Modern methods of articular cartilage restoration

Injuries to the ankle, knee and wrist joints are the most common reasons for visiting a traumatologist. These joints suffer as a result of both sports and everyday injuries, and the degree of complexity of such injuries varies quite widely.

With serious joint injuries, cartilage is often destroyed, swelling and hemorrhage occur, and the joint can become blocked. All this is accompanied by severe pain. In addition, articular cartilage often suffers from inflammatory pathologies and degenerative diseases. Joint diseases should not be ignored under any circumstances, since advanced pathology leads to the development of arthrosis and a reduction in the patient’s motor capabilities.

Unpleasant sensations in the joint can be temporarily eliminated with the help of medications. Physiotherapy, massage and physical therapy will help with injuries. However, conservative methods of treating damage to articular cartilage are not always effective, and then it is necessary to resort to surgical intervention.

There are many methods of surgical treatment of damage to articular cartilage, successfully used in Israeli clinics, including by specialists from the Ilyssa Medical Group center. Let's look at some of these techniques in more detail.

What are chondroprotectors and how do they treat joints?

August 13, 2021
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Content

• What are chondroprotectors
• How to choose the right chondroprotector
• What is the composition of the chondroprotector?
• What chondroprotectors exist?
• What else you need to know about chondroprotectors
• Where does the mistrust of chondroprotectors come from?
• The best chondroprotectors for joints
• Teraflex
• Don
• Piascledine 300
• Artra
• Diaflex
• Honda Forte

On the Internet you can find a lot of information about chondroprotectors. Let's figure out what these drugs are, how they work, what they treat, and whether they are effective in principle.

How to choose the right chondroprotector

The main thing when choosing a chondroprotector is to carefully read the composition. Chondroprotectors contain components such as chondroitin sulfate, collagen hydrolysate and glucosamine. Moreover, each of these components is very important.

By method of application

There are such chondroprotectors:

• External
  - gels and ointments that are applied to the skin at the site of the problem joint (external chondroprotectors often contain pain-relieving components). But many doctors are skeptical about this group of drugs and believe that they are ineffective.
• Injectable
  - these anti-inflammatory drugs are prescribed for serious joint diseases, and they are selected exclusively by a doctor.
• Tablets and capsules
  are chondroprotectors that are used for treatment and recovery after injuries and any damage to the joints.
• Powdered
  - such chondroprotectors are rare, but, for example, powdered collagen is absorbed much better than tableted collagen.

1.2. The essence of a new method of treating ANFH

With non-surgical treatment, without causing injury and while maintaining the integrity of the structure of the hip joint, the body's resistance increases, new bone tissue grows and normal functions of the hip joint are restored.

During the process of physiological recovery, products of necrotic bone tissue are eliminated, conditions are created not only for the growth of new bone tissue, but also for the reconstruction of the bone structure, improving microcirculation and the flow of Qi and blood. As a result, the strength, density and rigidity of the trabeculae are increased, the mechanical properties of the femoral head are improved, bones are strengthened and muscles are softened, and the function of the hip joint is restored, which improves the patient’s quality of life.

A new non-surgical, non-traumatic method of treating ANFH, being safe and effective, makes it possible to change the existing belief in the inevitability of endoprosthetics, presenting it as extreme and forced.

What is the composition of the chondroprotector?

The main active ingredients of chondroprotectors are glucosamine, chondroitin and collagen. A specific chondroprotector may contain either one of these components or be multicomponent. In any case, when choosing a chondroprotector, you must consult a doctor who is aware of your specific joint problem.

1. Glucosamine.
   This substance is produced by the cartilage tissue of joints. Glucosamine is found in synovial fluid (this is a kind of lubricant in the joint capsule that prevents joints from rubbing against each other). Glucosamine reduces inflammation, slows tissue breakdown, and helps produce chondroitin.
2. Chondroitin.
   An important component of ligaments and cartilage. Chondroitin makes joints more elastic, flexible, and provides shock absorption when you put stress on your joints. Joint mobility usually improves after 1-3 months of taking chondroitin. Swelling goes away, pain decreases, cartilage begins to recover.
3. Collagen.
   Collagen mainly consists of connective tissue (cartilage and ligaments), as well as nails and hair. Collagen is necessary for those who have damaged joints, as well as for their preventive strengthening.

