I found a draft of CCTV's "Road to Health" program, which should be helpful to you ~ Don't worry, your grandfather will be fine!
Moderator: Many elderly people think that leg pain is normal when they are old and do not need treatment. Is this right?
Lv Wei: This idea is wrong. Under normal circumstances, there will be no pain in the legs. Pain indicates that there is something wrong with the joint and should be paid attention to. Every part of the elderly body, including joints, will have certain degenerative changes. We call it osteoarthritis, which can also be called proliferative arthritis, senile arthritis and degenerative arthritis. The reason why osteoarthritis occurs gradually with the increase of age is that the joint damage is accumulating, which leads to cartilage damage and joint degeneration. In addition, with the increase of age, the nutrition of cartilage is hindered, and the brittleness of joints increases, which is also prone to problems. Osteoarthritis is a common disease, the incidence rate is as high as 3%-9%. 55 -65 years old, the incidence of osteoarthritis is the highest, accounting for 30%-40% of osteoarthritis.
Moderator: Besides age, what other factors are related to the occurrence of osteoarthritis?
Ma Ben: The related factors of osteoarthritis include 1 and gender. Older women are 2-3 times more likely to suffer from osteoarthritis than men of the same age. 2. obesity. 3, joint trauma, ligament injury, joint deformity. 4. Metabolic diseases. 5. Genetic factors.
Lv Wei: Osteoarthritis varies widely. Let's look at a model. The knee joint consists of three parts: femur of thigh, tibia of calf and patella in front of knee. The femur and tibia form the articular surface of tibia. There is a special structure (purple part) between tibial joints, which is meniscus. One is filled between the medial joint and the lateral joint, and a joint is also formed between the patella and femur. Ligament structure connects femur and tibia. The changes of osteoarthritis usually occur in early osteochondrosis (the surface of femur, tibia and patella). Understand the change process through an animation. The articular cartilage on the surface of the femur is very smooth, and it will be grumpy, uneven and lose its luster after the cartilage changes. With the progress of the disease, cracks will appear on the cartilage surface of the acute child, and pain will appear at this time. Once broken, it can fall off along the broken part, and the fallen cartilage may be absorbed by wear and tear, which will not directly cause great damage. Once the broken cartilage falls into the joint cavity, it will form a free body.
Ma Ben: The patient began to feel slight pain. With the progress of the disease, the pain will get worse and the patient will be very painful. Osteoporosis in the elderly is most likely to cause fractures in other parts.
Lv Wei: Severe osteoarthritis can lead to joint flexion and extension disorders, knee varus and valgus.
Moderator: Some patients didn't care too much about the pain at first, and didn't go to the hospital until the pain worsened. Is there any better way to relieve the pain?
Lv Wei: In this case, the effect of simple conservative treatment will not be very good. The ideal treatment is arthroscopic debridement. Let's watch a movie. We can directly observe the structure in the joint through arthroscopy and perform surgery in the joint cavity through instruments. This is a minimally invasive operation, and we can clearly see the structure in the joint from the monitoring picture. Arthroscopic surgery is suitable for the diagnosis and treatment of all intra-articular diseases.
Ma Ben: This method is suitable for early and middle arthritis surgery. Once it reaches the advanced stage, it is necessary to use artificial joint replacement, but there are exceptions. For example, if the elderly patients are complicated with various internal diseases and the condition and conditions do not allow major surgery, they can also be cleaned up through arthroscopy or improve their condition.
Lv Wei: At the same time of early conservative treatment, we should further clarify whether there are other direct causes of osteoarthritis and should treat it according to the causes. Once the symptoms get worse, arthroscopic examination and arthroscopic treatment should be carried out in time to prevent the further development of the disease. It is possible to restore function after arthroscopic surgery for 3 months, and strenuous exercise that damages joints should be avoided.
Moderator: Ms. Feng from Beijing, 26 years old. My grandfather is 7 1 years old and his knee hurts 17 years. Now my knees are getting thicker, and it is difficult to squat. How should I treat them? Can you stand surgery at your age?
Ma Ben: It can be operated. According to the typical manifestations of the patient, such as joint thickening, joint deformation, etc., and no other medical history, it is estimated that it is intermediate and advanced osteoarthritis. Arthroscopic cleaning can be performed to improve joint function and relieve pain. If the patient is complicated with other medical diseases, the operation can be adjusted appropriately before operation.
Moderator: Ms. Geng, from Sichuan, is 20 years old. My aunt is 45 years old this year. When she was young, she had varus knees. In recent years, her inner knee hurts. She went to the hospital for filming and found no obvious abnormality. What kind of disease is this? How to treat it?
