home Adviсe Preparations for bone and cartilage tissue. Folk ways to restore cartilage. Recovery after a compression fracture

Preparations for bone and cartilage tissue. Folk ways to restore cartilage. Recovery after a compression fracture

Cartilage in our body is designed to perform several functions: cushioning under heavy loads and ensuring normal mobility in the joints. They are located on internal surfaces bones and prevent their wear at the points of contact, it is also their task to nourish the joint by absorbing the necessary substances from the synovial membrane and periarticular tissues. Therefore, to ensure the normal functioning of the knee, restoration is necessary. cartilage tissue knee joint when it is damaged.

Cartilage is made up of cell structures- chondrocytes and an extracellular substance called the matrix, its amount is predominant. The regenerative abilities of any tissue in the body are determined by the possibility of cell reproduction. And in cartilage, due to the predominance of the matrix, this happens with great difficulty. Damage to the knee joint, which results in a violation of the structure of the cartilage tissue, can be for the following reasons:

age wear;
injuries during sports or heavy physical labor;
degenerative-dystrophic processes.

Medicinal ways to restore cartilage

In the treatment of diseases or injuries that lead to violations of the structure of the cartilage tissue of the knee joint, the most effective means are chondroprotectors. These include chondroitin sulfate and glucosamine. Each of these substances performs its task, in combination, their use allows you to normalize the properties and structure of the lubricating fluid, as well as start the production of the main elements of cartilage with further prevention of their destruction. In addition, chonroitin sulfate has the ability to neutralize enzymes that act in a destructive way on cartilage tissue.

Reception of these medicines only makes sense in the early stages of the process. The presence of expressed degenerative changes with complete destruction of the cartilage or deformation of the bones, the use of chondroprotectors is useless for recovery to occur, since they are not able to return the bones to their previous shape or grow new cartilage.

It should also be understood that it is impossible to restore the cartilage of the knee joint with the help of these drugs very quickly. For a successful process, their long-term and regular use is necessary. Therefore, effective treatment with this kind of drugs includes:

Complex use. The joint intake of chondroitin sulfate and glucosamine enhance each other's action and complement it.
It is necessary to strictly adhere to the duration of the course (at least 3-5 months) and timely admission. There is no point in using such substances on an occasional basis.
An important point is also the adequacy of dosing. The required dose of glucosamine should be at least 1000-1500 mg, and chondroitin sulfate - 1000 mg.
The degree of effectiveness of such drugs in order for the restoration of cartilage tissue to occur is also determined by the manufacturer. You should not buy medicines from little-known companies at an attractive price for the consumer, it is possible at the same time to acquire a completely ineffective or even dangerous substance for health, especially for bioadditives.
A positive point is also the fact that chondroprotectors have practically no side effects and almost no contraindications.

High efficiency in the restoration of the cartilage of the knee joint in the course of numerous experiments was proved by the use of STH - growth hormone. Many times stronger results can be obtained with a combination of the introduction of STH and thyrocalcitonin into the body. This hormone is produced by the thyroid gland and is responsible for reparative processes not only in cartilage, but also in bones. These two substances are able to enhance the processes of division of chondrocytes and increase the volume of the matrix.

The disadvantage of such treatment may be anabolic STG effect, which can cause a disproportion in the structure of the skeleton.

In second place in terms of the possibility of cartilage restoration are anabolic steroid. It is they who are able to reduce the processes of destruction and enhance regeneration. However, their undesirable effects on the body when systemic use, as well as classifying them as doping substances in sports, make long-term studies of their effectiveness for the treatment of cartilage difficult.

Within pharmacological dosages some types of vitamins can significantly affect the production of somatotropic hormone, enhance the processes of collagen synthesis, and improve the condition of the matrix. This a nicotinic acid, vitamin K, ascorbic acid in combination with amino acids alanine, proline and others.

A significant improvement is observed with the intra-articular injection of polyvinylpyrrolidone, which temporarily acts as a "prosthetic" substance, reducing the friction force and removing the main load from the knee joint.

Modern techniques

In many European countries, in particular in Germany, new and unique techniques in order to restore cartilage after it has been damaged. Let's consider some of them.

Sanation

With this option, it is possible to partially remove the edges and other areas of minor damage by endoscopic means, followed by surface polishing. In the same way, the meniscus is sutured and some sections of the synovial membrane are removed. This method helps to prevent further tissue destruction and speed up the healing process.

Use of stem cells

There are several ways in which new cartilage tissue is formed from stem cells. One of these techniques is the treatment of the surface of the joint by the surgeon with the help of a special tool with the formation of a microscopic network of cracks. At the same time, stem and blood cell elements penetrate through these formed holes and form a completely new and compacted fibrocartilaginous tissue.

If there is a more serious damage to the knee joint, then it is necessary to first carry out sanitation, and only then proceed to the above method.

Sometimes good results are obtained by the method of transplantation into the damaged zone of cells. bone marrow.

A relative disadvantage of this method is the imperfection of the resulting structure, since it contains few chondrocytes and does not have sufficient strength for another 3-4 years. At the slightest load, it can not withstand and collapses again. Nevertheless, the presence of even a fragile tissue is better than its complete absence.

Transplantation

There are several types of transplantation for this pathology. In one of the options, pieces of tissue are taken from intact places and transplanted to where the defect occurs. This is enough complex method especially when using an arthroscope.

The second method, which is already being used in Germany, is a transplant in sore spot cells that are cultured from several taken healthy elements V laboratory conditions. The use of this technique is especially effective for cartilage detachment.