Usually, when treating joints and ligaments, doctors prescribe new generation chondroprotectors - multicomponent ones, which contain a complex of all these substances.

Read also How to treat varicose veins: top 9 best ointments Varicose veins are easier to treat at the initial stage, so control the development of this disease. To treat varicose veins, there are effective ointments and gels that strengthen capillaries, relieve pain, swelling and inflammation.

1.5. Principles and features of treatment of ANFH using a new method

A new treatment method for ANFH, based on the fundamental theory of traditional Chinese medicine in combination with Western medicine, includes the latest scientific technologies, the achievements of modern scientific research in the field of traumatology, microstructure of bone joints and bone biomechanics, as well as other branches of science at the intersection of scientific disciplines. It reconsiders not only the causes of hip disease, its pathology and treatment, but also the stereotype of traditional judgments in traumatology. The new method forms a new approach to treatment, combining simultaneous effects on the body from the outside and from the inside.

The goal is to improve not only the microcirculation in the bone, the formation of the femoral head and acetabulum, but also to recreate the force relations in the hip joint, adjust the position of the pelvis and create a functionally adapted environment, so that in the process of restoring the biomechanical environment during the treatment of ANFH, integrity is maintained structures of the hip joint.

The principles of treatment of ANFH using the new method are as follows:

• absence of surgical intervention and mechanical damage to bone tissue;
• maintaining the integrity of the structure of the hip joint;
• replacement of dead bone tissue with new bone tissue;
• restoration of bone tissue structure;
• improvement of microcirculation;
• increasing the mechanical properties of the femoral head: strengthening bones, muscles and tendons;
• recreating the function of the hip joint.

As part of a comprehensive modeling of the interconnected physiological, pathological, regenerative and restorative process in necrotic bone tissue of the femur, the new method focuses on the balancing system of the human body itself, the redistribution and regulation of tension in the femoral head. During the treatment, the ability of the femoral head to recover is activated, bones, muscles and tendons are strengthened, and Qi

and blood.

Thus, this is a completely new treatment method in which the main way to update the function of the hip joint is a set of non-surgical, non-traumatic measures.

What chondroprotectors exist?

We have figured out the composition of chondroprotectors, but there are so many similar drugs on the Internet and pharmacies that it is very difficult for a person to choose the right one on his own. What to focus on? All chondroprotectors are conventionally divided into three generations:

The first generation of chondroprotectors.

These are products for the treatment of joints, which are based on natural substances (animal cartilage or plant extracts).

Second generation of chondroprotectors.

These are single-component preparations containing one of these substances: chondroitin, glucosamine, hyaluronic acid or collagen.

Third generation of chondroprotectors.

These are multicomponent preparations for joints and ligaments, which contain several active ingredients: chondroitin, collagen and glucosamine. Sometimes they are supplemented with vitamins, minerals and polyunsaturated fatty acids. Compared to first and second generation drugs, such chondroprotectors are much more effective.

Joint destruction
Photos from open sources

NUTRITION FOR CONNECTIVE TISSUE HEALTH

Many of us have heard about connective tissue in our bodies, but few know how important it is and how to preserve it. But connective tissue is not only one of the main components of our skin and subcutaneous tissue, but also the “building blocks” of blood vessels, bones, teeth, cornea and sclera of the eye, and cartilage. There is a connective tissue component in the myocardium, layers of connective tissue are found between muscle fibers, even part of the brain and adipose tissue are connective tissue. Connective tissue is the connecting link between all tissues of the body. 85% of a person’s body weight is this tissue!

Unfortunately, highly specialized doctors are rarely interested in our concomitant diseases, but damage to the eyes, teeth or spine are links in one chain, caused by a violation of the strength of connective tissue components as a result of hereditary or acquired metabolic disorders.