Lv Wei: O-leg is a common direct cause of osteoarthritis. Let's watch a movie. On the left is the normal X-ray of knee joint, the blue line is femur and femoral axis, and the red line is calf axis. Generally, they form a small included angle, and the red line is on the right. The X-ray film on the right is the X-ray film of the patient with genu varus, and the red line in the film is on the left, indicating that the calf has varus, and the stress on the medial joint space increases, which increases the chance of cartilage injury. Generally, patients with genu varus will suffer from medial pain of knee joint around 40 years old, forming early osteoarthritis. There is no obvious abnormality in the X-ray film of the patient, which indicates that the cartilage injury of the patient's knee joint is still light and has not reached the extent of extensive injury, and the medial space is still normal. In this case, the most appropriate treatment is to repair the damaged cartilage under arthroscopy, and then directly observe the cartilage damage in the lateral space. If there is no injury, orthopedic surgery can be performed at the same time or later to correct the varus angle of the knee joint and avoid the further development of osteoarthritis.
Moderator: Mr. Zhang from Shanghai, 53 years old. My right knee often hurts, but it's okay to walk on a flat road. Mainly knee pain, there is a "squeaking" sound when squatting. What happened? Do you need treatment?
Lv Wei: This is a typical knee pain. It should be a disease of patella joint, as shown in the figure, the patella is above and the femur is below. There is a V-shaped groove in front of the femur, and the patella corresponds to it. The medial and lateral gaps are equal. When the patella joint is abnormal, it will be damaged to form cartilage damage, and there will be a "squeaking" sound after rubbing. Treatment is necessary. Repair the damaged cartilage under arthroscopy first, and then perform arthroscopic patella balancing surgery. After solving the problem of patella tilt, the condition can be completely controlled.
Moderator: Ms. Liu from Jiangxi, 30 years old. My mother always can't eat when she goes upstairs and downstairs, and her knees hurt. What should I do?
Ma Ben: This patient is a manifestation of early osteoarthritis. If the effect of drug treatment (more than 4 weeks) is not good, arthroscopy should be performed first, and then symptomatic treatment should be given.
Moderator: Let's look at several common functional training methods, including the experiment of straight leg elevation, which can practice the strength of thigh muscles, knee flexion and joint activity training under no load. After this kind of training, patients usually need to reach about 500 times a day-1000 times, or they can hook their feet backwards after straightening their feet, and stick to 10 seconds each time, and then rest10 times. Training can be carried out 1-2 days after operation.
Moderator: Mr. Wang from Gansu, aged 27. My uncle is 45 years old. When I was young, I got Kaschin-Beck disease, and my whole body was swollen and painful. In recent years, his knees and ankles are obviously swollen and painful, which affects his activities. He went to the hospital several times and refused to replace the artificial joint. Is there any other way?
Lu Wei: Kaschin-Beck disease is an endemic disease, mainly the destruction of articular cartilage, which is characterized by multi-joint pain and severely limited function. The patient's condition will not have a good curative effect through conservative treatment, and arthroscopic cleaning can relieve the condition and improve the function.
Moderator: Mr. Hu from Hunan, 46 years old. I have been suffering from osteoarthritis for 4 years. My knee hurts and I feel cold. What should we pay attention to in life?
Ma Ben: Judging from the patient's symptoms, it should be the change of patellofemoral joint. Besides rheumatism, people with bone and joint diseases are afraid of cold. It is suggested that patients go to the hospital for further diagnosis, so as not to ignore the existence of other diseases.
Moderator: Ms. Wang from Beijing, 49 years old. I stayed in the air-conditioned room for a long time because of my work. Now my knees are cold every night, and I feel cold outside. What should I do?
Lv Wei: You can adjust the temperature of the air conditioner properly and take some protective measures, such as wearing knee pads and taking medicine orally.
Moderator: Mr. Wang from Beijing, 35 years old. My knee feels sore every morning. I didn't find any problems when I made the film. What is the reason?
Ma Ben: The internal structure of the knee joint is complex, and it is difficult to find problems with ordinary X-ray films. Even through B-ultrasound, magnetic vibration and other examinations, it is difficult to find tiny soft tissue lesions of the knee joint. It is suggested that patients should be examined by arthroscopy and treated by surgery if necessary.
Moderator: Ms. Zhang from Tianjin is 40 years old this year. I have hyperosteogeny in my kneecap and my legs are a little deformed. The doctor said it had something to do with bone spurs. Now my leg hurts. How should I treat it?
Lv Wei: Knee pain has little to do with bone spurs. Generally, the formation of bone spurs means joint degeneration, but joint degeneration is one of the manifestations of osteoarthritis. Patients should be treated by arthroscopic minimally invasive surgery for those bone spurs that affect their function and cause pain.
Moderator: Ms. Hou, from Shenyang, 38 years old. My right leg and knee joint often hurt for about two years. Now I can't lift my right leg and abduct it. How should I treat it?
Ma Ben: The patient's symptom is the change of early osteoarthritis, which needs further examination and then symptomatic treatment.
Lv Wei: I suggest that patients with osteoarthritis must distinguish between the concepts of functional training and excessive injury. Whether after conservative treatment or surgical treatment, we should increase the functional training of knee joint at any time to make functional training a part of life.