Group of drugs for joints and cartilage	Name of medicines and price in rubles
	Structum (1450), (670), Mukosat (650)
	Glucosamine (400), Dona (1300), Artiflex (650)
	(1500), Rumalon (2100)
Preparations with plant composition	Piascledin (1200), Zinaxin (600)
	(35), Nimesulide (85), Ketorolac (45), Meloxicam (65), Piroxicam (60), Ibuprofen (40), (70)
Glucocorticosteroids	Prednisolone (105), Methylprednisolone (190), Triamcinolone (380), Betamethasone (500), Dexamethasone (120)
Antibiotics	Tetracycline (45), Amoxiclav (220), Azithromycin (120), Ofloxacin (85), Ampicillin (20)
Ointments with non-steroidal anti-inflammatory drugs	Voltaren (220), (270), Artrosilene (330), (30), Ketorol (130)
	Kapsikam (300), Finalgon (330), Viprosal (270), Apizartron (250), Nyatoks (250)
Ointments with chondroprotective action	Teraflex (440), Artro-Active (100), Honda (240), Dikul's balm (180), Chondroitin-Akos (80)

Chondroprotectors

These drugs are prescribed by doctors to improve the structure of cartilage tissue. They increase the functional activity of the joints by preventing their degenerative changes. contain bioactive substances - structural elements of hyaline cartilage. They renew and stimulate the production of the elements that make up the joint tissues. The active ingredients of chondroprotectors are products obtained from the processing of marine invertebrates or salmon fish. Some preparations contain organic compounds isolated from beans or avocados.

Regardless of the composition of chondroprotectors, they prevent the destruction of the joints. Their therapeutic effect based on the pharmacological properties of the components:

stimulation of the biosynthesis of glycosaminoglycans, proteoglycans, collagen, proteins, hyaluronic acid;
inhibition of enzymes that destroy cartilage tissue;
increasing the production of synovial fluid and improving its quality.

Chondroprotectors are intended for long-term use. Treatment begins with their use in the form of solutions for parenteral administration for 1-2 weeks. Then the injections are replaced with tablets, dragees, preparations for local application to the area of inflammation. The therapeutic course can last several months, and in severe cases of pathology - 1-2 years. During treatment, anabolic processes in the cartilage matrix are gradually activated and prerequisites are created for the formation of damage-resistant tissues.

Long-term use of chondroprotectors allows you to reduce the dosage of glucocorticosteroids and NSAIDs, and sometimes completely cancel them. These medications are often accompanied by negative impact to internal organs. Therefore, long-term use of chondroprotectors minimizes the development of complications.

Derivatives of chondroitinsulfuric acid

Chondroitin sulfates are polymeric sulfated glycosaminoglycans. These specific components of cartilage are produced in the human body. If the biosynthesis of chondroitin sulfate is disturbed, then the processes of destruction of articular structures are triggered. Their symptoms become during walking, morning swelling of the articulation and stiffness of movements. Arise pain, their intensity increases. Taking preparations for joints and cartilage with chondroitin sulfate stops destructive and degenerative changes, stimulates the production of one's own chondrocytes. Chondroprotectors with the highest clinical efficacy:

Taking drugs with chondroitin sulfate is rarely accompanied by side effects. Sometimes there are dyspeptic disorders - nausea, excessive gas formation, diarrhea or constipation. With individual sensitivity to the active or auxiliary ingredient, an allergic skin reaction develops. Chondroprotectors are contraindicated during childbearing and lactation, with thrombophlebitis and a tendency to bleeding.

The dynamics of radiographic parameters during treatment with chondroitin sulfates is positive. , which is not present when taking NSAIDs - Diclofenac, Meloxicam, Nimesulide.

Glucosaminoglycan derivatives

Contribute to the restoration of cartilage tissue. This monosaccharide is the precursor of their structural units - glycosaminoglycans. In normal health, glucosamine is produced in the body in sufficient quantities. Chondroitin is biosynthesized from it, it is part of the synovial fluid, corrects the metabolism of bone and cartilage tissues. A decrease in the production of a chondroprotector leads to their destructive and degenerative changes. Rheumatologists and traumatologists recommend eliminating the deficiency by additional intake of glucosamine hydrochloride or glucosamine sulfate. What medications can a doctor prescribe?

Preparations with glucosamine are not used in the treatment of children under 15 years of age and breastfeeding women. Its contraindications also include the first trimester of pregnancy, severe pathologies of the liver and kidneys. Chondroprotectors are well tolerated, do not have a toxic effect on the body. IN rare cases there are epigastric pains, heartburn, sour belching, peristalsis disorder. With a high individual sensitivity to the components, an allergic reaction may develop.

The dosage regimen is determined by the doctor individually. For example, people suffering from obesity or taking diuretics require more chondroprotector.

Cartilage extracts of fish and animals

Therapy of destructive-degenerative pathologies of the musculoskeletal system is a complex and still unsolved problem. Pharmacists are developing new preparations for cartilage and joints, using the latest techniques and biological materials. One of them was a drug from a Romanian manufacturer - Alflutop. It is issued in the form injection solutions, which are administered 1-2 times a day in the following ways:

intramuscularly;
paravertebral;
periarticular;
into the joint cavity.

Alflutop is a biotechnological preparation containing sterile extracts of marine organisms. During production, the biomaterial is purified from proteins and lipids. The result is a solution with a high concentration of glycosaminoglycans, polypeptides, free amino acids and trace elements - sodium, potassium, calcium, magnesium, iron, copper and zinc. extract from marine fish contains proteoglycans that have a trophic effect, increasing the firmness and elasticity of cartilage tissues. The course application of Alflutop gives a multifaceted clinical effect:

reduces the intensity of the pain syndrome;
relieves inflammation and swelling;
eliminates the limitation of movements in the joint.

Indications for treatment with Alflutop are arthrosis of small joints, gonarthrosis, coxarthrosis, traumatic dystoses. Therapeutic course - 2-3 weeks. With the defeat of large joints, a longer use of the drug is necessary.

The high clinical efficacy of Alflutop is confirmed by the results of laboratory studies. After therapy, the concentration of globulins, seromucoids, leukocytes, fibrinogen and C-reactive proteins decreases in the synovial fluid.