There are so many types of connective tissue:

- bone - cartilage (hyaline, elastic and fibrous cartilage) - blood, lymph - connective tissue itself (loose fibrous, dense fibrous, reticular). - fatty

Today we are most concerned with collagens and elastins - vital proteins that form the basis of connective tissue and the main amorphous substance. Collagens and elastins are “springs”; our appearance and the condition of all connective tissues of the body depend on their healthy elasticity, and the amorphous substance is a “gel” that performs the most important functions.

It is through the main substance of connective tissue that water and nutrients are transported. Every cell of our body needs nutrition and cleansing from waste products, which are carried out through the smallest capillaries of the bloodstream. But capillaries are not able to “encompass” every cell, so from the capillaries nutrients enter the intercellular substance, and only from there to the cells, and waste from the cells first enters the intercellular substance.

Now imagine that instead of the desired gel (jelly-like) consistency of the main substance of the connective tissue - cement, or vice versa, broth, will the nutrients and hormones reach the cell membrane? How will waste be released into the lymphatic system? How will other functions of connective tissue be performed? What will happen to articular cartilage, which must withstand enormous loads - pressure of hundreds of atmospheres? What will happen to the permeability of the walls of blood vessels - after all, nutrients must penetrate through the walls of blood vessels into the intercellular substance? What about the cells of the immune system - phagocytes, macrophages, etc., which act not only in the blood, but also in the intercellular fluid? But what if the intercellular fluid is cement, through which it is impossible to get through? How then will the immune system detect these bad cells?

What can we do to ensure that the connective tissues of our body remain healthy and strong for a long time?

First of all, take care of the “health” of our collagen, of its sufficient quantity. In the body, collagen is formed from a precursor called procollagen.

Beverly Hills dermatologist Dr. David Emron has found that excessive sun exposure during tanning negatively affects the collagen fibers contained in the skin, leading to premature wrinkles and aging of the skin. Dr. Debra Jailman, a dermatologist in New York City, has discovered that the development of cellulite is closely linked to the weakening of the collagen elements that attach the skin to underlying structures and keep the skin in a smooth, taut state. Almost all experts who have studied collagen agree that a decrease in flexibility and mobility in joints with age is a consequence of the “aging” of collagen in connective tissues.

Can you get it from food? For many years, collagen was considered insoluble in water and therefore indigestible. The reason for this is that collagen supplied to the body from foods resists the effects of trypsin contained in the gastric environment, however, it is hydrolyzed by the bacterial enzyme collagenase. When collagen is boiled in water, it hydrolyzes, and the product becomes gelatin.

Collagen biosynthesis and the subsequent formation of connective tissue is a complex, multi-stage and relatively slow process (this is why connective tissue and cartilage injuries heal so slowly, especially in adults). Violation of individual stages of this process - in the case of blockade or lack of individual factors - leads to the synthesis of atypical, easily destroyed collagen. Thus, a lack of vitamin C inhibits the hydroxylation of proline and lysine, and therefore causes such a serious disease as scurvy. In case of other disorders, diseases such as rheumatoid arthritis, osteoarthritis, scleroderma and a number of other equally serious diseases arise.

The most important factor necessary for the construction of a full-fledged collagen molecule is the structural subunits of the protein - amino acids formed as a result of the breakdown of food proteins.

You certainly know that there are about three dozen amino acids that are nutritional factors. In the body, many of them are synthesized in the liver. However, some amino acids cannot be synthesized in the body, and a person must obtain them from food. The following amino acids are essential for humans: histidine, isoleucine, leucine, valine, lysine, methionine, phenylalanine, threonine and tryptophan. The body is constantly in the process of protein synthesis, and in the absence of at least one essential amino acid, the formation of proteins is suspended.

