Surgical and conservative treatment of synovitis of the knee joint

Effective treatment of chronic and reactive synovitis of the knee joint

Any joint of the human body covered with the synovial membrane, whose main function is preventing friction between the two adjacent joint surfaces. As a result of inflammation of this membrane considerably increases the amount of fluid in the articular capsule, the disease is termed synovitis.

It most often develops synovitis of the knee joint, this is due to the increased load on this part of the body.

The causes of the disease

Inflammation of the synovial membranes occurs under the influence of internal and external adverse factors, in most patients, the surgeons explained the effect:

  • Injuries.
  • Infection.
  • Autoimmune diseases.
  • Of metabolic disorders.
  • Allergies.

Synovitis of the knee could be a secondary manifestation of such diseases as arthritis.

The symptomatic manifestations of the disease

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There has been a gradual increase in symptoms. First, there is a swelling of the knee, then its slow increase in size. Deformity of the knee tells about the accumulation of fluid in the articular capsule. In the knee joint limited motion, down to his inability to fully bend. Increasing fluid pain, synovitis when it’s blunt, strong intensity, no.

Diagnostic feature of the disease is considered a puncture, that is, the introduction in the joint area of the syringe with the needle and the pumping of fluid. Synovitis when a secret is no of blood components, carried out laboratory analysis on the presence of microflora and various impurities.

Classification of the disease

To classify, synovitis because of appearance, the nature of the flow.

The cause of synovitis is subdivided:

  1. Infectious synovitis develops under the influence of pathogenic microflora. An infectious agent can penetrate into the joint capsule when the wounds from the external environment, from distant foci of infection from the blood or from nearby ulcers. Infectious inflammation cause streptococci, staphylococci, pneumococci, less frequently the tubercle Bacillus, Treponema pallidum (in syphilis), and other microorganisms.
  2. Aseptic synovitis – with this type of inflammation of pathogenic microorganisms in the exudate is not detected, the disease is reactive in nature and occurs under the influence of trauma due to irritation of the sheath torn meniscus or damaged cartilage, endocrine disorders, hemophilia.
  3. Allergic synovitis develops under the influence of a variety of allergens.
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Current patterns synovitis is divided into:

  1. Acute — develops within hours or days after the impact of a provoking factor. For this form characterized by all the symptoms of the disease, it is sometimes possible fixation of the febrile syndrome.
  2. Chronic synovitis appears after goes untreated acute. Characterized by recurrent accumulation of fluid, frequent exacerbations lead to degenerative changes of the joint and stretching the ligaments. Treatment of chronic synovitis of the knee joint most complex and protracted.
  3. There is a separate form of synovitis – reactive. There is a reactive synovitis due to existing problems with joint and most often it’s arthritis.

Comprehensive therapy for the disease

Treatment of synovitis of the knee joint should be comprehensive, with a moderate amount of effusion, the patient is treated on an outpatient basis. The definition of the whole scheme of treatment depends on the root cause of the disease, the degree of deformation of the joint and limitation in the movements, phases of the disease.

The main stages of treatment

  1. Comprehensive examination. The doctor should find out the root cause of the disease – injuries of adjacent ulcers.
  2. Puncture. Necessarily taking the synovial fluid for study, accurate identification of the pathogen will help to determine the purpose of drug therapy. Pumping liquid partially relieves pain and returns mobility to the joints. Puncture is almost painless, it does not require anesthesia.
  3. Immobilization. Ensuring immobility of the joint is an important step in the treatment of synovitis. For temporary immobilization choose a compression bandage, applying splints or a plaster Longuet. The period of immobility is usually a week or a little more.

Drug therapy

Drug therapy in synovitis is the most important guarantee of the absence of exacerbations in the future, the appointment and use of drugs of different groups prevent the destruction of the surfaces of the knee joint.