Rumalon is a chondroprotector, consisting of cartilage and bones of bulls. Morphogenetic proteins stimulate the growth of cartilage tissues and inhibit the enzymes that destroy them. The drug has disadvantages:

Rumalon is not used to treat rheumatoid arthritis;
the drug is effective only in the initial stages of joint diseases.

Rumalon is prescribed to patients with arthrosis, chondromalacia of the patella and meniscopathy. It is administered intramuscularly on the first day at a dose of 0.3 ml, on the second day - 0.5, and then for 1.5 months - 1 ml every other day. Treatment is carried out every six months, but in severe cases of pathology, more frequent use drug.

Herbal preparations

One of the most frequently used preparations for joints with herbal composition - Piascledin. He governs metabolic processes in cartilaginous tissues, exhibits anti-inflammatory and analgesic activity. After the course application of the chondroprotector, the morning swelling of the joints and stiffness of movements disappear. This is due to increased production of collagen and hyaluronic acid. The French symptom-modifying drug is not only known for its natural ingredients. It inhibits the activity of enzymes responsible for the production of mediators of pain, fever and inflammation:

prostaglandins;
bradykinins;
cytokines.

It contains a high concentration of phytosterols and fatty acids obtained from the hydrolysis of soybeans and avocado oil. In rheumatological practice, Piascledin is used in parallel with other drugs in the treatment of osteoarthritis of the knee and hip joints regardless of their stage of development. Doctors recommend taking 1 capsule at breakfast for six months.

Thanks to natural composition Piascledin does not have a wide list of contraindications. It cannot be used in the treatment of children under 18 years of age, during lactation and childbearing, if individual sensitivity to the ingredients is detected. During therapy, in rare cases, a local allergic reaction develops.

To reduce the severity of pain and eliminate stiffness of movements with degenerative lesions joints, patients were recommended the Danish drug Zinaxin. It contains plant extracts:

ginger rootcontaining a high concentration of bioflavonoids, phytoncides, organic acids, tannins;
Alpinia galanga, in the chemical composition of which - amino acids, sesquiterpene, zingiberene, triglycerides, fat-soluble vitamins,.

Zinaxin is taken 1 capsule 1-2 times a day with meals. The drug is well tolerated, so it can be used for several months. In rare cases, there are problems with digestion and peristalsis. Contraindications - pregnancy, breastfeeding, children under 12 years of age.

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are becoming the first choice for the treatment of joint diseases. This is explained by their powerful analgesic effect, which lasts for several hours. NSAIDs, unlike chondroprotectors, do not restore damaged tissues. But they quickly suppress the symptoms, eliminating physical and psychological discomfort. NSAIDs are characterized by the following pharmacological properties:

anti-inflammatory;
analgesic;
antipyretic;
antithrombotic.

The action of drugs is much more powerful than that of conventional analgesics. And some NSAIDs are comparable in strength to the analgesic effect of opiates. On initial stage treatment of degenerative pathologies of the joints, injection solutions are used 1-2 times a day for 1-3 days. Then therapy continues for 5-7 days with the help of tablets, capsules, dragees.

Clinical trials have established the anti-atherosclerotic effect of NSAIDs. The drugs had a positive effect on the course of Alzheimer's disease, prevented the formation of polyps in the colon. Scientists are studying these pharmacological properties of NSAIDs for further use in medical practice.

Anti-inflammatory drugs differ in bioavailability, speed of exposure, frequency of administration. A rheumatologist or vertebrologist may prescribe drugs with the following active ingredients:

NSAIDs are not used for longer than 10 days due to toxic effects on the gastric mucosa, kidneys, liver, and urinary organs. They are not prescribed to patients with hyperacid and erosive gastritis, ulcerative lesions GIT. Contraindications for the use of NSAIDs include pregnancy, lactation, severe diseases of the liver and urinary system. Minimize the undesirable effects of treatment with proton pump inhibitors - Omeprazole, Esomeprazole, Pantoprazole.

Glucocorticosteroids

Glucocorticosteroids are synthetic analogs of hormones produced in the body. They quickly stop the most acute inflammatory processes and eliminate intense pain. But because of their pronounced side effects (bone loss, increased blood pressure) doctors try to use glucocorticosteroids as little as possible. They are prescribed to patients with insufficient effectiveness of NSAIDs and autoimmune etiology of the disease. Indications - rheumatoid arthritis, acute rheumatic fever, systemic vasculitis. commonly used natural glucocorticosteroids - Cortisone and Hydrocortisone, their synthetic and semi-synthetic derivatives:

non-halogenated - Prednisolone, Methylprednisolone;
halogenated - Triamcinolone, Betamethasone, Dexamethasone.

In addition to the anti-inflammatory action, for hormonal drugs characterized by antiallergic and immunosuppressive activity. For rapid relief of pain and inflammation, intraarticular administration of glucocorticosteroids is recommended. Dosages of injection solutions and tablets are selected individually. At the beginning of therapy, high doses of drugs are used. They are evenly distributed over several doses throughout the day. Gradually move on to a single injection of glucocorticosteroids in the morning.

For glucocorticosteroids, a withdrawal syndrome is characteristic. If there is no gradual decrease in daily dosages, then the symptoms of articular diseases soon increase significantly.

At hormonal drugs a wide range of contraindications. They are not prescribed for peptic ulcer, cardiovascular, renal and liver pathologies, during pregnancy and lactation. If an infectious process occurs in the joint cavity, then the use of hormones is prohibited.

Antibacterial drugs

During the diagnosis of joint diseases, instrumental and laboratory research. Their results reveal infectious origin pathology, species affiliation of microorganisms and their sensitivity to antibiotics. Antibacterial and antimicrobials appointed in the following cases:

relief of infectious and inflammatory processes in the joints;
prevention of joint infection in respiratory, urogenital or intestinal pathologies.