Therefore, it is extremely important for the health of our connective tissues to have complete proteins in our diet. Complete proteins include proteins from animal products, such as eggs, dairy products, meat, poultry, and fish. Vegetable protein from different types of legumes, soybeans, peas, various cereals and vegetables is considered incomplete. The disadvantage of incomplete protein is its relatively poor amino acid composition and a rather low degree of absorption. For example, soy contains relatively a lot of protein, but it is absorbed by the body by 30–40%, while egg white is almost completely absorbed. Therefore, a person’s diet should contain a sufficient amount of animal protein, and if your goal is to lose excess weight, then this protein should be combined with a minimum amount of fat. The following products meet this requirement: egg whites, lean meat (beef, chicken, turkey), fish (pollock, cod, haddock, flounder, pike perch, hake, pink salmon, salmon), milk and low-fat fermented milk products.

In addition to complete proteins, other nutritional components are also extremely important:

Vitamin C – participates in the synthesis of collagen by promoting special enzymes. The human body does not produce vitamin C and it must be obtained from food. The consequence of impaired collagen synthesis is an increase in the permeability of the walls of blood vessels, which leads to hemorrhages in the skin, joints, bleeding gums, etc.

Sources of vitamin C: dried rose hips, black currants, red and bell peppers, horseradish, citrus fruits, sorrel, strawberries, radishes, gooseberries, cabbage, tomatoes, potatoes, broccoli, mango, parsley, domestic apples, apricots, peaches, persimmons, sea buckthorn, rowan, oats, spinach, pomelo, melon.

Minerals:

Sulfur is part of structural proteins (collagens), certain glycosaminoglycones that are present in cartilage, in the sclera of the eye (they give strength to the sclera, participating in supporting the shape of the eye), in the cornea of ​​the eye (provide transparency of the cornea), and also prevent the formation of blood clots.

Sources of sulfur:

Vegetables: cabbage, onions, cereals, cereals, legumes, mustard, horseradish, gooseberries, grapes, apples, garlic, asparagus, baked goods.

Animals: lean beef, fish, chicken eggs, milk and dairy products.

Silicon is included in the composition of elastin, a substance that determines the strength, elasticity and permeability of blood vessels.

Sources of silicon

Plant-based: whole grains, cereal products, beets, soybeans, turnips, radishes, green beans, potatoes, onions, Jerusalem artichokes, seaweed, bran, wild berries, greens, brown rice, apricots, bananas, cherries, raisins, figs, cabbage , corn, celery, nuts.

Silicon is also present in grape juice, wines and beer.

Animals: caviar, eggs.

Some amount of silicon is found in mineral waters

Copper - strengthens the cross-links of collagen (collagen fiber consists of “threads” - collagen fibrils, the “cross-linking” of which requires an enzyme activated by copper ions).

It is clear that the body must receive such an important element daily from the outside - with food, water or through the skin.

It’s clear about water - passed through copper pipes, the water arrives enriched with copper ions - approximately 1 mg per liter. What products contain this essential element? There is a lot of copper in nuts, raw egg yolk, liver, legumes, cereals, dairy products, vegetables, fruits and berries. Copper is found in fresh animal meat, fish, seafood, sprouted wheat, soybeans, rye bread, asparagus, potatoes and herbs: dill, cinquefoil, madder, cucumber, leaves of the tea bush, swollen lobelia. And the leaves and root of ginseng contain the highest percentage of copper of any plant.

Zinc affects all processes in the connective tissue - both synthesis and breakdown. It promotes rapid healing of wounds.

Zinc activates enzymes (matrix metalloproteases, MMPs), which disassemble molecules of intercellular substance; promotes the formation of phagocytes and enhances the activity of macrophages, which contributes to the cleansing of necrotic tissue elements; helps attract fibroblast cells to the affected area; replenishes the deficiency of hyaluronic acid (this acid belongs to glycosaminoglycans, which form the amorphous substance of connective tissue); activates enzymes responsible for collagen synthesis.

Sources of zinc: meat of geese, chicken, beans, corn, beef, pork, liver.

Zinc is less absorbed from grains and legumes than from meat and fish.

