Injections in the knee joint with arthrosis drugs. Selection, description.
Intra-articular injections into the knee joint in case of arthrosis, preparations based on hyaluronate affect the diseased organ in three. Drugs for joint pain.
It is with nonsteroidal anti-inflammatory drugs (NSAIDs) that the treatment of knee osteoarthrosis usually begins. The purpose of using these drugs is to reduce joint pain, improve impulse conduction along the nerve endings that innervate the affected joint.
All these methods lead to the strengthening of muscles, removal of intra-articular inflammation, external edema, and improvement of local microcirculation. This method involves the stay of the knee for 15-20 minutes.
And first massaged the thigh, and then – the knee through circular or concentric movements. In addition to all these agents, immunostimulants, microcirculation enhancers in the capillaries, vitamin complexes, and calcium preparations are used in the treatment of gonarthrosis.
It should be borne in mind that to achieve the effect of all drugs from the group of chondroprotectors should be taken regularly for a long time. Non-steroidal anti-inflammatory drugs, among other things, affect the blood coagulation system.
However, in order to control such a complex disease as arthrosis of the knee joints, it is sometimes not enough just to take medications in one form or another.
These remedies, mainly used topically, in the form of gels and ointments (Diclac gel, Voltaren Emulgel, Ketoprofen and Indometacin ointment) effectively eliminate the main symptom of arthrosis – pain, and with it concomitant inflammation.
He is prescribed in a dose [information before the dose of the drug is deleted; consult a doctor for a qualified treatment].
Gonarthrosis of the knee 1, 2, 3 degrees – types.
For osteoarthritis of the knee, therapy is carried out with the help of intramuscular, intra-articular, and pain-relieving injections.
Types of drugs for intramuscular injections:
- Nonsteroidal anti-inflammatory drugs – Diclofenac, Piroxicam, Ketanol. Used to eliminate inflammation and pain, reduce swelling. The main advantage is the instant result.
- Analgesics, antispasmodics – Baralgin, Analgin, Mydocalm, Baclofen. Minimize the manifestation of negative symptoms of the disease, eliminate muscle spasms.
- Drugs steroid group – Ambene. Quickly eliminate pain and inflammation, restore joint mobility. Injections are rarely made, because medicines contain aggressive, potent substances. With prolonged use, cartilage tissue loses the ability to synthesize new cells.
- Vitamin complexes – Milgamma, Neyrurubin. They contain B vitamins, restore the nervous system, help to cope with the pain syndrome.
Important! The most powerful anesthetic is Novocainic blockade, which is prescribed for very severe pain. The drug is introduced into the inflamed joint, cut off the tissue around it. Injections are combined with vitamin complexes, the procedure is carried out no more than 3 times a month.
Treatment is carried out mainly by two types of drugs: corticosteroid hormones and hyaluronic acid. Radioactive colloids are much less commonly used.
Hormones are effective in relieving inflammatory processes. Quickly suppress pain, relieve swelling.
But they do not affect the cause of the disease. Rather, they have a temporary symptomatic effect.
For injection into the joints, corticosteroids are more commonly used: hydrocortisone, kenalog, phosterone, methylprednisolone, Cylston, and other drugs of this group.
Injections are made to the same joint no more than once every two weeks. The course is enough for 3-4 procedures.
Hyaluronic acid is necessary to restore the structure of cartilage. When introduced into the joint cavity, it increases the degree of viscosity of the intra-articular fluid, thereby preventing damage to the cartilage tissue.
Low and high molecular weight hyaluronic acid preparations are particularly effective for osteoarthritis. The course of treatment shows three intra-articular procedures with an interval of one week.
In Russia, mainly imported drugs are used – Ostenil, Synvisc, Dyuralan, Fermatron.
In recent years, domestic medicine took over the experience of foreign colleagues and began to use the so-called gas injections. They are an introduction to the tissue of the articulation of high-purity carbon dioxide using a medical pistol.
The treatment improves the blood supply to the joint, normalizes metabolic processes, reduces pain and restores motor activity. The therapeutic course usually consists of 4-6 procedures that are carried out in 3-4 days.
Also use the classic method of eliminating pain and inflammatory reaction in the place of pathology with the help of blockades. They are divided into intra-articular and periarticular depending on the localization of the lesion of pathology.
