Osteonecrosis initially brings pain, according to the affected district, it is compounded by the load and walking. As the disease progresses, local fractures can occur up to the collapse of the bone in the most severe cases, with high painfulness even at rest. Patients may have had symptoms for more than a year before bone necrosis is diagnosed. Typically they report, associated with growing pain, difficulty in performing "normal" gestures until just before (going up or downstairs, walking, running). This difficulty can go as far as forcing the patient to use walking aids, even relegating him to bed or wheelchair.
The avascular necrosis of the knee or osteonecrosis of the knee or aseptic necrosis, similar to ' osteonecrosis of the femoral head, is a disease very similar myocardial infarction It occurs when a more or less extensive part of the knee bone no longer receives adequate blood perfusion. Ischemia then leads to bone death. Later, local fractures and bone collapse can occur in severe cases.
What are the symptoms?
Osteonecrosis is manifested by intense pain that increases when the patient moves the joint.
Pain is often present even at rest. In the early stages, it does not involve limitations in the movements of the joint, which instead occur in the later stages of the disease when secondary arthrosis of the knee occurs. Unlike degenerative diseases, this pathology usually has a rather abrupt onset and mainly affects the medial femoral condyle.
What are the causes of osteonecrosis of the knee?
It occurs when the disease occurs without a known cause.
However, there are risk factors that can determine the onset of the disease and are:
• alcohol abuse
• hyperuricaemia (a high plasma concentration of uric acid is present in the blood)
• dyslipidaemias (cholesterol and high triglycerides)
• diabetes mellitus
In this case, the pathology occurs due to a pre-existing morbid condition :
1. a knee injury
2. protracted cortisone therapy
3. high-dose local radiation therapy
4. a gas embolism, which is a decompression sickness
Like osteonecrosis of the femoral head, which affects the hip, the variety of factors underlying the secondary forms of avascular necrosis of the knee (hemidemiology) is very numerous, so much so that it is not possible to identify age or gender at greater risk.
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What tests are needed to diagnose it?
The first investigation to be performed is standard radiography, which allows excluding most of the diagnoses.
Unfortunately, however, in the early stages of traditional radiography, it can be perfectly negative, because the morphological alterations that characterize the last stages of the disease have not yet occurred.
Therefore, if a patient who accuses knee pain falls into the "at-risk" categories previously seen, but has a normal "plate", the orthopedist should request an MRI, which allows identifying the necrotic lesion before it determines the morphological changes visible on the radiography.
This is an expensive test and it is useful to reserve only for patients for whom the radiography is not conclusive.
In advanced necrosis, the use of MRI is useless: the traditional "plate" is more than enough.
How is osteonecrosis treated?
When the bone undergoes an ischemic process, the chances of recovery progressively decrease as the disease progresses.
In fact, only the initial necrosis offers hopes for recovery.
When the disease is in its infancy, core decompression (or microperforations) operations are mainly used . The goal is to facilitate drainage and revitalize the necrotic bone.
The surgeon drills a hole in the bone to extract the damaged area, thus improving vascularization and the formation of a new bone. This is an intervention that cannot guarantee healing, but the chances are greater the earlier treatment.
In the final stages, however, osteonecrosis of the knee irreversibly evolves towards gonarthrosis, which is a degenerative disease and therefore can only be treated with palliative therapies and implantation of a prosthesis.
Home Remedies for Knee Pain
There are some common but established ways to reduce knee pain.
Massage with 'Essential Oil':
Massage is very useful for pain in all joints of the body, not just the knees. And using 'essential oil' in this massage can be more beneficial. ‘Essential Oil’ made from ginger and orange helps in curing knee pain. These oils relax muscles and reduce pain in the affected area.
Heat and cold:
Applying hot ice to the affected area is beneficial. However, depending on the type of pain, do not take steam or rub ice.
If there is an infection or inflammation in the knee, hot steam should not be given, as it may increase the severity of the problem. Hot steam is very effective in curing chronic knee pain such as arthritis. And ice should be applied to the pain caused by sports and accidents.
Apple Cider Vinegar:
It contains anti-inflammatory ingredients that can relieve chronic knee pain like arthritis. Apple cider vinegar lubricates bone joints, which will reduce pain and facilitate movement. Before going to bed at night, mix half a cup of apple cider vinegar in a glass of water and drink it every day.
Eating ginger oil, extract or ginger directly is beneficial for the knees. Ginger is rich in gingerol, a natural anti-inflammatory. Drinking two cups of ginger tea every day will also be beneficial.
Turmeric has been well known since ancient times due to its medicinal properties. It contains another powerful anti-inflammatory ingredient 'Curcumin', which is very effective in curing bone joint pain and inflammation. Mix ginger and turmeric powder in a glass of water and boil it for 12 to 15 minutes and drink it daily.
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