Post-traumatic arthritis: treatment of knee, ankle and other
Post-traumatic arthritis: how to maintain the joints after injury?
Post-traumatic arthritis is a joint disease that is caused by mechanical damage of tissue around the cartilage, ligaments, meniscus, tendons and capsules. Usually affects the joints in knees and ankle area.
Trauma joints lose their functionality pretty quickly. When you receive a small damage disorders develop slowly.
Therefore, it is necessary to consult a doctor immediately after injuries, dislocations and sprains. Then the treatment will be more effective.
The causes and mechanism of development of the disease
Post-traumatic arthritis may develop on the background:
- joint injuries with concomitant rupture of the tissue in which the inflammation begins;
- sprains (usually in the ankle region or knee);
- the inflammatory process in the body (tonsillitis, flu);
- the metabolic disorders;
- a failure in the endocrine system.
The main reason of development of disease is the violation of the integrity of the surfaces of the joints, poor blood flow to specific structures and prolonged immobilization. This state occurs after fractures with displacement elements.
So post-traumatic arthritis of the knee can be caused by a fracture of the condyles of the femur and the tibia. Arthritis of the elbow is often caused by damage to the base of the radius.
Another common cause of arthritis is a ligament rupture. For example, post-traumatic arthritis of the ankle joint is caused by rupture of the tibiofibular syndesmosis, and the defeat of the knee joint with damage to the cruciate ligaments.
Doctors say that in the anamnesis of patients suffering post-traumatic arthritis, the combination of the described damage. For example, a fracture of the ankle combined with the tibiofibular syndesmosis.
The risk of developing the disease increases several times with the untimely measures taken. As a result, the joints are defects that have not been adjusted.
For example, if you offset them in the ankle region of 1 mm, the weight starts to be unevenly distributed and affects only one third of the area of the cartilage. This causes overload and quick degeneration of cartilage.
Load, continuing for a long period of time, causing post-traumatic arthritis, both indoors and exterior damage. Long-term restriction of movement prevents proper blood flow. Muscles begin to shorten and lose elasticity. Often, the process becomes irreversible.
It happens that when injury disrupted the integrity of the blood vessels that causes bleeding. If the situation is more complicated, it is expressed in the restriction of mobility of joints and sharp pains.
One of the varieties of post-traumatic arthritis — a disease caused by the surgical intervention. Despite the fact that surgical treatment, according to doctors, has greater efficiency, it also causes additional trauma.
In the places where there was damaged tissue, scars appear, in violation of proper circulation. In addition, the operation often remove elements of the joint, subjected to strong deformation. This is the cause of the violation of congruency of bone surfaces.
Provocateur violations can become closed fractures, causing hemorrhage into the joint cavity, and also injuries with cracks and tear of the cartilage.
Arthritis can provoke banal and dislocation, which causes rupture of the joint capsule and ligaments.
Often this disease affects people who are passionate about extreme sports. They can damage the elbows, knees and shoulders.
Initial symptoms and further symptoms
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In their symptoms of post-traumatic arthritis is similar to other types of arthritis.
The disease is characterized by:
- swelling in the areas of connection of the vessels;
- sense aches at the site of injury;
- stiffness and restriction of movements;
- crunch and other unpleasant symptoms.
In the initial stages associated with small pains and the appearance of crunch, which intensified during the motion. At rest there is no pain.
Striking feature is the intermittent starting and damped the pain in moments of movement after standstill. Then the pain becomes systemic. She is concerned not only with movement and weight bearing but also at rest. Joints can ache when weather changes and at night. The amount of movement is severely limited.
As a rule, there is alternation of the acute form of the disease with remission. In the acute stage there is swelling. Persistent pain provoked muscle spasm on the reflex level. Sometimes there are contractures of the muscles. Peace does not bring the patient relief.
Plagued by pain and cramps. The joint loses its original contours. The man begins to limp. Late stage coarse inherent curvature of the joint, subluxation, and contractures.
When examined by the physician at the initial stage of the disease the changes are not noticeable. The volume of traffic depends on the nature of the injury and the quality of rehabilitation measures.
Later, there are deformation and restriction of movement. Palpation patients complain of pain. Also the doctor may notice thickening and irregularities of the edges of the joint space. It is possible and the curvature of the axis of the limb. When synovitis in the joint occurs fluctuation.
