impossible without a preliminary examination and establishment of the etiology (cause) of the disease, since different types of arthritis require different approaches to treatment. As part of the examination, patients may be referred for the following studies:

• laboratory tests of blood, urine, joint fluid
  - general clinical, biochemical, immunological, genetic, microbiological;
• X-ray of the knee
  - bone growths and deformations are identified, the height of the joint space is measured;
• MRI of the knee
  - changes in soft articular and periarticular tissues are detected;
• Ultrasound
  – examination of the soft tissues of the knee and determination of the volume of joint fluid;
• arthroscopy
  – endoscopic examination of the internal articular surface; If necessary, joint fluid is taken for examination.