Injections into the knee joint with arthrosis: drugs. Selection, description, instructions

The great ancient Greek scientist 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 are manifested. The article discusses when it is necessary to give injections to the knee joint with arthrosis, drugs necessary for these procedures.

What is arthrosis and causes

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

This is due to the fact that the physical activity of the population has significantly decreased: sedentary work, the use of public transport and personal cars, unbalanced plentiful food - as a result, overweight, which increases the load on the joints. As a treatment, doctors offer injections to 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 field of activity is associated with heavy physical labor. In addition, other factors can create prerequisites for the development of the disease, such as autoimmune diseases, previous infectious and inflammatory processes, genetic predisposition, diseases of the endocrine system, metabolic disorders and others.

How 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 reduces friction during movement. Joint nutrition is carried out through synovial fluid, since it does not have its own blood vessels.

It is this property that makes cartilage vulnerable. Due to a malfunction in metabolic processes or an excessively large articular load, hyaline cartilage can undergo degenerative changes, and in the absence or inadequate nutritional supply, its restoration and regeneration is extremely slow. Thinning of the layer of hyaline cartilage leads to increased friction in the joint during movements, which leads to accelerated destruction of the cartilage and contributes to the development of inflammatory processes. In humans, this process is manifested by the occurrence of pain, stiffness, and limitation of mobility. At this stage, injections to the knee joint may come to the rescue. Reviews of specialists and patients about these procedures indicate their effectiveness.

At the final step of this pathological process, the cartilage is destroyed, and instead of it, coarse connective tissue grows. As a result of such changes, the joint is deformed and can no longer perform its functions. To prevent this from happening, chondroprotectors are used. The price of them is low and allows you to apply them quite widely.

Unfortunately, they act only at the initial stages of cartilage tissue destruction 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 cartilage tissue regenerates extremely slowly. The duration of the course, the mode of administration, which injections into the knee joint and in what dosages to produce, all this is determined and prescribed by the doctor individually for each patient, based on the initial condition and observing the changes during treatment.

Ways and methods of treatment

Treatment of arthrosis can be medication and surgical. Surgical treatment implies a joint replacement - endoprosthetics.

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

For treatment to give good results, it should be aimed at removing inflammatory processes, pain and restoration of cartilage. To do this, use:

• anti-inflammatory non-steroidal agents;
• intraarticular drug injections;
• local warming agents to improve blood flow in the affected area (in the form of ointments, gels and creams);
• chondroprotectors.

Non-steroidal anti-inflammatory drugs

Medicines of this type relieve inflammation, swelling, have an antipyretic and analgesic effect.

According to the severity of the analgesic effect, the most powerful are: "Ibuprofen", "Diclofenac sodium" ("Voltaren"). NSAIDs do not cause euphoria, drowsiness, addiction, drug dependence, but their prolonged use is detrimental to the gastric mucosa. Therefore, for the relief of acute pain, Diclofenac (injections) is prescribed. The price of five ampoules in a package is about two hundred rubles. Application: intramuscularly for two to five days, and then transferred to the tablet form of the drug (if necessary).

It is also possible to use "Ketonal" - injections intramuscularly or intravenously, as well as injection forms of "Flamax", "Arthrosilene". With intravenous administration, the intervals between procedures should be at least 8 hours.

Hormonal corticosteroids and chondroprotectors

The price becomes not so important if the pain overcomes, and ointments or creams are no longer effective. 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 the destruction of the joint and often cause adverse reactions.

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

Chondroprotectors are drugs and drugs that contribute to the formation of completely new structural elements of cartilage tissue. They regenerate it and prevent further destruction.

Chondroprotectors include 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 themselves.

Release Forms

Currently, pharmaceutical companies produce chondroitin and glucosamine in the following forms:

• solutions for injection;
• creams, ointments, gels;
• capsules, oral powders, tablets.

Three generations of chondroprotectors are distinguished:

1. The first is of animal origin. Usually well tolerated, the effect occurs quickly, but can lead to allergies. This type includes drugs such as Rumalon and Alflutop.
2. The second - synthetic preparations of chondroitin sulfate (Chondroxide, Structum, Chondrolon, Mucosat), glucosamine (Don, Elbon, Sustilak) and hyaluronic acid (Fermatron, Sinvisk, “Hyaluron”, “Hyalgan”)
3. Third , complex (combined) medicinal substances that contain various combinations of chondroitin and glucosamine ("Arthra", "Teraflex").