Patients turn to rheumatologists for acute stage inflammation, accompanied by active growth and reproduction of pathogenic microorganisms. They complain of severe swelling, pain during movement and at rest. Doctors don't wait for results laboratory tests. They prescribe antibiotics to patients that are active against both Gram-positive and Gram-negative bacteria. Then the therapeutic regimen is adjusted. It includes other drugs that can effectively destroy the pathogens that caused infectious process in a particular patient. In the treatment of joint diseases, the following antibiotics are most often used:

tetracyclines - Tetracycline, Metacycline, Doxycycline;
fluoroquinolones - Ofloxacin, Levofloxacin;
macrolides - Erythromycin, Clarithromycin, Azithromycin;
penicillins - Carbenicillin, Amoxicillin, Ampicillin;
cephalosporins - Cefazolin, Ceftriaxone, Cefotaxime.

With frequent relapses infectious diseases patients are prescribed protected semi-synthetic penicillins - Amoxiclav, Panclav, Augmentin. They contain clavulanic acid. It does not have therapeutic properties, but prolongs and enhances the action of active ingredients. Clavulanic acid prevents pathogenic bacteria from developing resistance to antibiotics.

Patients with infectious arthritis are treated in a hospital. At the beginning of therapy, injectable forms of antibiotics are used, and then a course of tablets or capsules follows. Treatment lasts from 10 to 14 days. The patient is considered recovered if no pathogenic microorganisms were found in the biological sample.

Taking antibiotics provokes undesirable consequences - weakening of the immune system and the death of beneficial intestinal microflora. To prevent a pathological condition, it is recommended to take eubiotics for 7-14 days. These are drugs with lacto- and bifidobacteria - Lactobacterin, Bifidumbacterin, Linex, Acipol, Hilak forte.

Medicines for topical application

In rheumatological practice, agents for external use are actively used - gels, creams, balms. In the initial stages of diseases of the joints and cartilage, they are used as monotherapy. When diagnosing diseases of the middle and high degree gravity, external agents are used as part of complex treatment. Ointments and gels enhance the effect of injectable solutions and tablets, and reduce their dosage. Their active ingredients penetrate into the bloodstream in small quantities, do not cause local and systemic side effects. The greatest clinical efficacy is typical for such drugs:

non-steroidal anti-inflammatory drugs - Voltaren, Fastum, Ketorol, Artrosilene, or ointment;
ointments with a warming and distracting effect - Apizartron, Viprosal, Kapsikam, Nayatoks, Finalgon;
chondroprotectors for external use - Artro-Active (blue line), Teraflex, Honda, Dikul's balms.

Ointments with NSAIDs stop inflammation, eliminate pain and swelling. Warming agents improve blood circulation, replenish the reserves of nutrients and biologically active substances in the joints. Chondroprotectors stimulate the restoration of tissues that have undergone destructive and degenerative changes. External agents should not be used during pregnancy, lactation, individual sensitivity to the ingredients.

The sooner the treatment of joint diseases begins, the faster the patient's recovery occurs. After the diagnostic measures the doctor will draw up a therapeutic regimen. He will select individually for each patient, taking into account his age and the severity of the pathology.

The integrity of cartilage tissue in the knee joint is impaired by different reasons. In the elderly and the elderly, this is due to a decrease in the production of collagen and chondrocytes - the structural units of hyaline cartilage. In young patients, knee pathologies are diagnosed after it has been injured as a result of blows, severe bruises, and serious physical exertion. But the most common cause of thinning, wear and tear of cartilage tissue is articular pathology. These are gonarthrosis, gouty, rheumatic, psoriatic arthritis, synovitis.

View of the destroyed hyaline cartilage.

Conservative methods are used to restore cartilage in the knee joint in orthopedics and traumatology. This is a long-term course of taking chondroprotectors, regular exercise with a small amplitude, and a sparing therapeutic diet. If they are ineffective, the patient is prepared for a surgical operation to transplant cartilage grafts or implant the grown cartilage.

The effectiveness of conservative therapy

Before restoring cartilage tissue in the joints, a thorough diagnosis is required to determine the cause of the destructive-degenerative changes that have occurred. The most informative X-ray. On the obtained images, all articular elements are clearly visible: cartilage, synovial bag, bone surfaces. Formed osteophytes (overgrown edges of bone plates) usually indicate the development of severe knee pathology - gonarthrosis. The diagnostician evaluates the condition of the hyaline cartilage. With gonarthrosis of 1 or 2 severity, partial tissue restoration is possible. If a patient has a disease of 3 or 4 x-ray stages, then cartilage cannot be regenerated. In this case, bone and cartilage transplants or endoprosthetics are performed.

Bilateral lesion of the knee joints.

Patients often ask orthopedists whether cartilage tissue in the knee joint is being restored. So far, no drugs have been synthesized that would reverse the disease. But partial recovery is possible subject to all medical recommendations, including those related to changes familiar image life. To increase functional activity knee joint the following conditions must be met:

the cause of cartilage wear was found and treated to eliminate it. Some degenerative pathologies, for example, rheumatoid arthritis, until it can be completely cured. But taking drugs suspends the disease until a stable remission;
physical activity strictly dosed. Doctors recommend avoiding sharp, traumatic weakened joint exercises, performing frequent movements with a minimum amplitude. In the treatment of gonarthrosis, gymnastic complexes developed by and have proven themselves well;
salt, high-fat foods and simple carbohydrates. Most of the daily menu should be fresh vegetables and fruits, lean meat, cereals. In the absence of contraindications, at least 2 liters of pure non-carbonated water should be consumed daily.

In order for chondrocytes to be produced in sufficient quantities, a lot of viscous fluid must be produced in the synovial capsule. It is necessary to ensure smooth sliding of bone surfaces. Synovial fluid supplies articular structures with molecular oxygen, nutrients and biologically active substances. The most effective and budgetary way to increase its production is to regularly engage in physiotherapy exercises.