  • Non-steroidal anti-inflammatory drugs are prescribed to ease the inflammation. Under their influence decreases the amount of exudate, reduced pain. Usually assigned a preformed or injectable anti-inflammatory ointment. To NITV include Diclofenac, Ketoprofen, Nise, Diklak. In the treatment of synovitis of the knee joint use Voltaren ointment, Ketonal, Indomethacin, a widely used Collagen gel Ultra. NITV irritant acting on the mucous membranes of the digestive system, so patients with peptic ulcer disease they are recommended to use rectal candles that also have all the effects of other forms of drugs.
  • Inhibitors of proteolytic enzymes – drugs that prevent degenerative changes and to reduce the amount of exudate. Their use is necessary and in the chronic stage of the disease. These drugs include Gordoks, Trasilol, Contrycal. The drug is administered intravenously or used in the form of capsules.
  • Antibiotics are used when infectious or severe reactive synovitis. They are administered into the joint cavity, or used in the form of intramuscular injections. Prescribe Ceftriaxone, Metrogyl,
  • Corticosteroids are used in severe illness. The use of hormonal therapy effectively reduces inflammation, thereby decreasing pain. Use Dexamethasone, Kenalog — 40.
  • Regulators of the microcirculation is necessary for the normalization of metabolic processes and nutrition of tissue. Prescribed vitamin PP, ATP, Trental, Heparin.
  • Use of vitamin – mineral complexes. Their application allows to improve the microcirculation, increases the production of collagen.
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Physiotherapy

The use of physiotherapy procedures in synovitis allows to partially reduce pain, prevents further inflammation, has a positive effect on mobility. Uses currents of different frequencies, magnetic therapy, UHF, electrophoresis with the necessary medicinal substance. Physiotherapy is usually prescribed by the doctor about the 3rd day from the beginning of the development of the disease.

Treatment in the chronic form of the disease

In the treatment of chronic synovitis of the knee joint in the acute stage is also assigned to medical therapy and is performed arthrocentesis with the introduction into its cavity of the drug. In a lengthy and repetitive process, make a decision about the surgery

Surgical intervention is necessary in the absence of effect from the ongoing regimens. In the presence of the joint cavity from inclusions of the meniscus of the cartilage or bone surgery is carried out in the acute form of the disease.

In protracted chronic course surgery is necessary if there is evidence of irreversible pathological processes in the shell – sclerosis, the buildup of lint in the spongy substance.

Without surgery a prolonged duration can lead to complete relaxation of the muscular – ligamentous apparatus, in which the main function of the knee joint is lost.

Operation the methodology is simple — make an incision over the joint, a fall in the synovial cavity and assess its status. In the presence of alien elements, they are removed, also modified excised synovium. After surgery the limb immobilizers, movement without load is recommended to be initiated at the 3rd day after surgery. After surgery use few days hemostatic and antibacterial therapy.

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Folk remedies in fight against disease

Folk treatment of synovitis of the knee joint with the help of popular recipes should only be carried out in combination with the basic therapy, grandma’s recipes, benefit and chronic disease.

Well restores the disturbed metabolism and prevents further pathological processes following recipe:

  1. It is necessary to mix the dry raw material of thyme, eucalyptus, Echinacea, tansy, birch leaf, mistletoe. To prepare you will need one tablespoon of the herb mixture and a Cup of boiling water. Drink the resulting broth during the day, 1 before each meal.
  2. Therapeutic effect on the affected joint provides self-prepared ointment. The crushed root of comfrey mixed with an equal quantity of lard. With the mixture the affected joint is lubricated by up to 3 times a day, enhances the effect of the dressing on top.

When the knee joint synovitis is experiencing increased load, so the lighter will have a positive impact on General health.

Forecast

Patients with synovitis are often repeatedly ask the doctor about the relapse. In this case all treatment is carried out again. No secondary recurrence of the disease depends on the compliance of all proposed methods of treatment and preventive measures.

High efficiency of treatment is observed in allergic and aseptic synovitis. Purulent synovitis, the formation of contractures in the most severe cases, sepsis occurs.

Video: Gymnastic exercises for the knee