Injections in the knee joint with arthrosis: drugs. Choice, description, instructions

The great ancient Greek scholar and philosopher Aristotle said: "Movement is life." But, unfortunately, not all people can fully enjoy it. Every tenth person on the planet experiences pain after physical activity, crunching in joints and internal stiffness of movements, which significantly worsens the quality of life. So the first signs of arthrosis appear. In the article, it is considered, when it is necessary to do pricks in the knee joint with arthrosis, the preparations necessary for these procedures.

What is arthrosis and the causes

Osteoarthritis is a chronic disease that manifests itself in the gradual destruction of the intraarticular cartilage. As a rule, the disease manifests itself in elderly people as a result of the natural aging process of the body tissues, but recently in men and women over the age of forty, this disease is increasingly diagnosed.

This is due to the fact that physical activity of the population has significantly decreased: sedentary work, use of public transport and personal cars, unbalanced copious nutrition - as a consequence, overweight, which increases the burden on the joints. As a treatment, doctors offer injections in the knee joint. With arthrosis, drugs are injected mainly into the joint.

The causes of secondary arthrosis can be traumatic lesions (bruises, dislocations, fractures), too high loads for athletes and workers whose scope of activities is associated with heavy physical labor. In addition, other factors, such as autoimmune diseases, transferred infectious and inflammatory processes, genetic predisposition, endocrine system diseases, metabolic disorders processes, etc., can also create prerequisites for the development of the disease.

How the cartilage is destroyed

All joints in the human body have an almost identical structure - two or more articular surfaces lined with cartilaginous tissue, enclosed in a synovial bag containing synovial fluid. Hyaline cartilage has a smooth and elastic structure, which allows you to reduce friction during movement. The joint is powered by synovial fluid, as it does not have its own blood vessels.

It is this property that makes the cartilage vulnerable. Due to the failure of the exchange processes or too much articular load, hyaline cartilage can undergo degenerative changes, and in the absence or inadequate nutrient supply, its recovery and regeneration occurs extremely slowly. Thinning of the hyaline cartilage layer results in increased friction in the joint during movements, which leads to faster destruction of the cartilage and promotes the development of inflammatory processes. In humans, this process is manifested by the appearance of pain, stiffness, and limitation of mobility. At this stage, injections can come to the aid of the knee joint. Feedback from experts and patients on these procedures indicate their effectiveness.

At the final step of this pathological process, cartilage is destroyed, and coarse connective tissue grows instead. As a result of such changes, the joint is deformed and can no longer perform its functions. To prevent this, chondroprotectors are used. The price for them is small and allows them to be used widely enough.

Unfortunately, they act only at the initial stages of destruction of the cartilaginous tissue and may not produce the expected effect in the case of a running process. In addition, it is necessary to take such drugs for a long time, for three to six months, and in some individual cases, up to one and a half years, because the cartilage tissue regenerates extremely slowly. The duration of the course, the regimen of administration, what injections to the knee joint and in what dosages to produce - all this is determined and appointed by the doctor to each patient individually, based on the initial condition and observing the changes in the course of treatment.

Methods and methods of treatment

Treatment of arthrosis can be medicated and surgical. Operative treatment involves the replacement of a joint - endoprosthetics.

The main task of drug therapy for arthrosis is to stop further destruction of cartilage tissue and preserve the function of the joint.

In order for the treatment to yield good results, it should be aimed at the removal of inflammatory processes, pain and restoration of cartilaginous tissues. To do this, use:

• Anti-inflammatory non-steroid agents;
• Intra-articular medicinal injections;
• Local warming agents to improve blood flow in the affected area (in the form of ointments, gels and creams);
• Chondroprotectors.

Anti-inflammatory non-steroid agents

Drugs of this type relieve inflammation, puffiness, have antipyretic and analgesic effect.

According to the severity of the analgesic effect, the strongest are: "Ibuprofen", "Diclofenac sodium" ("Voltaren"). NSAIDs do not cause euphoria, drowsiness, addiction, drug dependence, but long-term use of them disastrously affects the mucous membrane of the stomach. Therefore, for the relief of acute pain, Diclofenac (injections) is prescribed. The price of five ampoules in the package is about two hundred rubles. Application: intramuscularly for two to five days, and then transferred to the tablet form of taking the drug (if necessary).