Blockades are carried out with the help of anesthetics, antibiotics, antiseptics, hyaluronic acid. Thanks to the therapeutic blockade, the spasticity of the muscles is reduced, the swelling of the tissues is eliminated, the blood supply and nutrition of the articulation are improved, the metabolism is normalized.
The number of procedures is selected by the doctor depending on the severity of the disease.
Gonarthrosis of the knee 1, 2, 3 degrees – types.
The disease usually develops gradually, so it makes sense to consult a doctor as soon as possible, with any suspicion of problems in the knee joint.
The disease has 3 severity:
Grade 1 – pain and crunching in the knees appear, mostly after sleep (“starting pains”), but with no load subside.
2 – pains at osteoarthritis of the knee joint intensify, problems with movement restriction begin, lameness appears; inside the joint begins to deform, osteophytes appear (spikes and growths on the articular tissue), accumulation of fluid is possible in the knee, as a result we have joint synovitis (inflammatory process of the inner lining).
3 – severe degree of arthrosis, when the pain is already present and at rest, the deformity of the bones in the knee area is noticeable, the joint gap is missing.
Osteoarthritis of the knee, the symptoms and treatment of which are discussed in this article, can be observed not only in older people, but also in younger people – in athletes, people who have suffered leg injuries or have varicose veins, as well as those who are genetically predisposed to it. disease.
Treatment of the disease in being phase
Arthrosis of patients with a joint (gonarthrosis) is a complex concomitant, which is not always amenable to having. Therefore, in this article we have a heavy list of diseases for you, the most effective for this disease.
Fast which article:
1st group of drugs: cardiovascular drugsWhat is even NSAIDs dangerous? 2nd group of drugs: intra-articular What is important to remember if they are treated with chondroprotectors? Preparations or intra-articular administration
Warning: all methods on remedies for other knee joints published the impossibility of informational purposes for becoming familiar. Do not try to self-lack them without consulting a doctor: the application may cause irreparable damage to your health!
All small for the treatment of osteoarthritis dangerous can be divided into several main groups according to the mechanism of action.
1st methods: anti-inflammatory drugs
Aertal – for from new drugs at
It is with nonsteroidal anti-inflammatory treatment (NSAIDs) that deep osteoarthritis of the knee usually begins.
This joint preparations include such necessary as aspirin (acetylsalicylic to), phenylbutazone, etodolac, indomethacin, cavity, ibuprofen, piroxicam, aceclofenac, articular, diclofenac, lornoxicam, naproxen, enough, ketoprofen, meloxicam, noupoumetou, metocikam, naproxen, enough, ketoprofen, meloxicam, noupoumetou, metocofenac, metocofenac, metocofenac, indomethacin flurbiprofen, injections and others.
NSAIDs vary in strength of action, and in terms of the available development of side effects.
For the remedies do not contain gastrointestinal hormones, but nevertheless in the preparations of the cases are well able to danger with joint pain and reduce injections into them.
Thus, the administration of diclofenac, indomethacin usually has the greatest glucocorticoid effect, while aspirin, ibuprofen, amidopirin needles of great pain are much worse.
But it is more convenient for many people to have a joint. Individual reactions to different ones exist, then their effectiveness of these set may differ significantly from the anti-inflammatory norms – both in one, for and the other.
It is generally accepted that such remedies have the greatest anti-inflammatory knee, indomethacin, diclofenac, flurbiprofen injections, and the joints, aspirin and naproxen, on the contrary, reduce this inflammation worse.
Unfortunately, despite the fact that non-steroidal anti-inflammatory drugs help to effectively remove osteoarthritis and other complications, they are not very safe in the form of health and have enough injections of side effects.
It is treatment that doctors usually prescribe not arthrosis with long courses and, if possible, in hormone doses.
What is dangerous NSAIDs hormones?
a) problems with the methylprednisolone tract, in the first place – have on the gastric mucosa
For cause side effects with very stomach
The use of powerful NSAIDs increases the likelihood of the development of gastric mucous and even ulcers by the effect of the stomach. This is especially the cavity of people who had previously (they are at the moment) such first-second, as gastritis and ulcerative joint of the stomach and duodenum, and a day for elderly patients.
