آرتروز زانو

صفحه اصلی / آرتروز زانو

آرتروز زانو هنگام از بین رفتن ماده ژلاتینی بین استخوان های مفصل و ساییده شدن دو استخوان به هم بوجود می آید. مفاصل بدن اجزای اصلی حرکت انسان به شمار می آیند، آرتروز ممکن است در هر مفصلی اتفاق افتد. زانو عضوی است که در معرض ابتلا به آرتروز و همچنین روماتیسم می باشد.

عوامل زمینه ساز آرتروز زانو

عوامل مختلفی وجود دارد که امکان ابتلا به بیماری آرتروز زانو را در فرد افزایش می دهد. برخی از این عوامل عبارتند از:

  • عوامل ژنتیکی
  • اضافه وزن
  • داشتن سابقه آسیب دیدگی زانو
  • چاقی مفرط
  • منیسک دیسکی شکل و کیست منیسک
  • بی ثباتی زانو به دلیل شلی رباط ها
  • دررفتگی ها و شکستگی هایی که درون مفصل رخ می دهد.
  • ابتلا به بیماری های درون مفصلی مانند: بیماری های عفونی در مفصل، آرتریت روماتوئید
  • ضربه و فشار ناگهانی که بر اثر اتفاق هایی مانند تصادف به مفصل زانو وارد می شود.
  • دفرمه شدن مفصل زانو، به طور مثال پای پراندزی یا پای ضربدری
  • بروز بیماری کندرومالاسی یا همان نرمی غضروف زیر کشکک
  • شرایط شغلی نامناسب باعث ایجاد فشار مضاعف به مفصل زانو می شود.

چگونه آرتروز زانو را بشناسیم؟

آرتروز زانو یک نوع بیماری است که در طی آن مفصل زانو دردناک و ملتهب می شود. همچنین لازم است بدانید که در این بیماری درد به صورت تدریجی و در طول زمان نمایان می شود. البته در بعضی موارد ممکن است درد به صورت ناگهانی رخ دهد. برخی از این علائم عبارتند از:

  • تشدید درد در هنگام انجام فعالیت
  • خم و راست کردن زانو همراه با درد فراوان
  • تشدید درد بعد از نشستن و استراحت کردن
  • خشکی مفصل زانو
  • تورم مفصل زانو

خشکی زانو به معنی قفل شدن زانو در هنگام حرکت کردن است. همچنین امکان شنیده شدن صدای قژ قژ و یا صدای تق تق زانو وجو دارد. دردی که به این خاطر بروز می کند ممکن است احساس ضعف و یا خمیدگی در فرد به وجود آورد. بسیاری از افرادی که به بیماری آرتروز زانو مبتلا هستند در هوای بارانی بیشتر متوجه آن می شوند.

در حین انجام معاینه فیزیکی، پزشک علائم زیر را مورد بررسی قرار می دهد.

  • بی ثباتی مفصل
  • تورم، گرمی یا قرمزی مفصل
  • احساس درد در مواقع تحمیل وزن بر روی زانو
  • محدوده حرکتی فعال و غیر فعال زانو
  • احساس تق تق در داخل مفصل در هنگام حرکت
  • وجود حساسیت به لمس زانو

چاقی و آرتروز زانو

یکی از عامل های مهمی که ممکن است احتمال بروز آرتروز زانو در مردان را افزایش دهد، چاقی است. افرادی که نمی خواهند به آرتروز زانو مبتلا شوند باید حواسشان به وزنشان باشد. طبق بررسی و تحقیقات انجام شده پژوهشگران به این نتیجه رسیده اند که نیاز به تعویض مفصل زانو در افراد چاق نسبت به افرادی که وزن معمولی دارند بیشتر است.

چاقی و آرتروز زانو

درمان آرتروز زانو

پزشک متخصص ارتوپدی خوب، راه های درمان را جهت تسکین و کاهش درد و رنج بیمار پیشنهاد می دهد، ابتدا پزشک متخصص ارتوپدی درمان های سرمایی را پیشنهاد می کند، بدین صورت که بیمار کمپرس یخ را به مدت 20 الی 30 دقیقه در طول روز روی زانو قرار دهد. همچنین پزشک داروهای چرک خشک کن بدون نسخه که تب بر هستند تجویز می کند. مسکن جهت کاهش درد و تب مثل استامینوفن نیز تجویز می شوند. همچنین ممکن است پزشک معالج فیزیوتراپی، برخی از پماد ها و پرچسب ها را جهت کاهش درد پیشنهاد کند که این ها تقریبا تا 33 تا 57 در صد از وضعیت مریض را بهبود می بخشد و به تقویت عضلات ساق پا و انعطاف پذیری زانو  کمک زیادی می کند.

