In this case, we will focus on the treatment of knee and hip joints. In recent years, in the treatment of these joints, the method of intra-articular injections of various liquids and gels (so-called liquid implants), which, according to the authors of such inventions, should contribute to the restoration of destroyed cartilage, has become widespread. One injection of the drug into the articular bag (most often already destroyed) costs a tidy sum. If there is no effect, the patient is recommended to repeat the injection (the cost of injection does not change). For a while, the patient is relieved (not always), but after a maximum of six months, the pain and lameness return, and x-rays show a more depressing picture of collapsing cartilage. This treatment is designed for human laziness, and its cost – on the imagination of the doctor: the worse the condition of cartilage, the more expensive the treatment will be… So this algorithm is seen by medical professionals, but what about the Hippocratic oath: “do no harm”? Sure!
For the sake of objectivity it should be said that surgeons using such chondroprotector for the treatment of the joints, and yourself believe by their treatment because pharmacologists convinced… But what happens with the joints really?
To understand the meaninglessness of such procedures and even assess the harm caused to the joint by such methods of “treatment”, it is necessary to understand the structure and function of all elements of the joint:
- Cartilage covering articular surfaces, hyaline. It is a specialized form of connective tissue in which dense (!) the consistency of the intercellular substance determines the ability of the tissue to withstand mechanical stress without the occurrence of permanent deformation.
- Cartilage creates support for soft tissues.
• Cartilage forms a cushion and gliding the joint surfaces.
Now consider whether any liquid (gel, liquid implant), introduced into the joint capsule, for example a knee joint, to penetrate the cartilage and to close “gaps” like the patch? Of course not! But patients believe doctors who take a huge amount of money from them, but do not guarantee the result of treatment…
The second aspect is that the liquid (Chandrasekhar) needs somehow to penetrate into cartilage, hyaline inside his shell and fix it. (Let me remind you that there is also elastic cartilage — the auricle, and fibrous cartilage — the intervertebral disc, and they all contain dense and heavy-duty collagen fibers.) But the fact is that cartilage has no blood vessels, no lymph vessels, no nerves… How does it get nourishment, you ask.
Cartilage is nourished by the diffusion of nutrients from the capillaries, which are located in the adjacent connective tissue — the cartilage (and articular cartilage is not covered by the cartilage) or from the synovial fluid in the joint cavity.
Diffusion is a kind of pump that has a cycle of cartilage compression and pressure drop in it. Simply put, when bending the knee joint there is a pressure drop in the synovial fluid of the joint cavity, when unbending — compression of cartilage. The starting mechanism of diffusion is the work of muscles, tendons and ligaments of the joint — another mechanism of supply of food to the cartilaginous tissue of the joint is not provided by nature!
Unlike other tissues, hyaline cartilage is highly susceptible to degenerative processes associated with aging. That is, over the years, if the leg muscles, and with them the tendons and ligaments of the joints, weaken, the joints cease to receive food (with their active operation), and the cartilage calcifies (that is, their dehydration). This process is called asbestos degeneration.
X-rays (MRI, CT) show that the articular gap loses its congruence, ceases to be smooth and covered with foci that can be compared with rust (that is, the formation of abnormal collagen fibrils). Attempts by surgeons (including and private) to clean the cartilage using arthroscopy only lead to more rapid degeneration (disappearance) of cartilage. The so-called therapeutic effect after arthroscopy explained only anesthesia (anesthesia) with NSAIDs introduced into the joint.
Thus, any surgical penetration into the joint in order to partially restore cartilage,” cleaning ” of the joint from exostoses and other degenerative changes within the joint, as well as diagnostic arthroscopy-all these interventions lead to accelerated destruction of the joint! Patients usually feel deterioration in the joint a few days after injections or arthroscopy. As a result, they no longer have the illusion of a bloodless solution to the problem, as, however, there is no money spent on cutting-edge treatment of the joint.
What to do if the hip or knee joint works badly? There is only one way out: you need to prepare for surgery to replace the diseased joint — endoprosthesis! And while a person consists of muscles, ligaments and tendons, inside of which is the entire “transport” system of the body, all the blood and lymphatic vessels, there is no other way!
Only osteochondrosis of the spine with intervertebral hernias, protrusions, does not need such an operation. Although the replacement of the intervertebral disc (IVD) doctors began to consider as the only possible way to get rid of back pain. But despite the fact that the fibrous cartilage of the IVD is erased during aging, it may well be supported by deep muscles and ligaments of the spine (neighboring vertebrae)!
Unlike the spine, the knee joint and hip joint do not have understudies! They, of course, are also important, but they are still not as vital as the spine, which is the spinal cord (CNS). Joint replacement is one of the few surgical operations that helps you to recover almost the full life of the joint (no running and no jumping), but also the livelihoods of the whole organism, which is difficult to ensure that the organs and parts of the body all the necessary nutrients without actively working muscles of the lower extremities.
But, as practice shows, surgeons who have learned to put well implants (endoprostheses), almost always in a hurry to carry out endoprosthesis, without thinking about the fact that the patient must be somatically prepared for this rather bloody operation. In this regard, the operated, but not prepared for surgery patients after some time (usually after 2-5 years) again have problems with a new joint, which (in theory) should not hurt at all, he’s an implant!
These problems, paradoxically, are due to the anatomical structure of the joint. It is important to remember that any joint of the lower extremities is just a part of the leg! In addition to the joint, as mentioned above, there are muscles and ligaments in the leg, not only the affected (or implanted) joint, but also the muscles above and below the lying joints, kinematically connected to each other. In addition to muscles, there are bones (tubular) of the thigh and lower leg, pelvis and lower back bones, ankle bones, and all these anatomical structures are interconnected and, more interestingly, they all depend on each other.
If you have to endoprosthesis, all these anatomical structures and tissues should be possible to try to prepare for the upcoming operation. To do this, you need to spend one or more courses of kinesitherapy to increase muscle memory, which is useful in the rehabilitation period after surgery. And such training should be carried out for each patient! But this, unfortunately, is not done — in the vast majority of cases, preoperative preparation for endoprosthesis and postoperative rehabilitation are ignored. As a result, the operated patients eventually have problems that other patients learn about and therefore are afraid to go for surgery for endoprosthesis. What a pity! It is in this solution that there are huge reserves for restoring the quality of life of people with diseased joints.
Knee or hip replacement helps to significantly improve the quality of life, but such an operation must be carefully prepared, and after the operation to undergo a full rehabilitation course of kinesitherapy.