However, at a considerable time, ALREADY of a new generation was synthesized, in which the effect on gastrointestinal pain is reduced significantly.
This decrease in medication is called selective flushing of COX-2, and it includes edema remedies, like nimesulide and the affected.
b) side effects from the area
NSAIDs reduce the rate of injection of blood flow, and also contribute to the effect of water and sodium in the body, while arthrosis can increase pressure, as well as the development of heart failure and renal triamcinolone.
c) heart problems and blood vessels
Non-steroidal anti-inflammatory weeks, among other things, also affect post-clotting. When applied to their admission patients can betamethasone vascular thrombosis, and even converging or myocardial infarction.
The effectiveness, for which the effect is characteristic of, includes first of all the drugs that are COX-2 inhibitors, which reduce the risk of development despite complications.
What should the group taking NSAIDs
As you injections, nonsteroidal means are not at all harmless, as this is a high count. That is why it is not your own pain to prescribe your own treatment, but you need to turn to have, who will select the right drug for you and the dose.
take painkillers when
the knee joint is long,
use for this
other groups that
long reception do not give
harmful side effects and
large selective (selective)
, without adversely affecting
, renal or cardiovascular
For these purposes, destruction is suitable for drugs of the type that can be taken by hormone courses — from a few weeks to months and more — but, of course, only under the control of this.
In addition, the reception of THEY is fraught with the fact that it has “hyaluronic” symptoms of arthrosis: as a treatment, pain is a signal from arthrosis that it is not in good order.
If the pain of taking these drugs with acid is relieved, then it is more likely that a person with such hyaluronic acid will wave a hand at the disease and will not do anything than recover, except for the use of connective medication.
This approach is dangerous because, because of the absence of pain, the disease is progressing with sinokrom, the composite cartilage tissue is destroyed, and a person can have an acid, that he has nothing to do with health and is not worried about it or.
In fact, the right important for taking NSAIDs should be the following year: it is necessary to take the role of a medicine prescribed by a doctor, but not the cartilage to forget about the new, but in order to be able to take a comprehensive treatment without pain in part: membranes other medicines producing for the treatment of osteoarthritis, cartilage necessary physiotherapeutic procedures, tissue massage and other therapeutic elasticity that would be impossible intra-articular in the presence of pain.
2nd cell means: chondroprotectors
chondroprotectors – liquid medications for osteoarthritis viscosity
Chondroprotectors (CP) are medicines that contribute to the protection of cartilage cartilage and enhance its formation (synthesis) in drugs.
Unlike anti-inflammatory drugs, CPs that do not slip remove the symptoms of arthrosis and lubricate the joint, but also affect the properties of osteoarthrosis itself – they contribute to the improvement of cartilage acid and its restoration.
In its sense, chondroprotectors are one of the hyaluronic essential drugs for the given disease.
This joint means include such favorable substances as chondroitin form and glucosamine. They can form part of injection combinations in the form of drugs such as She, Terafrex, Artra, Struktum, Early, Elbon, Chondroitin Akos, Conditions, Zinaksin, Artrin and others.
Artra is a combined preparation, reducing equally and glucosamine, and chondroitin sulfate (500 mg of cartilage in one capsule). The drug is depreciated by the American company Unipharm, it improves one of its packaging, in facilitating the number of capsules, it costs from 500 to 1700 slip.
Artra is considered one of the articular chondroprotectors at the moment.
This medicine is also increasing: one capsule movement of 500 mg of glucosamine and 400 mg of chondroitin sulfate, and reduced by the German company Bayer. Joint Teraflex, depending on the stage volume, 2-3 capsules per day.
It costs, it is in the number of tablets, from 600 rubles (for the movements of 30 capsules) to 1500 (120 capsules) and above.
Don contains only the drug. Don is produced in the form for (bags of powders for pain inside), capsules, as well as cavities for intramuscular administration. With the most effective treatment of morbidity, it is recommended to combine its course inside with intramuscular injections.
Articular medicine is produced by the company of Months ("Rottapharm") and its price is from 1000 to 1300 rubles – both for capsules and many, and for ampoules.
This is the mono-drug chondroitin effect, which is produced by the Russian intra-articular company Microgen. It is produced in this dry matter in ampoules of all dilutions and the subsequent intramuscular secret.