It is also possible to apply Ketonal - injections intramuscularly or intravenously, as well as injection forms of "Flamax", "Artrozilena". When administered intravenously, the intervals between procedures should be at least 8 hours.

Hormonal corticosteroids and chondroprotectors

The price becomes not so important, if pain overcomes, and ointments or creams are not effective any more. When arthrosis reaches the stage of exacerbation, it becomes advisable to take hormonal corticosteroids. These drugs contribute to the rapid and effective suppression of the inflammatory process, but with prolonged use lead to joint destruction and often cause side reactions.

Therefore, from the GCS doctors prescribe intra-articular drugs "Diprospan", "Kenalog", "Hydrocortisone" in the form of injections, which reduces the likelihood that undesirable consequences will occur, to a minimum.

Chondroprotectors are medicines and preparations that promote the formation of completely new structural elements of cartilage tissue. They regenerate it and prevent further destruction.

The chondroprotectors contain two key components: glucosamine and chondroitin sulfate. It is these substances that are required for the formation of synovial fluid, and the human body normally produces them.

Forms of release

At the moment, pharmaceutical companies produce drugs chondroitin and glucosamine in such forms:

• Solutions for injections;
• Creams, ointments, gels;
• Capsules, powders for oral administration, tablets.

There are three generations of chondroprotectors:

1. The first is of animal origin. Usually well tolerated, the effect comes quickly, but can lead to allergies. This type includes such drugs as "Rumalon" and "Alflutop".
2. The second is the synthetic preparations of chondroitin sulfate (Chondroxide, Structum, Chondrolon, Mukosat), glucosamine (Don, Elbon, Sustilac) and hyaluronic acid (Fermatron, Synvisc, "Hyaluron", "Gialgan")
3. The third - complex (combined) medicinal substances, which contain various combinations of chondroitin and glucosamine ("Artra", "Teraflex").

Classification by methods of administration

The classification of chondroprotectors is based on various methods of administration:

1. Intra-articular injection is the most effective method, as the effect develops quickly and persists long enough. Repeat such manipulations only a few times a year. This is suitable for drugs that contain hyaluronic acid, such as Gialgan, Fermatron. The disadvantages of this method can be attributed to the fact that injections inside the joints are medical manipulation and are conducted in a hospital. Most often, chondroprotectors are introduced into the knee joints.
2. Intramuscular injection is a convenient and widely used method of introducing chondroprotectors. In this way, they introduce "Alflutop", "Hondrolon", "Artradol", "Chondroguard" and many other intramuscular preparations. Suitable for patients who, for various reasons, are not able to swallow a pill or capsule or have severe kidney disease.
3. Capsules and tablets are the most widely used and widely used method of drug administration. Does not require aseptic conditions, the intervention of specially trained personnel, suitable for self-application. However, there are also shortcomings in this method: a long course of treatment, a large drug load on the liver and kidneys.
4. External application in the form of creams, ointments or gels - the method is good as an addition to the oral route of administration, but not as a monotherapy. Preparations of hyaluronic acid and chondroitin practically do not penetrate the skin into the joint, but in combination with physiotherapeutic methods the permeability of these substances can increase. As an anesthetic, Diclofenac (injections) can be used.The price of topical preparations is in the range of 200-600 rubles.

The most effective drugs

The most effective means are "Alflutop" (SC Biotehnos, SA, Romania). The basis of the drug is extract from marine organisms of four species. Degreased concentrate is free from foreign impurities and proteins. The main effect of the drug is directed to the regulation of metabolic processes in the tissues of cartilage.

A similar action is possessed by such preparations as "Chondroxide", "Chondrolon", "Structum", "Don". Application: intramuscularly, deep, 1 ml daily for three weeks.

With participation in the process of large joints, the introduction is performed intra-articularly, one or two milliliters per each joint, once every three to four days (the total is five to six administrations), and then - intramuscular injections, which are carried out for twenty days. The course should be repeated in six months.

Means can be delivered in packages of ten one-millimeter ampoules or five ampoules of two ml each.

Approximate price in pharmacies - 3300 rubles per packing.

