Including patients' health education, self-training, weight loss, aerobic exercise, joint mobility training, muscle strength training, walker use, knee varus wedge insole, occupational therapy and joint protection, and auxiliary facilities for daily life. A considerable number of patients in Europe and America can alleviate symptoms and return to normal life and work through the above treatment. China's investment in this area and the concept of medical staff are still relatively weak, and medical staff at all levels should pay attention to strengthening this work in the future.
Patients with knee osteoarthritis often suffer from weakness of quadriceps femoris muscle strength, which used to be thought to be caused by disuse atrophy. However, recent studies abroad believe that quadriceps femoris muscle weakness is not entirely caused by osteoarthritis, but may be one of the risk factors of knee osteoarthritis. Because the muscle strength of quadriceps femoris is weakened, it affects the stability of knee joint and reduces the buffering ability of normal muscles. Therefore, strengthening muscle strength training and aerobic training of quadriceps femoris is beneficial to patients with osteoarthritis.
2. Drug treatment of osteoarthritis
(1) Sodium hyaluronate is the main component of synovial fluid in joint cavity and one of the components of cartilage matrix, which plays a lubricating role in joints and reduces the friction between tissues. After being injected into the joint cavity, it can obviously improve the inflammatory reaction of synovial fluid, enhance the viscosity and lubrication of synovial fluid, protect articular cartilage, promote the healing and regeneration of articular cartilage, relieve pain and increase the mobility of joint. Intra-articular injection, 1 time 25mg, 1 time for 5 weeks, must be strictly sterile.
(2) Glucosamine is the most important monosaccharide that constitutes glycosaminoglycan (GS) and proteoglycan in articular cartilage matrix. Normal people can synthesize GS by glucosamine, but the synthesis of GS in chondrocytes of patients with osteoarthritis is blocked or insufficient, which leads to the softening and loss of elasticity of cartilage matrix, the destruction of collagen fiber structure, the increase of cartilage surface cavities and the wear and tear of bones. Glucosamine can block the pathogenesis of osteoarthritis, promote chondrocytes to synthesize proteoglycan with normal structure, inhibit the production of enzymes (such as collagenase and phospholipase A2) that damage tissues and cartilage, reduce the damage of chondrocytes, improve joint mobility, relieve joint pain and delay the course of osteoarthritis. Oral 1 time 250 ~ 500 mg, 1 time three times a day, with meals.
(3) Non-steroidal analgesic and anti-inflammatory drugs: can inhibit the synthesis of cyclooxygenase and prostaglandin, resist inflammatory reaction, and relieve joint edema and pain. Ibuprofen/kloc-0, 200 ~ 400 mg each time,/kloc-0, three times a day; Or glucosamine 1 time 200mg, 1 time 3 times a day; Nimesulide 1 time 100mg, 1 time twice a day for 4 ~ 6 weeks.
3. Surgical treatment of osteoarthritis
If the symptoms of osteoarthritis are very serious, drug treatment is ineffective and affects the daily life of patients, surgical intervention should be considered.
1. For knee osteoarthritis, some people advocate arthroscopic joint dissection first. This kind of operation has a certain effect on some patients in the near future, but the long-term effect is not necessarily.
2. For most patients with osteoarthritis, femoral head necrosis and rheumatoid arthritis, joint replacement surgery has a significant effect in relieving pain and restoring joint function. However, due to some short-term and long-term complications of joint replacement surgery, such as loosening and wear of components and osteolysis, these complications can not be completely solved at present. Therefore, it is very important to strictly grasp the surgical indications of joint replacement. Strictly speaking, surgical indications include: ① radiological evidence of joint injury; ② Moderate or severe persistent pain or disability; (3) For all kinds of patients who are ineffective in non-surgical treatment.
Because the effect of artificial joint replacement is closely related to the length of operation, the doctor's experience, the patient's preoperative physical condition, perioperative management, rehabilitation training and so on. Therefore, a good joint surgeon should have all kinds of knowledge, be well-trained and skilled, and be competent for artificial joint replacement independently.
4. Recommended drugs for the effective treatment of osteoarthritis: Kanglisha.