Treatment and rehabilitation
Treatment of disorders is carried out by orthopedists and traumatologists. Duration of therapeutic measures long.
Restoring lost functions is complex, the process depends on the degree of destruction of joint and cartilage, as well as its localization.
First and foremost, the doctors are trying to stop the effects of bleeding and to develop blood circulation. In the absence of lesions in the joints are being prescribed drug therapy. It involves the use of drugs, such as Aspirin, Indomethacin and Voltaren.
A sharp pain ease through corticosteroids (Diprospan and Hydrocortisone — preparations on a hormonal basis). To such as resorted to if non-steroidal remedies were powerless.
According to the testimony to build cartilage resorting to medication Artra, don, teraflex. They are the protectors of the cartilage and joint tissue.
From injectables, it should be noted drugs Synocrom, Naltrex, Ostenil. A high level of efficiency has and does.
In non-running form of the disease in addition to drugs recommended on:
- physiotherapy with ozocerite and paraffin;
- novocaine electrophoresis
- laser therapy;
- physical education;
- manual therapy.
When muscle spasms antispasmodic drugs recommended.
Complex physical therapy
Therapeutic exercise is extremely important, as without it, the joint may lose its mobility. The exercises recommended in the absence of fractures. To expose the joint load is recommended in stages.
Exercises should be performed slowly, with small amplitude movements that gradually built up. Development of the affected area allows the patient to quickly restore lost functions.
It is important that the exercises do not start without prior warming up of the muscles. This can be achieved with the help of special creams that relieve inflammation.
These include funds, which include chamomile, horsetail mugwort, burdock, hydrolyzed collagen, and glucosamine. These substances contribute to the increased permeability of the cream through the skin and pain relief.
Conservative methods of treatment do not possess the necessary efficacy if treatment is started late. Therefore, if the result of these measures is not, then resort to surgery.
Podiatrists have extensive experience treating such injuries. Often doctors suggest hip replacement, which solves the problem of lameness and torturing pain.
During surgery, surgeons can resort to osteotomy, osteosynthesis with the use of different structures of metal (nails, screws, pins, plates).
Also produced of plastic surgery with the use of patient’s own tissues or artificial substitutes.
If the introduction of an endoprosthesis for some reason contraindicated, is advised to resort to arthrodesis. The procedure is to fix the joint in a favorable terms of functionality position.
Any operation has been planned and is prescribed only when indicated on the basis of surveys. As a rule, resorted to the use of General anesthesia.
Also, there are intervention of open access with the use of arthroscopy. The basis of operation is the use of the arthroscope.
The tool is inserted through small incisions. Thus, are subject to removal of overgrowth of bone and tissue. This method features a high level of efficiency and faster recovery.
Wound after the operation, are subject to rapid healing. After about 2-3 days they are already delayed. The appearance of inflammation or other complications are excluded. The restoration of joint mobility occurs in a month.
After surgery was prescribed a course of antibiotics, physiotherapy, massage and physical therapy. After removing the stitches the patient continues outpatient treatment.
The effect of the surgery depends on the severity and duration of the injury, and the presence of secondary manifestations of the disease. It should be noted that in some cases, full recovery of lost functions is simply impossible.
To develop post-traumatic arthritis, even after the injury, not worthy of attention, it is imperative to consult a specialist.
The doctor will be able to choose the appropriate medication that causes rapid healing of damaged tissue, relieving the inflammatory process, regeneration of blood vessels subjected to damage.
If patient notes numbness, conduct Doppler ultrasound or electromyography.
Procedures will help to determine the condition of the blood vessels and nerves.
What’s the danger?
In severe cases, delayed treatment can occur synovitis or arthrosis deformans. The progression of the disease able to hit the joint capsule and cartilage.
In the case of severe injury may occur complications of the inflammatory process immediately after the defeat. Such development can cause leukemia, fever and fever. The last symptom is very indicative. Therefore, when the temperature increase to delay a trip to the doctor is impossible.
In the presence of leukocytosis should conduct a survey of the whole body.
Post-traumatic arthritis is a serious and unpleasant disease. The cause lies in the inability of the injured joint to withstand the same strength. Starting in the cartilage tissue, this disease destroys the entire joint.
The success of treatment depends entirely on the stage of the disease.