معمولاً فیزیوتراپی و فعالیت های ورزشی از شدت درد می کاهد و تاثیر فراوانی بر روند بهبودی بیمار  دارد. انجام نرمش های ورزشی سبک  و نرمش های مخصوص حالت نشستن یا ایستادن می تواند از آرتروز زانو پیشگیری کند. در برخی مواقع می توان از زانو بندهای معمولی، یا در مواقع خاص می توان از زانوبندهایی که زانو را کاملا در حالت ثابت نگه دارد (زانو بندهایی شبیه آتل)، استفاده کرد تا مانع تحمل فشار زیاد بر روی زانو ها شود.

همچنین در برخی موارد می توان از کفش طبی مخصوص، که در راه رفتن مانع فشار آوردن به پا می شوند استفاده کرد. در صورت بروز التهاب و آرتروز و احساس درد شدید معمولا پزشک داروهای چرک خشک کن برای کاهش عفونت و خوابیدن ورم  و کاهش درد بیمار تجویز می کند، در صورت عدم بهبودی با روش های پیشنهاد شده، پزشک داوری تزریقی مسکن درد تجویز می نماید.

در نهایت اگر تمامی راه حل های پیشنهادی (استفاده از کمپرس یخ) نتیجه ای در تسکین درد نداشت، پزشک ارتوپد اسید هیالورونیک برای تقویت مفصل تزریق می کند که این ماده به شکل قابل ملاحظه ای شدت درد را کم و غضروف را نرم و انعطاف پذیر می کند (دقت شود این روش حتما باید توسط پزشک ارتوپد انجام شود). عمل جراحی آخرین گزینه در صورت بهبود نیافتن بیمار است که با ایجاد شکاف روی زانو قسمت از بین رفته آن ترمیم یا برداشته شده و در صورت نیاز کل مفصل تعویض می شود. همانطور که ذکر شد سعی پزشک ارتوپد بر نگه داری مفصل اصلی می باشد.

در حالت کلی روش های درمانی آرتروز زانو را می توان به شکل زیر بیان کرد:

  • دارو درمانی: در مراحل اولیه بروز این بیماری پزشک برخی داروهای خاص را برای بیمار تجویز می کند که مصرف دقیق و به موقع آن ها بسیار اهمیت دارد. همچنین لازم است بدانید برای افرادی که درد شدیدی را تحمل می کنند مسکن و داروهای قوی تری تجویز می شود.
  • تزریق: با تزریق استروئید یا ژل در داخل مفصل می توان میزان درد را کاهش داد.
  • مگنت تراپی: یکی از روش های پرکاربرد برای درمان و کاهش درد آرتروز زانو، مگنت تراپی است. در این روش یک میدان مغناطیسی با توجه به شرایط برای زانو تنظیم می شود. این امواج مغناطیسی موجب تنظیم جریان خون و افزایش گردش خون در ناحیه زانو می شود.
  • لیزر تراپی: در روش لیزر تراپی با استفاه از دستگاه های پیشرفته می توان به بهبودی این بیماری کمک کرد. لیزر تراپی امروزه به عنوان یک روش های موثر شناخته شده است. تعداد جلسات درمانی این روش وابسته به میزان درد و بیماری فرد است.
  • PRP: روش پی آر پی همان روش درمانی با پلاسمای غنی از پلاکت است. این روش به بیمار کمک می کند تا التهاب ناشی از آرتروز کاهش یابد.
  • طب سوزنی: انجام روش های مختلف طب سوزنی می تواند به درمان و کاهش در این بیماری کمک کند. اغلب بیمارانی که از این روش استفاه کرده اند شاهد نتایج خوبی بوده اند.
  • ماساژ: این روش می تواند موجب کاهش چشمگیر درد در بیمار باشد.
  • بریس یا زانو بند: استفاده از زانوبندهای طبی می تواند به درد زانو کمک کند.
ارتروز زانو

توصیه هایی برای افرادی که به بیماری آرتروز زان و مبتلا هستند

رعایت نکات و توصیه های زیر برای افرادی که به بیماری مفصل زانو مبتلا هستند ضروری است.