Chondroprotectors

This is the only group of drugs, the list of indications of which includes the regeneration of cartilaginous tissues. Chondroprotectors are prescribed to patients with pathologies of the musculoskeletal system. Their reception is recommended at the stage of rehabilitation after a knee injury (fracture, dislocation, rupture of ligaments or tendons) or a surgical operation (arthrodesis, arthroplasty).

Restoration of knee joints with chondroprotectors takes several months or years. In order to constantly have the maximum therapeutic concentration of active ingredients in the articulation cavity, it is necessary to take 1-2 capsules or tablets daily. After 2-3 months of treatment, you need to take a 2-week break and start taking chondroprotectors again.

The active ingredients of these products are chondroitin sulfate, glucosamine sulfate or hydrochloride, hyaluronic acid and collagen. The first two components have a broad evidence base for regenerative activity. In domestic and foreign medical centers, many years of research were conducted with the participation of volunteers. The results of X-ray diagnostics confirmed the clinical efficacy of glucosamine and chondroitin - the size of the joint space decreased.

But you can’t just come to the pharmacy and buy any chondroprotector. How to restore the cartilage of the knee joint in a short time and not harm your health:

At the beginning of treatment, patients are recommended a 20-day course of parenteral administration of chondroprotectors: Rumalon, Dona, Chondrolon, Mukosat. Then therapy is carried out in tablet forms. Patients are prescribed Teraflex, (with ibuprofen), Structum, Glucosamine-Maximum.

Approximately 2-3 weeks after taking the drugs, their active ingredients begin to reduce the severity of symptoms. They have anti-inflammatory, analgesic, anti-edema effect. This allows you to significantly reduce the doses of analgesics, muscle relaxants.

Liquid prosthetics

If oral administration hyaluronic acid (HS) is not effective enough, then its intra-articular administration is effective for restoring joints. Target medical procedure- improvement rheological properties synovia and stimulation of cartilage metabolism. Local therapy with drugs hyaluronic acid often used as the main method, especially periodically complicated by synovitis (inflammation of the synovial membrane). In orthopedics and traumatology, intra-articular administration of GS is practiced to reduce the dosages of glucocorticosteroids and NSAIDs used by increasing the functional activity of the knee. After the penetration of this chondroprotector into the joint cavity, it has a therapeutic effect for several months. Patients are prescribed drugs of one of two groups that differ in physicochemical and biological properties:

products with sodium hyaluronate. The chemical compound consists of straight polymer chains in which N-acetylglucosamines and glucuronic acid alternate in the form of disaccharides;
Gilans. The active ingredient of the drug consists of cross-linked hyaluronate molecules. Carboxyl and acetyl groups are in a free state, poorly soluble in water, which determines the gel-like texture of the preparations.

Hyaluronic acid - providing its viscosity and cushioning properties. If there were no HA in the synovium, then it would be an ordinary plasma dialysate. It is always located on the articular surfaces and is used by chondrocytes for the biosynthesis of proteoglycans - building material cartilage of the knee joint.

In the treatment of synovitis and gonarthrosis, Synvisc, Intraject Gialuform, Giastat, Viscosil, Ostenil, Synocrom, Fermatron, Suplazin are most often used. The cost of drugs is from 2000 to 30000 rubles. Rheumatologists recommend standard course treatment for patients: 3-5 weeks. If necessary, parenteral administration is repeated after about six months. Synvisc is enough to use only 1 or 3 times for 6 months.

Surgical operations

Restoration of joints with gonarthrosis of 3 or 4 x-ray stages conservative methods impossible. The patient undergoes arthroplasty or replacement of the knee joint with a prosthesis. But in some countries of Europe and Asia, surgical operations on the introduction of artificial cartilage tissues onto the bone surfaces. How to restore joints the latest technologies and avoid arthroplasty:

transplantation. During the operation, the patient's own cartilage tissue, taken from healthy joints, is transplanted, or hyaline cartilage obtained by cell culture is used;
sanitation - surgical intervention endoscopic method. The doctor excises the damaged areas of the joint, polishes the remaining structures. The operation stops the progression of the disease and stimulates cartilage metabolism.

most difficult and effective method- special treatment of articular surfaces, after which microscopic cracks appear on them. The penetration of blood cells and stem cells through them contributes to the formation of new, healthy cartilage tissues. The resulting structure is fragile, easily damaged with little physical exertion. Therefore, the rehabilitation period lasts several years.

Restoration of the cartilage tissue of the knee joint by folk remedies is impossible. Traditional medicine suggests eating chicken cartilage and a large number of dishes with gelatin in the form of jelly, jelly, fruit and berry jelly. Despite the high content of collagen in them, it does not enter the joint cavities, therefore it does not regenerate hyaline cartilage.

Joints are a vulnerable place in the human body. Constant load - weight and movement, injuries, malnutrition, inflammatory processes lead to their gradual destruction - degeneration, or osteoarthritis.

Degenerative diseases of the joints occupy the first place among all diseases of the musculoskeletal system. Often they coexist with inflammatory processes, exacerbating the manifestations of each other.

A joint is a complex structure that contains bones and cartilage that covers them. Thanks to cartilage, there is an unhindered sliding of the articular surfaces relative to each other. Bones provide cartilage with nutrients. As soon as problems arise in one component of the joint, the entire system begins to suffer.

There are 3 main factors that destroy joints:

Disturbed metabolism within the cartilage. The main substance of cartilage is collagen and proteins. Proteins consist of chondroitin and glycosamines. Violation of their metabolism is the leading destructive factor in the opinion of most scientists and doctors.
Inflammatory process that triggers cartilage damage. Damaged cartilage begins to produce other substances that can independently cause inflammation in other parts of the joint and stimulate bone growth with the formation of spikes.
The result of recurring inflammation is osteoarthritis.
Loads. Moreover, their number, degree, and time of action are also important. Loads and frequent injuries trigger the process of destruction of the joint, destroy its cartilage, and cause deformation of the bones.

Which joints are affected the most?