Classification by route of administration

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

1. Intra-articular injections are the most effective method, as the effect develops quickly and lasts long enough. To repeat such manipulations is necessary only a few times a year. It is suitable for preparations that contain hyaluronic acid, such as Gialgan, Fermatron. The disadvantages of this method include the fact that injections into the joints are medical manipulation and are carried out in a hospital. Most often, the introduction of chondroprotectors is carried out in the knee joints.
2. Intramuscular injections are a convenient and widespread method of administering chondroprotectors. In this way, Alflutop, Chondrolon, Artradol, Chondrogard and many other intramuscular preparations are administered. Suitable for patients who, for various reasons, are unable to swallow a tablet or capsule or have severe kidney disease.
3. Capsules and tablets are the most used and widespread method of drug administration. It does not require aseptic conditions, the intervention of specially trained personnel, suitable for independent use. However, this method also has drawbacks: a long course of treatment, a large drug load on the liver and kidneys.
4. External use in the form of creams, ointments or gels - the method is good as an addition to the oral route of administration, but not as monotherapy. Hyaluronic acid and chondroitin preparations 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, you can use Diclofenac "(injections). The price of external preparations is in the range of 200-600 rubles.

The most effective drugs

The most effective remedy is Alflutop (SC Biotehnos, SA; Romania). The basis of the drug is the extraction of four species from marine organisms. The low-fat concentrate is free from impurities and proteins. The main effect of the drug is aimed at regulating metabolic processes in the tissues of the cartilage.

Similar effects are possessed by such drugs as Chondroxide, Chondrolone, Structum, Don. Application: intramuscularly, deeply, 1 ml daily for three weeks.

With the participation in the process of large joints, the introduction is carried out intraarticularly one or two milliliters into each diseased joint once every three to four days (the total number is five to six injections), and then intramuscular injections, which are carried out for twenty days. Repetition of the course should be done in six months.

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

The approximate price in pharmacies is 3300 rubles per package.

The drug "Rumalon"

Rumalon was recognized as another effective drug (CJSC Bryntsalov A, Russia). It includes an extract of the brain and cartilage of the calf trachea.

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). Injection courses should be repeated twice a year at least or up to four times a year with a complicated course of the disease over several years.

Available in packs of ten ampoules containing one milliliter of the finished solution.

The approximate price in pharmacies is from 1100 rubles per package.

Drugs with glucosamine and chondroitin

Classical and widely used are such means:

1. "Don" - a glucosamine preparation, is a powder for oral administration and a ready-made solution in ampoules for injection. It is made by the Italian company Rottapharm. The price of packaging is from 900 to 1600 rubles.
2. "Artradol" is a chondroitin preparation for intramuscular administration of the production of the Russian company "Trivium". The package can be 10 or 5 ampoules of 2 ml. The price is about 700-1000 rubles per package.
3. Chondrolon is a solution of chondroitin sulfate in ampoules of Russian manufacture. One package priced from 1000 to 1300 rubles contains ten ampoules.
4. Structum is a capsule-based preparation of chondroitin sulfate, manufactured by the French company Pierre Fabre Medicament Production. Available in two dosages - 500 and 250 mg. The price in pharmacies is approximately 700 - 1500 rubles per package.

Combinations of chondroitin and glucosamine

Combined medications:

1. "Arthra" - pills. Are made by the American company UNIPHARM. They contain glucosamine hydrochloride in a dosage of 500 mg and chondroitin sodium sulfate 500 mg, practically do not have side effects. Release form - tableted, 30-120 pcs. in the package, the price varies from 500 to 1900 rubles, depending on their quantity.
2. "Teraflex" - a complex preparation of the American company Sagmel, contains chondroitin 400 mg and glucosamine 500 mg, is available in cream and capsule form. 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 by the presence of ibuprofen in the composition of a non-steroidal anti-inflammatory drug. Together with oral administration of capsules, it is recommended to use chondroitin and glucosamine preparations externally (“Teraflex” in the form of a cream).

Injections into the knee joint for arthrosis: hyaluronic acid preparations

The most common hyaluronic acid preparations in pharmacies are currently:

1. “Ostenil”, “Sinokrom” and “Sinokrom Forte” - from Austria and Germany, “Fermatron” - from the UK, “Suplazin” - from Ireland.
2. Not so often, but still there are such drugs as “Viscosil” (Germany) and “ViscoPlus” (Sweden), Italian “Gialgan”, “Giallux” (South Korea), American “Synvisc” and “Duralan Es Jay”.
3. Of the drugs produced in Russia, Intraject Gialoform (Tuscany Moscow) and Giastat (Tula) are distinguished.

Hyaluronic acid preparations for injection into the joint are available in ready-made form in disposable syringes, which is very convenient for use.

Intra-articular injections in the knee joint with arthrosis, hyaluronate-based drugs affect the diseased organ in three directions:

• reduce friction and increase amortization due to the fact that they increase the amount of synovial fluid and its viscosity;
• intensively nourish the cells of cartilage tissue, 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 into the knee joint is a modern tool for the treatment of diseases associated with the musculoskeletal system. In 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 fluid implant significantly reduces the load on the joint, supplies the cartilage with nutrients and forms a natural prosthesis, which is very similar in composition to human synovial fluid.

Also effective are drugs containing chondroitin and glucosamine.

Intra-articular administration of these drugs has a quick and lasting effect.