Fruits and vegetables are generally low in zinc. So vegetarians and people who eat insufficient amounts of foods containing this micronutrient may develop a deficiency.

Long-term consumption of foods that are too salty or too sweet can also reduce zinc levels in the body.

Magnesium. Magnesium deficiency reduces and slows down the rate of collagen synthesis.

Sources of magnesium: Wheat bran, soy flour, almonds, walnuts, peas, wheat, cabbage, cereals.

Antioxidants protect cells, including fibroblasts (which are responsible for rebuilding connective tissue) from the negative effects of free radicals in the cell's information center.

Antioxidants are substances that allow the human body to extract and bind oxidants. Like other antioxidants, the catechins found in green tea selectively inhibit specific enzyme activities that lead to cancer. They can also detect and repair DNA changes caused by oxidants. Currently, the following are used as antioxidants:

— antioxidant vitamins: beta-carotene (pro-vitamin) and other carotenoids (astaxanthin, lycopene, lutein, etc.), A, C, E. Each vitamin performs its own function. Therefore, it is necessary that each of them is present in your food products.

- Beta-carotene. Found in brightly colored green, orange, and yellow fruits and vegetables. For example, in carrots, pumpkin, apricots, mangoes, papaya, red peppers, spinach, cabbage, turnips, broccoli, melon.

— Vitamin C. Contained in red and green peppers, kiwi, oranges, grapefruits, tomatoes, potatoes, cabbage, strawberries, etc.

— Vitamin E. Also known as tocopherol, it is found in any plant food, but vegetable oils (naturally vegetable-pressed) are especially rich in it. For example, olive, corn, peanut, sesame, almond, wheat germ oil.

- antioxidant microelements: selenium, zinc, copper, chromium, manganese, etc. - natural (plant) antioxidants or bioflavonoids: extracts from the seeds or skins of red grapes, tree bark, blueberries, green tea, etc. — antioxidant amino acids: methionine, tyrosine, cysteine, taurine, etc.

Strong and popular antioxidants are also succinic and lipoic acids, coenzyme Q10, melatonin, etc.

Glucosamine is the main building material for connective tissue. Stimulates the production of the same collagen by cartilage cells, as well as such an important substance as chondroitin. At the same time, the produced chondroitin, after breakdown, will decompose into several components, one of which is glucosamine.

Glucosamine itself is produced by cartilage cells from glucose and an important amino acid - glutamine.

Glucosamine in food

Glucosamine is present in many foods, but tends to break down when exposed to extreme heat. The main source of glutamine can be cartilage, as well as foods high in glutamine – chicken, beef, hard cheese.

Chondroitin is the main component of the amorphous substance of cartilage. An important element of tendons, ligaments, cartilage, skin, blood vessels. It has anti-inflammatory properties and plays an important role in the restoration of cartilage tissue. Thanks to chondroitin, fluid is retained in cartilage tissue. Upon breakdown, it produces glucosamine as one of the components.

Chondroitin is produced by cartilage cells when using the same glucosamine.

Chondroitin in food

Contained in the skin, tendons and cartilage of animal origin and, to an even greater extent, in fish (especially salmon, salmon). It is for this reason that chondroitin supplements are made from salmon cartilage

What else you need to know about chondroprotectors

Rheumatologists say that it is important to choose the right form of the drug for the joints, as well as the composition. Products based on animal tissue and plant extracts (Alflutop, Rumalon, Piaskledin) do not have a pronounced protective effect on chondrocytes. But synthetic or semi-synthetic chondroprotectors (“Injectran”, “Teraflex”, “Diaflex”, “Honda”, “Arthra”) show a very pronounced positive effect if taken correctly. As for gels and ointments for joints, they help little. Doctors explain this by saying that the chondroprotective ointment penetrates the skin by 1-2 mm, and the joint is much deeper. Conclusion: only chondroprotectors in the form of tablets or injections are effective in treating joints and ligaments.