First of all, the most intensively working joints fall ill - knee, hip, intervertebral, joints of the hands.

For example, the cartilaginous tissue of the knee joint experiences daily stress and weight, and active movements. She's damaged, destroyed, and restored normal work knee joint is not so easy. The same processes occur in other joints.

How to find out about joint damage?

It is impossible not to notice diseases of the musculoskeletal system. Pain in the lower back and neck, knees, hands, crunching during movement, inability to straighten up or climb stairs - all these are clear signs of osteoarthritis.

Later, the pain begins to bother even when resting, in the morning there is stiffness of the body, in severe cases you may need a cane or walker.

Can joints be restored?

Restoration of damaged joints primarily involves the restoration of their cartilaginous tissue and perichondrium. And if you can restore the structure of the bone by taking calcium and vitamin D3, then things are more complicated with cartilage.

First of all, it is necessary to influence the work of cartilage cells - chondrocytes, protect them from inflammation, and reduce the activity of destructive substances. Then it is necessary to stimulate the recovery process in intercellular substance cartilage.

Drugs that perform all these tasks are called chondroprotectors - "protecting cartilage."

What are chondroprotectors?

There are several groups of chondroprotectors. They differ active substance, mechanism of influence, effect, number of components in the composition. Chondroprotectors are especially effective in the treatment of early stages of osteoarthritis.

In severe cases and intense pain combined preparations are used - chondroprotectors and non-steroidal anti-inflammatory drugs.

Chondroprotectors should be taken in long courses to achieve maximum effect and restore joint function.

General indications for the appointment of chondroprotectors:

degenerative diseases of the joints - arthrosis of any area;
osteocondritis of the spine;
inflammatory processes in the joints - arthritis;
destruction of articular cartilage.

Medicines based on chondroitin sulfate

Chondroitin belongs to the most important class of glycosamines. It is involved in the formation of cartilage proteins, the restoration of its structure and properties. The drug enhances the production of collagen and hyaluronic acid.

By stimulating chondrocyte cells, chondroitin provides a better degree of cartilage and perichondrium regeneration in comparison with other drugs. when it is taken, it recovers faster. In addition, pain and stiffness decrease, and other manifestations of osteoarthritis disappear.

Chondroitin-based drugs include mucosat, structum, artradol, chondrogard, artrin, chondroitin-akos, chondrolone. These drugs are produced in the form of tablets, capsules and solutions, designed for long-term use.

Preparations containing glucosamine

Glucosamine is a substance found in nature. It is the main component of chitin, which is most often extracted from the shell of crustaceans. Glucosamine-based preparations protect cartilage from damage and restore normal metabolism in it.

These include don, elbon, chondroxide maximum, sustilac, glucosamine sulfate.

Glucosamine preparations are available in the form of powders, tablets, injections and even creams (chondroxide maximum).

Medicinal products of animal origin

There are also medicines that are made from the cartilage and bones of animals - for example, marine life or calves.

These drugs include rumalon - an extract of bone marrow and cartilage tissue of calves. It contains various components of cartilage and thus stimulates its recovery. In addition, rumalon as a natural defense slows down the aging of cartilage.

The medicine is produced only in the form of a solution, it is administered intramuscularly. Like most animal products, it increases the risk of developing allergies. Due to the content of a foreign protein, it can trigger immunity against its own body, therefore it is prohibited in autoimmune diseases ( rheumatoid arthritis). Pregnancy or its planning, breast-feeding are also contraindications for taking the drug.

The analogue of rumalon is biartrin. A similar drug, which is obtained from marine animals, is called alflutop.

Mucopolysaccharides

They slow down the aging of cartilage and increase the production of intra-articular fluid, restore joint mobility.

These medicines have many contraindications - gastric ulcer and duodenum, diabetes, kidney and liver disease, accompanied by insufficiency. But in some situations, it is mucopolysaccharides - the best drug for selection.

Arteparon belongs to this group. This drug is administered intramuscularly, prescribed for a long course.

Multicomponent drugs

To influence several symptoms of splicing, preparations containing both chondroitin sulfate and glycosamine are used. These include teraflex, artron complex, chondroflex, chondrogluxide, artra.

Multicomponent preparations have high efficiency, are also used for a long time. They are produced mainly in the form of tablets and capsules, some are used topically - as ointments and creams (Teraflex M). Well tolerated, only allergy can be noted from side effects and sometimes discomfort in the stomach.

Combined drugs

Since pain is an inevitable companion of osteoarthritis, getting rid of it is the most important task of complex treatment. For these purposes, chondroprotectors have been developed, which include not only cartilage components, but also non-steroidal anti-inflammatory drugs.

These drugs include teraflex advance, artrodar.

Combined drugs could be considered the gold standard for the treatment of osteoarthritis, if not for their side effects, in particular, on the functioning of the gastrointestinal tract. Due to the non-steroidal anti-inflammatory drugs included in the composition, patients may experience:

heartburn and stomach pain;
exacerbation or appearance of peptic ulcer;
bleeding from the gastrointestinal tract.

In old age, these manifestations most often proceed erased, imperceptibly and can lead to serious complications. It is necessary to prescribe combination drugs to patients after 60 years of age with caution and be sure to warn what uncontrolled use may threaten.

Long-term use of combination drugs also increases the risk of bleeding and peptic ulcer disease.

The effectiveness and safety of the use of chondroprotectors has been studied for more than 25 years all over the world. Best Results showed drugs based on glycosamine, chondroitin sulfate and their combinations.

Hyaluronic acid preparations

Hyaluronic acid - essential part intra-articular fluid, it acts as a lubricant. In case of violation of the production of hyaluronic acid, movements in the joints are difficult, microtraumas occur. This leads to the growth of bone edges and the formation of spikes, pain when walking, crunching when moving.

Medicines based on hyaluronic acid are injected into the joint. In this case, they instantly reach the affected area and provide healing effect. Courses of therapy are repeated after six months or a year.