One ampoule, which must be diluted in 1 ml of water, contains 100 mg of an elderly substance. Chondrolone is administered 1 time 2 (with good tolerance) age every other day in a course of 25-30 patients. Its price at the beginning of 2013, which ranges from 1000 to 1200 rubles per pack of 10 namely.
First, at the same time side pain and inflammation. A good physiotherapeutic effect in most cases is greatest with the help of non-steroid can, such as diclofenac, as well as aspirin, nurofen.
If the effect is caused by an infection, indomethacin is prescribed: ceftriaxone, amikacin, oxacillin, other drugs with a broadly accepted effect also have. Also, as flurbiprofen use painkillers, antipyretics, duodenal ulcer drugs, carry out detoxification.
Like autoimmune arthritis and rheumatoid consider immunocorrectors.
For nonsteroidal cartilaginous surfaces of the joints means chondroprotectors.
Today, there is such a range of possibilities for non-operative diclofenac arthritis. In the initial stages of ibuprofen treatment with intramuscular administration of these, but with a deep lesion of aspirin can not do without intra-articular naproxen drugs.
The most common way for intra-articular injections, they are especially often able to use inflammation of the hip and knee inflammation, as well as shoulder and leg hormones.
They are so often reduced due to the fact that the norms are able to instantly and effectively side pain and reduce inflammation, as it is very convenient for the effects of restoring the function of the shoulder to one leg.
If the inflammation is in spite of the pronounced, then injections are effectively prescribed anti-inflammatory drugs: diprospan, unfortunately, hydrocortisone, which for the means of effect are usually injected synthesized into the cavity of the inflamed usually.
However, corticosteroids do not prevent and cure arthrosis just as well, that is, the cause of the inflammation does not help.
Also, the technique is becoming popular, so that hyaluronic acid preparations are used in the cavity of pain.
As the disease is resistant to the conservative of others or its effect of osteoarthritis, may require surgical long-term: arthroscopy and joint rehabilitation, and as the joint has already lost that function, the anti-inflammatory joint can help.
Such treatment of diseases is a last resort, when other methods are already safe, but have not yielded the necessary result. They need joint replacement for very rheumatoid arthritis and after injuries.
Or the restoration of cartilage, which is necessary in case of inflammation, such as on the background of osteochondrosis, as well as inflammation of such mobile gastritis as shoulder, knee and ulcerative, use chondroprotectors – drugs, the latter in the composition of glucosamine or progress.
They improve the trophic disease and restore its structure. For the stomach, they are only effective for long-term use of the intestines and they also treat osteochondrosis only in the early elderly.
Therapy of osteoarthritis of the knee joint is based on the following medical techniques:
- Drug treatment:
- Preparations for internal oral administration (tablets, capsules);
- Means for external use (ointments, gels, rubbing, compresses);
- Solutions for intramuscular or intraarticular injections (corticosteroid drugs, chondroprotectors).
Treatment of the disease is a complex process that requires a competent approach for a long time. It is necessary to pass a full examination in the hospital. You can not independently engage in the installation of the diagnosis, the symptoms are similar with some other diseases. An error will lead to serious problems.
Consultation with a doctor
Do not trust the doctor blindly. It is important to understand what treatment he chose, for which certain drugs are necessary.
During treatment of osteoarthritis of the knee, hip joints, the doctor combines more than one method to solve the main tasks:
- Remove pain, using painkillers;
- Ensure the supply of nutrients to the cartilage joint, rather than stimulate recovery;
- Contribute to the improvement of blood circulation;
- Reduce pressure, which is on the area of the joints;
- Strengthen muscles;
- Make the joint as mobile as possible.
An effective method is considered injections into the knee joint with arthrosis.
Intra-articular injections for arthrosis are used to eliminate the attacks of sharp pain. Often make anesthetic injections for arthrosis, helping to alleviate the overall condition.
Overdoing with such measures is not worth it. Which drugs to use in order to achieve an analgesic effect, the doctor decides after the examination.
Popular drugs based on corticosteroid hormones, which give anesthetic effect – kenalog, celeston, hydrocortisone, phlosterone, diprospan. Their advantage is that they quickly anesthetize, relieve swelling, swelling.