  • 30 دقیقه پیاده روی در روز روند بهبودی بیماران را بالا می برد.
  • افرادی که به این بیماری مبتلا هستند باید در هنگام نشستن و بلند شدن از روی صندلی دست های خود رابه عنوان حائل بر روی دسته های صندلی قرار دهند.
  • در صورت امکان کمتر از پله ها بالا و پایین بروند و بیشتر از آسانسور استفاده کنند. اما در صورتی که به وسیله های آسانبر دسترسی ندارند از پهلو از پله بالا یا پایین بروند.
  • از انجام دادن حرکات شدید و ناگهانی دوری کنند.
  • افرادی که به این بیماری مبتلا هستند، همچنین افراد مسن باید از نشستن در وضعیت هایی که مجبور به خم کردن زانوهای خود هستند، خوددرای کنند.
  • پوشیدن کفش های خشک و سفت ممنوع است؛ زیرا این کفش ها مانع از انجام حرکات طبیعی مچ پا و تحمیل فشار بر روی زانوها می شوند.
  • از پوشیدن کفش هایی که کف لغزنده دارند باید خودداری شود.
  • اگر این بیماری در افراد پیشرفت کند لازم است که نماز در پشت میز خوانده شود.
  • استفاده از سطح شیب دار نسبت به پلکان بیشتر توصیه می شود.

زمان بستری و استراحت پس از درمان آرتروز زانو

بنا به وضعیت مریض و شدت ابتلای وی به بیماری آرتروز مدت بازه زمانی استراحت مشخص می شود، بیمار می تواند به مدت 6 الی 12 هفته و به هنگام راه رفتن از عصا استفاده نماید، تا در این مدت فرصت کافی برای تشکیل بافت های جدید برای غضروف ایجاد شود. پس از یک الی سه هفته می توان کار روزانه را ادامه داد.

ورزش کردن پس از درمان آرتروز زانو

انجام نرمش های ورزشی بستگی به چند عامل دارد، که شدت ابتلای بیمار به آرتروز و نحوه درمان آن در پاسخ به این امر بسیار مهم است. در بعضی مواقع می توان از زانوی بیمار ام آر آی گرفت تا به جزئیات بیشتری دسترسی داشته باشیم.

در بسیاری از مواقع که شخص زانوی خود را عمل کرده و یا عمل تعویض مفصل زانو انجام داده، بیمار کاملاً بهبود یافته و می تواند وزش های سنگینی انجام دهد که فشار زیادی بر زانو می آورد. تعویض مفصل زانو یک روش درمان بسیار موفق و امن برای اشخاصی که از مشکلات زانو رنج می برند به شمار می رود.

دلایل ابتلا به آرتروز زانو

  • وزن:  افزایش وزن باعث افزایش فشار وارده به همه مفاصل و مخصوصاً مفاصل زانو می ‌شود. بدین ترتیب که هر کیلو اضافه وزن  می‌ تواند ۳ تا ۴ کیلو وزن اضافی به زانوها وارد کند.
  • وراثت:  این عامل می ‌تواند یک فرد را بیشتر در معرض ابتلا به آرتروز زانو در مقایسه با سایر اشخاص قرار دهد. این موضوع می‌تواند به خاطر مشکلات ارثی  ایجاد شود.
  • جنسیت:  زنان در سنین 60 سالگی و بالاتر از آن با احتمال بیشتری نسبت به مردان به آرتروز زانو مبتلا می‌شوند.
  • فعالیت‌ های ورزشی:  انجام فعالیت‌های ورزشی سنگین مثل فوتبال، تنیس، می تواند شخص را در معرض خطر ابتلا به ریسک آرتروز زانو قرار دهد. دقت شود نرمش های سبک می تواند تقویت عضلات شود و خطر ابتلا به آرتروز را کاهش دهد. در حقیقت، ضعیف بودن عضلات زانو می‌ تواند باعث ابتلای فرد به آرتروز شود.
  • آسیب‌های تکراری به زانو :  ممکن است آسیب هایی در نتیجه شغل  ها معمولاً در نتیجه نوع شغلی که فرد به آن اشتغال دارد ایجاد ‌شود. افرادی که به مشاغل خاص که نیازمند  فشار به مفاصل مثل زانو زدن، چمپاته، یا بلند کردن اجسام سنگین هستند، به احتمال بیشتری به آرتروز زانو مبتلا می‌شوند. در این حالت دلیل ایجاد مشکل، وارد شدن فشار ثابت به مفاصل به خاطر فعالیت شغلی فرد است.
  • سایر بیماری‌ها: افراد مبتلا به آرتریت روماتوئید که دومین نوع شایع آرتریت است به احتمال بیشتر به آرتروز زانو مبتلا می ‌شوند. علاوه بر این افراد دچار مشکلات متابولیکی، افزایش غیر طبیعی آهن خون و یا افزایش غیر عادی هورمون رشد نیز به افزایش بروز آرتروز زانو کمک می کند.

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