Hyaluronic acid preparations are not used for severe inflammation, skin diseases. Contraindications include children's age.

Given the intra-articular injection, treatment with hyaluronic acid is carried out only by orthopedic traumatologists.

Homeopathic and antihomotoxic remedies

Homeopathy and antihomotoxic therapy are involved in the treatment of osteoarthritis along with classical medicine. Main advantage homeopathic medicines is the absence of side effects and contraindications for treatment. They can be used for a long time and show good long-term results.

Of the well-established drugs, Cel T and Traumeel C are known. They have anti-inflammatory and analgesic effects, by reducing inflammation they restore the functioning of the joints. They are used in the form of solutions, tablets and gel.

Antihomotoxic and homeopathic treatment can be carried out during pregnancy and in childhood. Breast-feeding also not a hindrance.

Collagen-based preparations

Collagen-based preparations are mostly dietary supplements. One of the well known is Collagen Ultra. Serious side effects from taking this supplement were not noted, but its benefits remain in question.

Folk remedies

Is there an alternative for those who are not used to being treated traditional means? Yes, on early stages treatment with folk methods is possible.

For the most part, these are plant-based compresses designed to relieve swelling and inflammation in a diseased joint. Cabbage leaves with honey, burdock, elecampane root, vodka tincture dandelion.

But we must remember that the treatment of folk remedies eliminates the symptoms, but does not affect the cause. They cannot stop the destruction of cartilage.

Food

If there are chondroprotectors in tablets, why not use them in natural form? After all, aspic dishes (jelly, fish aspic) and sweet jellies are rich in collagen - natural, not synthetic.

But do not lean on jellies with osteoarthritis. The harm to the heart will be much greater than the intended benefit.

You need to eat foods rich in protein, sulfur, selenium, fatty acids. These are the “bricks” from which healthy cartilage will be built.

The diet must include:

dairy products;
lean meats (beef, chicken);
sources of sulfur (sea bass and chum salmon, cod, gooseberries and plums, cabbage and onions, eggs);
sources of selenium (garlic, sea kale, whole wheat bread);
polyunsaturated fatty acid(mackerel, sardine, salmon, olive and linseed oils).

By using healthy foods, you can slow down the aging and destruction of cartilage, improve the functioning of the joints.

Which method should be preferred?

With osteoarthritis, you should not get carried away with any one type of treatment. Therapy for degenerative joint diseases should be comprehensive - from proper nutrition to a well-chosen scheme of chondroprotectors.

Only a doctor should prescribe treatment. Self-medication in case of osteoarthritis is unacceptable.

Various pathological conditions of the spine are associated with a violation of the structure of cartilage tissue. Under these conditions, the direction of treatment, designed to restore the lost function of the cartilage, becomes relevant.

What methods can be used to achieve the goal? To answer this question, it is necessary to understand the very structure of the cartilaginous tissue important for the spine.

Where is cartilage located in the spine? This structure consists of formations such as intervertebral discs. They are cartilage in the form of an ellipse, which are located between two adjacent vertebrae along the entire length of the spinal column.

Intervertebral discs perform the function of depreciation - they smooth out the range of motion, prevent the vertebrae from hitting each other. Each disc has a nucleus pulposus inside, which is surrounded by a fibrous capsule. Pathology occurs when a section of the nucleus (disc herniation) comes out through a defect in the capsule, which comes into anatomical conflict with the surrounding formations.

What is cartilage made of? Its structure includes:

Chondrocyte cells.
Intercellular matrix.

The latter contains very important substances, without which the work of cartilage is impossible. At the molecular level, cartilage is made up of:

Collagen is the main protein connective tissue human body. Creates a "scaffold" for the rest of the molecules in the cartilage.
Hyaluronic acid - provides the property of elasticity.
Proteoglycans are molecules that fill the gaps between collagen fibers.
Chondroitin sulfate - together with hyaluronic acid is responsible for the elastic properties of discs.

A feature of cartilage is the absence of blood vessels. The discs are nourished by synovial fluid and by diffusion from other tissues. As a result, the metabolism in cartilage is low-intensity, so the restoration of cartilage tissue is a difficult process.

Causes of pathology

There are not so many diseases that cause cartilage pathology, but they occupy a significant proportion of spinal diseases. Cartilage restoration is necessary in the following conditions:

Osteochondrosis.
Protrusion and herniation of the disc.
Intervertebral disc injury.
Systemic connective tissue diseases.
Lack of protein and trace elements in the body.

These problems cause a whole cascade pathological processes. If the cartilage structure is disturbed, its fragments begin to compress the surrounding structures. Begins inflammatory process. The reaction may involve nerve roots and plexuses, muscles and ligaments, and even bone tissue.

Advanced cartilage diseases lead to disability. That is why it is important to begin the restoration of these structures as early as possible.

Recovery Methods

Vertebrology is a branch of medicine that develops methods for treating diseases of the spine. This science has been looking for the most efficient schemes effects on damaged cartilage tissue of the spine.

The following areas of treatment can be distinguished:

Changing the diet.
The use of drugs.
Application of stem cells and other experimental methods.
Assistive technologies: physiotherapy, massage, exercise therapy.

It is worth dwelling in more detail on each of the listed methods in order to achieve the most effective results in the restoration of cartilage tissue.

Nutrition

Using only cartilage drugs without lifestyle changes will be the least effective treatment option. Need to get rid of bad habits such as alcohol and smoking. They disrupt the processes of blood circulation, which aggravates the disease.

It is very important to change the nature of the diet. Add to your diet:

Dairy products - contain calcium, which strengthens cartilage and bone tissue.
rich meat broths- they contain hyaluronic acid necessary for cartilage.
Aspic and jellied fish - also contain mucopolysaccharides and proteins that are useful for the spine.
Seafood. They contain phosphorus, calcium and other trace elements.
Desserts with gelatin - contain mucopolysaccharides.
Vegetables and fruits are a source of vitamins that strengthen immune system and hinder inflammatory response.
Worth in in large numbers use clean water And fresh juices. The fluid makes the cartilage elastic and enhances metabolic processes.