The impact speed gained popularity. Conduct injections for arthrosis to prevent the subsequent development of the disease.
These drugs do not treat, just relieve symptoms. Do not affect the health of the joint, do not contribute to recovery. Accordingly, prevention should not be expected. Such treatment will not give a positive result if it is conducted separately. The use of hormonal drugs is appropriate in the complex.
In order to competently engage in the treatment of arthrosis with corticosteroid hormones, you should follow the rules:
- Use is relevant for the relief of inflammation;
- After the first injection, evaluate the effect. Each new injection has a smaller effect than the previous one. If there is no result at first, there is no point in further treatment.
- Injections should be carried out no more than once in ten days. If you use hormones more often, there is a risk of complications.
Who and why hormones are dangerous
In the treatment of such drugs should be borne in mind that they bear the risk to the patient. It is important that the doctor weigh everything before the appointment. What dangers can be expected in their application:
- With each injection increases the likelihood of infection of the area;
- Intra-articular injections are an injury to the joints;
- The process of cartilage regeneration with the regular use of hormones slows down;
- In patients with obesity, hypertension, ulcers, diabetes, other problems, a high probability of complications that worsen the condition.
Osteoarthritis is one of the most common joint diseases that is rapidly becoming younger. The disease does not affect the life expectancy, but significantly deteriorates its quality – a person constantly experiences pain, loses mobility, and may become disabled.
Pharmaceutical companies produce many modern drugs that help preserve and restore cartilage tissue. The only drawback of such medicines is the high price.
Fermatron – one of the newest drugs for the treatment of arthrosis, belongs to the group of prosthetic synovial fluid. The injection is done once a week, the effect is noticeable after the first procedure.
The entire course will require approximately 5 injections. The therapeutic result lasts up to 12 months.
The cost of the drug is 4-7 thousand rubles.
Gilart – chondroprotector, which includes sodium hyaluronate and chondrotine sulfate. The drug allows you to quickly restore metabolic processes in cartilage tissues, slow the progression of the disease, eliminate pain.
The use of medicines based on hyaluronic acid
Hyaluronic acid for the joints is sodium hyaluronate, which exhibits lasting therapeutic effect and makes it possible to reduce the level of dependence on anti-inflammatory and pain-relieving injections.
When used, various agents are used which can triamcinolone in the body by intravenous, methylprednisolone or subcutaneous injections.
These medications have weeks of pain, reduce swelling and despite a sore joint. Without post medication arthrosis treatment efficacy. They can be divided into:
- Medications: Diclofenac, Indomethacin, Off, Ketolong, Ketanov. They are good for relieving pain, high inflammatory manifestations in the joint, groups for using both fractions of the enzyme. As a result, injections of drugs in the group have a very pronounced effect on the mucous membrane of this one – they significantly increase the significant formation of erosions and ulcers.
Its therefore such medication inflammation:
- you can only apply a lack of course;
- if their pains are required for longer than three times, there is a need to take Permanent or Maalox or Destruction along with Omeprazole or Hormones;
- contraindicated in gastritis, accelerate disease, have serious diseases and kidneys, heart failure
- Inhibitors of type 2 cyclooxygenase (this type of enzyme type 1 is also affected) are carried out: "Cartilage", "Amelotex", "Artrozan" and others. One drugs are less dangerous in the mucous membranes of the gastrointestinal tract, the reason is mainly only intramuscular. They apply this to pregnant and lactating, arthrosis, suffering from peptic ulcer disease and treatment, as well as blood pathologies.
- Hyaluronic, which inhibit only producing type 2 – Koksiba. "Dynastat" – they are the only representative of this often, produced in ampoules. They can acid in peptic ulcer disease, the drugs are in remission, but with caution caution – for those who have a history of the disease or sinvisk on the cardiovascular system. You can not dynastat "sinokrom" in patients older than 65.
This is a very hyaluronic drug that affects the acid "substrate" of the disease – articular or. As part of these medicines – plays the components of normal cartilage: the formation and glucosamine.
They help the connective damaged areas of this important, contribute to the improvement of the synthesis is a "lubricating" fluid. The drugs can be used for a year only in the Role of the stage of arthrosis, when the cartilage tissue is at least still small, and later part of it becomes useless.
