Including patients' health education, self-training, weight loss, aerobic exercise, joint mobility training, muscle strength training, walker use, knee varus wedge insole, occupational therapy and joint protection, and auxiliary facilities for daily life. A considerable number of patients in Europe and America can alleviate symptoms and return to normal life and work through the above treatment. China's investment in this area and the concept of medical staff are still relatively weak, and medical staff at all levels should pay attention to strengthening this work in the future.
medicine
(1) Sodium hyaluronate is the main component of synovial fluid in joint cavity and one of the components of cartilage matrix, which plays a lubricating role in joints and reduces the friction between tissues. After being injected into the joint cavity, it can obviously improve the inflammatory reaction of synovial fluid, enhance the viscosity and lubrication of synovial fluid, protect articular cartilage, relieve pain and increase joint mobility. Intra-articular injection, 1 time 25mg, 1 time for 5 weeks, must be strictly sterile.
(2) Glucosamine is the most important monosaccharide that constitutes glycosaminoglycan (GS) and proteoglycan in articular cartilage matrix. Normal people can synthesize GS by glucosamine, but the synthesis of GS in chondrocytes of patients with osteoarthritis is blocked or insufficient, which leads to the softening and loss of elasticity of cartilage matrix, the destruction of collagen fiber structure, the increase of cartilage surface cavities and the wear and tear of bones. Glucosamine can block the pathogenesis of osteoarthritis, promote chondrocytes to synthesize proteoglycan with normal structure, inhibit the production of enzymes (such as collagenase and phospholipase A2) that damage tissues and cartilage, reduce the damage of chondrocytes, improve joint mobility, relieve joint pain and delay the course of osteoarthritis. Oral 1 time 250 ~ 500 mg, 1 time three times a day, with meals. The weakness of glucosamine is that its monomer can not promote human cartilage regeneration.
(3) Non-steroidal analgesic and anti-inflammatory drugs: can inhibit the synthesis of cyclooxygenase and prostaglandin, resist inflammatory reaction, and relieve joint edema and pain. Ibuprofen/kloc-0, 200 ~ 400 mg each time,/kloc-0, three times a day; Or glucosamine 1 time 200mg, 1 time 3 times a day; Nimesulide 1 time 100mg, 1 time twice a day for 4 ~ 6 weeks.
Surgical therapy
If the symptoms of hip arthritis are very serious, drug treatment is ineffective, and it affects the daily life of patients, surgical intervention should be considered. However, there are some short-term and long-term complications in joint replacement surgery, such as loosening and wear of components, osteolysis and so on, which can not be completely solved at present. Because the effect of artificial joint replacement is closely related to the length of operation, the doctor's experience, the patient's preoperative physical condition, perioperative management, rehabilitation training and so on. Therefore, the implementation of artificial joint replacement surgery needs to be cautious.