Nutrition should be complete in protein and carbohydrate composition, sufficient in energy value. In this case, anabolic hormones involved in the restoration of cartilage will be produced in sufficient quantities in the body.

Medications

To date, the basis for the restoration of the cartilaginous tissue of the spine is created by drugs. The drugs are used in various dosage forms and belong to different chemical groups, but in one way or another they protect the cartilage from additional damage.

You can divide drugs into the following groups:

Chondroprotectors.
Vitamins and antioxidants.
Hormonal agents.

Each of them has a number of advantages and disadvantages. In addition, medications can cause side effects, so they should be prescribed by the attending physician.

Chondroprotectors

Modern medicine is trying to find the ideal remedy that acts on the mechanism of the development of the disease, and not on its symptoms. To date, clinical trials of drugs from the chondroprotectors group are actively undergoing.

These drugs contain cartilage substances or their analogues, which notice the deficiency of their own metabolites and prevent the progression of the pathology. Chondroprotectors are divided into several groups:

Preparations containing only chondroitin sulfate: Chondroxide, Chondrolol.
Products with natural ingredients (extracts of sea organisms, bone tissue calves): Rumalon, Aflutol.
Medicines containing mucopolysaccharides - Arteparon.
Preparations containing glucosamine - a precursor of chondrotin. This group includes the medicine Artron Flex.
Combined means: Teraflex, Artron-complex.

There are also drugs containing non-steroidal anti-inflammatory drugs along with chondroprotectors. The combination is aimed at rapid decline the intensity of the pain syndrome.

Advantages and disadvantages

The wide potential of drugs in this group is due to the presence of a number of significant advantages. These include the following properties of drugs:

Influence directly on metabolism, elimination of deficiency of own metabolites.
A wide range of dosage forms: tablets, injections, ointments and gels.
Good tolerance, minimum side effects.
Proven clinical efficacy with long-term use.

Chondroprotectors have not yet received widespread distribution. This is due to the presence of certain disadvantages:

It is difficult to penetrate into the tissues of the spinal column.
Long-term use is required. The course lasts 3-6 months.
Reduce symptoms only a month after the start of treatment.
Requires combination with symptomatic means, physiotherapy.
High price.

The doctor should individually select the drug based on the patient's condition and the results of clinical trials.

Hormones

Clinical trials have shown a significant effect of cartilage restoration when using anabolic hormones - growth hormone and thyrocalcitonin.

The first is produced in the pituitary gland and is responsible for the growth and development of the body in youth. With age, the level of the hormone falls, and the cartilage tissue loses its strength and elasticity properties. The introduction of the somatotropic hormone preparation in the form of an injection led to an improvement in the reparative (restorative) properties of the intervertebral disc.

The simultaneous use of thyrocalcitonin, another pituitary hormone, potentiates the effect. It affects activity. thyroid gland and enhances the anabolic effect. Under the action of hormones in the liver, protein synthesis is activated, the number of chondrocytes increases, cartilage acquires the property of strength.

Unfortunately, hormones have a number of negative effects. They lead to skeletal imbalances, disruption of the liver and kidneys, and changes in blood pressure levels.

That is why the widespread use of growth hormone and thyrocalcitonin is not observed. The drugs are used in a limited number of clinics and are being tested.

Vitamins and Antioxidants

The use of vitamins and microelements to restore cartilage has a significant effect. The following drugs are used:

Nicotinic acid (vitamin K) - a tool that promotes the production of somatotropic hormone. The dosage of the drug is carefully selected in order not to affect the processes of blood coagulation.
Vitamin C. Ascorbic acid has an antioxidant effect, it prevents the inflammatory response, activates the body's immune forces, and contributes to the normalization of metabolic processes.
Vitamin D - together with calcium, it helps to strengthen not only bone tissue, but also cartilage. Does not allow the development of degeneration in the form of bone osteophytes and osteoporosis.

In addition to vitamins, the doctor may prescribe complexes of trace elements, mainly calcium and phosphorus. Enhance the effect of amino acids: lysine, proline, alanine, vitamin P. The most rational is the appointment of a complete multivitamin complex containing necessary substances at the right dosage.

Experimental Methods

Medicine is striving forward, using the most modern developments of scientists. Some experimental techniques have great potential for restoring the cartilage of the spine:

The use of stem cells. Embryonic cells are embedded in the cartilage and are converted into chondrocytes, replacing the lost function.
The introduction of ready-made chondrocytes into the cartilage. The application of the method is hindered by the body's immune response to the introduction of foreign cells.
Replacement of synovial fluid through the use of polyvinylpyrrolidone. The disadvantage is the complexity of the application in case of damage to several discs of the spine.
The use of clenbuterol and other adrenergic receptor stimulants. The drugs have an effect similar to anabolic hormones, but do not have their side effects.

In addition to the techniques described, it is widely used surgical correction pathology. Sometimes it is impossible to eliminate the pathology of the disk in another way. When cartilage repair fails, doctors resort to removing the herniated or entire disc and replacing it with a prosthesis.

Auxiliary recovery methods

All the methods of cartilage restoration described above have a long-term effect. How to accelerate the action of vitamins and chondroprotectors? For such purposes, physiotherapy methods are often used:

UHF, UFO.
Electrophoresis and phonophoresis.
Electromyostimulation.
Paraffin applications.
Hot baths.

You can complement the procedures with a massage. Save healthy tissue possible with proper driving. Static and dynamic overloads are excluded, exercise therapy complexes and therapeutic exercises are used.

These procedures must be performed under the supervision of a specialist.

During the first months of treatment, the symptoms will not change significantly. The following drugs help to alleviate the patient's condition:

Spinal corsets, bandages and orthopedic belts also help to reduce the intensity of symptoms. The attending physician will help you choose the design.