And, of course, you need to listen to the feelings of the patient himself. If this or that drug suits him (inflammation goes away, pain decreases, crunching goes away, mobility in the joint appears), then the specific chondroprotector is effective for him.

1.4. Recovery criteria for a new treatment method for ANFH

Recovery and complete cure of femoral head necrosis cannot be measured by any single criterion. The concept of recovery with a non-surgical method of treating ANFH involves improving or increasing the physiological functions of the hip joint, approaching those of a healthy person. However, this does not at all mean the repair of the femoral head affected by necrosis to the level of the clone and a copy of the geometric dimensions of the normal femoral head in the sense of its anatomy, histology and morphology.

In practice, the degree of destruction of the hip joint in patients with ANFH is very diverse, the impact of destruction on the physiological function is different, so the best way to restore and renew the function of the hip joint is selected based on the specific case.

Requirements for the general condition of the patient and the functions of his hip joint, as well as for the restoration of the dynamics of muscle strength, constitute the content of the recovery criteria in the treatment of ANFH.

Restorative treatment of femoral head necrosis involves achieving the following results:

1. Improving the general condition of the patient:

• improvement of general somatic condition;
• improvement of psychological state;
• adaptation to performing functional duties;
• patient social activation;

2. Restoring the functions of the hip joint:

• dissolution and elimination of necrotic bone, replacing it with new bone, improving and restoring the structure of trabeculae;
• improvement and restoration of muscle strength and coordination;
• restoration and functional adaptation of the hip joint;
• restoration and improvement of motor function and ability to withstand stress;
• improvement or approaching normal gait and the patient’s condition in motion and at rest.

Where does the mistrust of chondroprotectors come from?

There have always been two opposing opinions regarding chondroprotectors (both among patients and among doctors and representatives of the pharmaceutical market): some are confident that such drugs are indispensable for the symptomatic treatment of arthrosis, others say that the positive effect of chondroprotectors is a myth. Moreover, in many countries, chondroprotectors are not included in the treatment protocols for osteoarthritis. Why is that? Because we all hope that a “magic pill” will immediately get rid of health problems, but we don’t want to make special efforts to solve the issue comprehensively. Treatment of joints is not only drugs, but also lifestyle changes, weight loss, dosed exercise, etc. Often we hope to start drinking chondroprotectors and quickly heal our joints. If there is no improvement, we give up this idea.

You should not expect a positive result from taking chondroprotectors if you have the third stage of arthrosis - here conservative treatment is useless, only surgical treatment.

But most rheumatologists are still confident that taking chondroprotectors will greatly improve the situation with arthrosis of the first or second degree, when the cartilage has not yet been destroyed and chondrocytes are alive.

In addition to facilitating gliding, synovial fluid nourishes cartilage

Photos from open sources

Restoration of the femoral head according to the following parameters:

• Muscle strength
  - improvement or normalization of the contractile and extensor strength of the muscles themselves;
• Stability
  - a stable state or improvement in the relative position and centering of the femoral head and acetabulum within physiologically acceptable limits;
• Mobility
  - normalization of the contractility of the muscles that provide mobility of the hip joint;
• Coordination
  - the ability of each muscle of the hip joint to quickly respond to the movement of the gluteal muscle group and lower extremities while maintaining a certain position - performing this physiological function or improving it;
• Balance
  - creating a balanced system of flexor and extensor muscles in the hip joint;
• Durability -
  the formation of strength, rigidity, surface hardness and cartilage lubrication in the bone tissue of the hip joint to adapt to the performance of functional loads;
• Absence of pain
  - absence of pathological reaction or its decrease under conditions of functional load of the hip joint;
• Shape
  - improvement or normalization of the physiological function of the hip joint during its restoration under power load conditions. (It must be noted that restoring the shape of the femoral head is in no way cloning or copying the shape of the normal femoral head).

In practice, the restoration criteria take into account: the type of necrosis of the femoral head, the degree of destruction of the structure of the femoral head, the degree of destruction of the hip joint, the degree of loss of physiological functions, the patient's age, his profession, his general state of health and his requirements for hip joint restoration. Based on developed, scientifically based recovery criteria, a treatment plan is developed.