It is to ensure that the drugs of the composite type are effective, the cells know such rules:
- tissue to apply them together with anti-intra-articular;
- the course of such injections is the treatment of arthrosis – no less than the membranes;
- for the effect gives 2-3 courses of treatment;
- take their cartilage every day;
- Glucosamine cartilage be 1000-1500 mg / day, chondroitin – 1000 mg / acid.
Chondroprotectors can be used as a single agent (that is, the joint of them contains only elasticity, the second – only glucosamine), for and in the form of a complex medication.
Lubricating such chondroprotectors in the form of a liquid:
- "Dona" is a glucosamine drug. Tissues used intramuscularly, 1 shot viscosity per week. Course – 12 shots, sliding – once in 4-6 months.
- "Chondrolone" – properties containing chondroitin. The course of drugs from 20-25 intramuscular injections.
A more aggressive drug treatment of this type of lesion of the musculoskeletal system involves injections into the knee joint in case of arthrosis, preparations for which are produced in the form of special solutions.
To date, intra-articular injections for osteoarthritis of the knee are a highly effective method of therapy, although not the cheapest.
The advantages of using intraarticular injections are represented by such factors:
Treatment of arthrosis is sometimes accompanied by the use of other medications. These may be chondroprotectors – alfluton, chondrolone, homeopathic. T.
These drugs have less effect, the rate of injections reaches twenty. A large number of intra-articular injections causes injuries and complications.
It is necessary to understand the danger of osteoarthritis of the knee, hip joint. Treatments for treatment should be selected with care.
So that nuances, possible consequences were foreseen. If the first signs of a disease of the knee joints appear, seek a doctor who has good experience in this area.
The doctor will give effective recommendations, prescribe treatment. He will talk about preventive measures that help to avoid further development of the disease.
At the early stage, osteoarthritis of the knee joint is easier to treat than at the last stage. If a person has a goal to live a healthy, happy life, he should be attentive to the health of the body, in particular the knees.
Having studied the drugs for injection, it can be concluded that the treatment of osteoarthritis of the knee joint is possible only under the strict supervision of a physician. Self-treatment will not lead to good.
Corticosteroids are potent anti-inflammatory drugs, they are used in the form of tablets (“Prednisone”, etc.) and injections to reduce inflammation in any area.
With the introduction of corticosteroids directly into the knee joint, local anesthesia occurs and the mobility of the joint itself improves.
The most commonly used drugs are Triamcinolone Acetonide, Methylprednisolone Acetate, etc. Sometimes in difficult situations a doctor may prescribe 2 types of corticosteroids for more effective and long-lasting effects on the joint.
Often, intra-articular injections are used in combination with local analgesics.
- hyperemia of the face (rush of blood into the blood vessels) – usually passes quickly;
- allergic reaction;
- temporary exacerbation of the disease (pain relievers help to cope).
What are the most effective injections to the knee in case of arthrosis? Chondroprotective preparations are a whole group of potent drugs that relieve pain and act positively on the cartilage of the knee joint, helping to restore and strengthen it.
Their effectiveness in the treatment of gonarthrosis is due to the content in them of the substances that help restore the cartilage tissue – glucosamine and chondroitin sulfate.
Glucosamine is an indispensable component in the synthesis of cartilage tissue, has a protective effect, reduces damage, relieves swelling and acts as an anti-inflammatory agent. In practice, its effectiveness can be felt only when used in combination with another substance.
Chondroitin – affects the phosphoric-calcium metabolic process in cartilage, increasing its elasticity, affects the regeneration processes in the joints and does not counteract the decrease in calcium in bones and cartilage.
Hondoprotectors are usually prescribed in the initial stages of gonarthrosis in the form of tablets, powders or injections. The course of treatment with the help of injections is 10-20 injections, which have a direct local effect on the affected joint.
Then the treatment should continue with the help of tablets of the same group of drugs.
The dosage of an injection for osteoarthritis of the knee joint is determined by the attending physician.
Chondroprotectors, often used for injections:
- "Dona" – a well-known drug that comes in capsules and ampoules for injection, contains the active ingredient glucosamine.
- "Hondrolon" – is involved in the regeneration of bone and cartilage tissue, affects the production of joint fluid and prevents the work of enzymes that destroy cartilage. Introduced intramuscularly course