Causes, treatment and consequences of hemarthrosis of the knee joint
Hemarthrosis of the knee: symptoms and treatment
Hemarthrosis – a condition which is based on damage to the tissue due to hemorrhage into the joint cavity.
Most often, the pathology is diagnosed in the knee joint, as the knee has a complex structure and are most susceptible to injury.
In addition to a traumatic factor, a major role in the development of plays hemarthrosis hemophilia, low blood clotting.
In this disease hemorrhage occur very often. Gradually, the joint capsule is stretched, which leads to disruption of its functions. The knee swells, becomes painful and restless.
Hemarthrosis is quite common disease. Most often it is diagnosed at the age of 25-45 years old, however, in patients with hemophilia it may occur in 1-3 years. In the elderly the cause of the pathology becomes the weakness of the bones and muscles of the body.
Causes and risk factors
The main reason for the development of hemarthrosis of the knee joint are injured.
These can be fractures of the patella, fractures or sprains, knee injuries, meniscus damage, sprains, ruptures of the capsule, injury of blood vessels. Each of these injuries can cause bleeding into the joint cavity.
Another reason for the development of the disease – hemophilia. In this case, even the slightest impact on the knee leads to hemorrhages. Often blood clots are formed spontaneously.
Repeated ingress of blood into the joint cavity begins the process of destruction of cartilage, leading to arthritis and arthrosis.
The doctors there are such risk factors for the development of the disease:
- intensive physical load;
- occupation traumatic kind of sport;
- the presence of hemophilia;
- the propensity for various types of hemorrhages;
- belonging to traumatic occupations.
The presence of two or more risk factors increases the likelihood of the disease several times.
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When damage to small blood vessels blood leaks into the joint cavity.
Gradually, the joint capsule is stretched, which leads to immobilization and severe pain. In addition to pain, the doctors there are such symptoms of hemarthrosis:
- the increase in the knee in size (sometimes for hours);
- the appearance of bumps on the front of the knee;
- smoothed contours of the knee;
- redness of the skin with damaged capillaries, bruising – when you break the large vessel;
- weakness in the knee;
- a feeling of softness and fluctuation on palpation of the joint;
- increased local temperature.
In that case, if the cause of the disease is hemophilia, the symptoms for a long time can not be felt. The fact that the first stage of this pathology blood clots are allocated in small amounts, so are often not visible.
And then, when violated functions of ligaments and cartilage, pain, and the skin becomes purple or bluish in color.
The degree of development of pathology
There are several classifications of the disease.
According to the clinical manifestations hemarthrosis is divided into acute, chronic and recurrent, and the presence of complications on complicated and complicated.
However, in clinical practice the greatest distribution was received by the classification according to the degree of articular damage.
Allocate 3 degrees of hemarthrosis:
- I degree – is characterized by the absence of any changes in the structure of the joint;
- Grade II – occurs with soft tissue injuries, joint capsule, meniscus, semilunar upper ligaments, the anterior cruciate ligament, fat suspension;
- III degree – characterized by serious defects in the cartilage joints or bones. In this case, soft tissue damage may be absent.
Diagnosis of the disease includes compulsory use of MRI. This study gives insight on the damage of blood vessels and soft tissues. As additional procedures is assigned to the x-ray and ultrasound of the knee.
So, with the help of x-ray establish the presence of cracks or fracture.
Another mandatory method of diagnosis – puncture joint cavity. If fluid show blood is a serious sign of hemarthrosis, if find fat is a symptom of fracture.
Upon detection of small fragments is arthroscopy, in which the bone fragments are removed and the exact diagnosis.
The treatment of hemarthrosis of the knee joint is aimed at removal of blood, bone shards and other unnecessary components from the joint cavity.
For this prescribed puncture and lavage of the cavity, and then introduce drugs that eliminate the inflammation and reduce pain.
There are two ways a puncture.
The classic way
Into the joint cavity by inserting a needle and sucking blood. After the procedure the joint drug administered blood clotting, painkillers and anti-inflammatories.
Then the knee bandage, impose a pressure bandage, and the top – plaster mold for immobilization. The drawback of this method is that the extraction of blood in the joint cavity creates a negative pressure that helps to restore or strengthen bleeding.
In addition, to extract all the blood to the end, usually fails, resulting in damage to the ligaments and cartilage antibodies. Such a treatment is effective if the illness happened for the first time. Then patients recover without relapses.
The second method — advanced
The second method aimed at reducing the negative pressure in the joint cavity.
Its essence consists in the following. Squeeze the knee in an elastic bandage, insert the needle and sucked most of the blood. Then through the same needle injected irrigation solution. But choose the medicine has already been through another puncture. That is, during this procedure, the joint at the same time is two needles.
Due to the formation of a greater speed of flow of the solution than its outflow, a positive pressure is formed.
This method is good that allows you to remove all the blood, without provoking new bleeding.
When the aspirated fluid will be completely absent blood outflow needle pull, and using another syringe injected some more medication.
Then to the knee impose a pressure bandage and hold immobilization with a plaster splint.
If the disease happened in a patient with hemophilia, he definitely injected intravenous antihemophilic globulin and prescribed a transfusion of blood plasma. In advanced cases or the chronic form of the disease is surgery.
Traditional methods of treatment
To relieve pain in the joints and to prevent re-bleeding will help some recipes of traditional medicine:
- Take 1 spoon of marjoram, nettle and yarrow and steep this fee is 0,7 liters of boiling water. Allow to stand for 1 hour. Tincture to drink 50 g 3 times a day before meals.
- Mix half a spoon of ammonia, 100 g of honey, 2 tablespoons of bile medical. The resulting cream is applied to the knee without rubbing for 1 hour.
- Take the herb Arnica and boiling water and allow to swell. Then attach it to the knee and wrap with gauze. Compress keep 1 hour. Is Arnica you can use the pharmacy clay or wormwood. They have the same action: resolve the swelling and eliminate bruising.
Complications and consequences
Over time, red blood cells, which constantly accumulates in the joint cavity, disintegrate. The result is a pigment hemosiderin, which negatively affects the cartilage and the joint capsule.
First, they lose their elasticity, and then the destruction. This leads to immobilization of the knee and as a result of disability of the patient.
Another complication of hemarthrosis is the development of infectious diseases. The blood that remains in the joint cavity, is a very good environment for reproduction of microbes.
Therefore, in the absence of proper treatment arise over time infectious synovitis, bursitis, arthritis. They greatly complicate the treatment process.
Rehabilitation after medical or surgical treatment involves exercises to stretch the tendons and warm up the knee joint, the resumption of movement of the knee.
In addition, eliminated intense physical activity and sports, is set to sparing mode.
Important in the recovery process of the knee joint is proper nutrition.
For example, in chronic hemarthrosis, it is recommended to eat more spinach, young cabbage, green onions, celery. These foods increase blood clotting, strengthens the walls of blood vessels, improve blood circulation.
Despite the fact that hemarthrosis of the knee is a fairly common disease, its prognosis is usually favorable. This is especially true in those cases where the cause of bleeding was trauma.
Then the probability of a favorable outcome is very high.
At the same time, the recurrence or a disease caused by hemophilia can cause complications.
To prevent this, reduce physical activity, to set a soft diet and to follow their way of life. If you follow these recommendations, the risk of complications is much reduced.