The content of both general and intended recovery criteria should be explained to the patient. It is necessary to reasonably describe their difference from each other and the reasons that caused this difference (the degree of destruction of the hip joint, the individual characteristics of the patient, the possibility of receiving full treatment, etc.), so that the patient is confident in the results of treatment, and full mutual understanding is achieved between the doctor and patient.

It must be emphasized once again that for recovery according to the developed criteria, genuine cooperation between the patient and the doctor is necessary, since the goal can only be achieved as a result of their joint efforts. Otherwise, despite the maximum costs, the result will be minimal.

Teraflex

Probably one of the most popular chondroprotectors produced in the USA, which contains chondroitin and glucosamine. This is an original drug with a fairly high cost. "Teraflex" effectively restores cartilage tissue and has no side effects. Many patients note clear positive dynamics while taking this chondroprotector. But be prepared to take Teraflex for a long time - 4-6 months, and sometimes a year. The drug is sold in packages of 60 to 200 tablets. “Teraflex” was actively advertised, so most people know it, although not all doctors consider it the most effective.

Teraflex

Contract Pharmacal Corporation, USA

Teraflex is a combination drug that contains two active substances: glucosamine hydrochloride and sodium chondroitin sulfate, which potentiate each other’s action.
Teraflex is used in the complex treatment of pathologies of the musculoskeletal system, which are accompanied by degenerative-dystrophic changes in the joint tissue, such as: osteoarthritis (primary and secondary); osteocondritis of the spine; degenerative-dystrophic pathologies of joints and spine; traumatic bone damage. from 676

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Causes of destruction of cartilage tissue

The cartilage in the joints is subjected to significant stress, and in certain circumstances it cannot withstand it: it begins to collapse. Especially if changes occur in the body that reduce its regenerative abilities. In this case, osteoarthritis develops - a disease caused by degenerative changes or destruction of the cartilage and bone tissue of the joints. Previously, another name for this condition was used - osteoarthritis, emphasizing the age-related nature of the changes. But, since inflammatory processes inevitably develop against the background of destruction of osteochondral structures, and it is they that cause characteristic symptoms, the term “osteoarthritis” is now predominantly used, and according to the international classification of diseases (ICD-10), both of these diagnoses are considered synonymous. In relation to dystrophic changes associated with the destruction of cartilage and bone tissue of the spine, it is customary to use the term “osteochondrosis”.

The causes of destruction of cartilage tissue are varied:

Don

This German chondroprotector can be called one of the first on the Russian market; the drug contains 750 mg of glucosamine. “Dona” has shown its effectiveness in treating joints: the chondroprotector perfectly relieves pain, restores mobility to the joint and prevents it from collapsing. "Dona" is prescribed both as the only tablets for the treatment of joints and in complex therapy. By the way, you can buy Dona not only in tablets, but also in injections and powder for solution. In general, patients respond very well to this product, but at the same price it is now possible to buy a third-generation chondroprotector, which contains not one, but several active components.

Don

Rottafarm, Italy

Primary and secondary osteoarthritis, glenohumeral periarthritis, osteochondrosis, spondylosis, chondromalacia of the patella.
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Piascledine 300

This chondroprotector made in France has a natural herbal composition. The active ingredients of “Piascledina 300” are unsaponifiable compounds of soybean oil and avocado oil. The chondroprotector helps improve metabolic processes in cartilage, reduces pain and inflammation, stops cell destruction, and improves joint mobility. You need to take Piaskledin 300 for at least six months. The product is a little expensive, but its effectiveness is high. The chondroprotector has virtually no side effects, so it has excellent ratings among both doctors and patients.