The drug "Rumalon"

Another effective drug is "Rumalon" (CJSC "Bryntsalov A", Russia). It includes the composition of the brain extract and the cartilage of the tracheal calves.

Application: only for deep intramuscular injections. For adults, the dose is 1 ml three times a week or 2 ml twice a week. The positive effects of such therapy become noticeable after a couple of weeks of treatment. The full course of treatment includes 25 injections of 1 ml each or 15, but 2 ml (for 6-8 weeks). The course of injections should be repeated twice a year at least four times a year for a complicated course of the disease for several years.

Produced in packages of ten ampoules, containing one milliliter of the finished solution.

Approximate price in pharmacies - from 1100 rubles per package.

Preparations with glucosamine and chondroitin

Classical and widely used are such means:

1. "Dona" is a preparation of glucosamine, it is a powder for oral administration and a ready solution in ampoules for injections. Produced by the Italian company Rottapharm. The price of packing is from 900 to 1600 rubles.
2. "Artradol" is a preparation of chondroitin for intramuscular injection of the Russian company Trivium. In the package can be 10 or 5 ampoules of 2 ml. The price is about 700-1000 rubles per packing.
3. "Hondrolon" is a solution of chondroitin sulfate in ampoules of Russian origin. One package at a cost of 1,000 to 1,300 rubles contains ten ampoules.
4. "Structum" - the drug chondroitin sulfate in capsules, is produced by the French firm Pierre Fabre Medicament Production. Produced in two dosages - 500 and 250 mg. The price in pharmacies is about 700 - 1500 rubles per package.

Combinations of chondroitin and glucosamine

Combined medicinal preparations:

1. "Artra" is a tablet. Produced by the American company UNIPHARM. Contain glucosamine hydrochloride in a dosage of 500 mg and chondroitin sodium sulfate 500 mg, with virtually no side effects. Form release - tableted, 30-120 pcs. In the package, the price varies from 500 to 1,900 rubles, depending on their number.
2. "Teraflex" is a complex preparation of the American company Sagmel, contains chondroitin 400 mg and glucosamine 500 mg, is available as a cream and in capsules. One package contains 30-120 capsules, the price, depending on the number of capsules, is 550-1850 rubles.
3. There is also an enhanced formula of the drug - Teraflex Advance . It differs from the classical one in the presence of a non-steroidal anti-inflammatory drug - ibuprofen. Together with the oral administration of capsules it is recommended to use preparations of chondroitin and glucosamine externally ("Teraflex" in the form of a cream).

Injections in the knee joint with arthrosis: hyaluronic acid preparations

The most common hyaluronic acid preparations in pharmacies are currently:

1. "Ostenil", "Sinocrome" and "Sinocrome Forte" - from Austria and Germany, "Fermatron" - from Great Britain, "Suplazin" - from Ireland.
2. Not so often, but still there are such drugs as "Viskosil" (Germany) and "ViscoPlus" (Sweden), Italian "Gialgan", "Hyalux" (South Korea), American "Synvisc" and "Durallan Es Jay."
3. Of the Russian-made preparations, Intraject Gialuform (Toskani Moscow) and Hyastat (Tula) are singled out.

Preparations of hyaluronic acid for injection into the joint are released in ready form in disposable syringes, which is very convenient for use.

Intra-articular nyxes in the knee joint with arthrosis, preparations based on hyaluronate affect the diseased organ in three directions:

• Reduce friction and increase cushioning by increasing the amount of synovial fluid and its viscosity;
• Intensively nourish the cells of cartilage tissues, thus stimulating the regeneration of hyaline cartilage;
• Prevent inflammatory processes and reduce the severity of their manifestations.

Conclusion

It can be stated that the injection of hyaluronic acid in the knee joint is a modern tool for the treatment of diseases associated with the musculoskeletal system. At the initial stages, the drug has a striking effect and allows you to forget about the manifestations of arthrosis for a long time. This safe liquid implant significantly reduces the load on the joint, supplies cartilage with nutrients and forms a natural (natural) prosthesis, which is very close in its composition to the synovial fluid of man.

Also effective drugs are drugs containing chondroitin and glucosamine.

The intra-articular administration of these drugs has a rapid and lasting effect.