Piascledine

Laboratoires Expanscience, France

The contents of Piaskledin capsules are components from plant materials.
Oil extracts (unsaponifiable components) from avocados and soybeans have a regulating effect on metabolism in cartilage tissues. The drug has an anti-inflammatory effect. The substances of the drug have an analgesic effect. from 952

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Artra

American chondroprotector with the best combination of quality and cost. This remedy is very popular among Russians. Arthra tablets stimulate regeneration in articular cartilage. The active substances of the chondroprotector are chondroitin and glucosamine (in equal proportions), and also contains calcium. "Arthra" is very effective for osteoarthritis of the spine and knees. "Arthra" is a third generation chondroprotector. A pronounced positive effect when taking the drug is noticeable after three months: pain and inflammation in the joints go away, swelling subsides, cartilage tissue is restored. A huge plus is that with the initial stage of joint disease, a complete cure can be achieved. Among the disadvantages of the drug "Arthra" are several side effects. Some patients report, for example, abdominal pain.

Artra

Unipharm Inc., USA

Artra is a combined chondroprotective drug for basic therapy of osteoarthritis of peripheral joints and spine with an enhanced therapeutic effect due to the interaction of two components - chondroitin and glucosamine.
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Differences in molecular weight

All liquid synovial fluid prostheses are divided into three groups based on molecular weight. Those in which it is as high as possible are considered more effective, since each of them has multiple intermolecular cross-links. Due to them, the medicine dissolves for a long time and during this entire time provides an analgesic, anti-inflammatory and wound-healing effect.

Lack of active movement in old age quickly worsens the symptoms of arthrosis. A simple experiment will show why this happens:

It is most promising today to treat arthrosis, regardless of its degree, with synthetic viscoprostheses. Due to their high molecular weight, such products, for example Noltrex, provide a long-lasting effect, and due to the polymer structure they have virtually no contraindications or side effects.

Diaflex

This Romanian-made chondroprotector is prescribed for the treatment of osteoarthritis. The active substance of Diaflex is diacerein. The chondroprotector slows down the destruction of cartilage, relieves inflammation and pain in the joint. The first positive effect after taking the drug is noticeable after 2-4 weeks. Diaflex can be purchased at a pharmacy with a prescription and is available in capsule form.

Diaflex

Rompharm Company SRL, Romania

The drug Diaflex is a non-steroidal anti-inflammatory drug (NSAID).
Diacerein is an anthraquinoline derivative, a diacetylated derivative of rhein. Metabolized to an active metabolite, rhein, it inhibits the activity of interleukin-1, which plays an important role in the development of inflammation and cartilage degradation in osteoarthritis. Inhibits the action of other cytokines (including interleukin-6, tumor necrosis factor-alpha). The action develops after 2-4 weeks. Diacerein has analgesic anti-inflammatory activity when taken orally. from 858

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Principles of proper nutrition for joint diseases

A diet for joint diseases should be healthy, balanced and tasty. The menu must be developed taking into account the disease that has affected the cartilage. For example, autoimmune diseases require a hypoallergenic diet. If you are overweight, you need to focus on losing weight.

When choosing a diet for joint pain, doctors recommend adhering to the following principles:

1. The diet should provide the patient with the right amount of energy and nutrients. The recommended proportion is 25 kcal per 1 kg of weight. If a person needs increased energy expenditure (after surgery, injury), the number of calories is increased by 1.5–2 times.
2. The most optimal diet for the body is a diet where 14% are proteins, 30% are fats, and 56% are healthy carbohydrates.
3. Fats and carbohydrates cannot be ignored, but they must be consumed correctly.
4. It is necessary to include vitamins, minerals, and dietary fiber in the diet. In case of illness, due to which the body loses many useful substances, it is necessary to compensate for this loss. For example, if calcium disappears quickly, you need to eat cottage cheese and yogurt.
5. When drawing up a diet, it is necessary to take into account the metabolic rate and the body’s ability to absorb food.

For successful digestion of food, establish the correct diet for your joints. Doctors recommend eating small meals five times a day. Too long breaks between meals overload the gastrointestinal tract, since you need to digest a lot of foods consumed at one time. In addition, a hungry person becomes nervous, which has a bad effect on the functioning of the nervous system.