The causes of pain in osteoarthrosis and the factors of disease progression (a review of literature)

Zaytseva, Elena Mikhaylovna; Алексеева, Л. И.; Зайцева, Е. М.; Alekseyeva, L I

doi:10.14412/1995-4484-2011-867

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2011

DOI: 10.14412/1995-4484-2011-867

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The causes of pain in osteoarthrosis and the factors of disease progression (a review of literature)

Elena Mikhaylovna Zaytseva¹,

Л. И. Алексеева²,

Е. М. Зайцева³

et al.

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Cited by 4 publications

References 77 publications

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High tibial osteotomy in patients with stages 2 and 3 of knee osteoarthritis. Short-term result and factors affecting the outcome

Evgenievich¹,

Anatolievich²,

Ивановна³

et al. 2018

MOJOR

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Introduction: The most common form of osteoarthritis (OA) is osteoarthritis of the knee. Conservative treatment of OA is effective only in stages I and II of the disease. Meanwhile, increasing incidence of knee osteoarthritis and lowering ages of the disease onset makes high tibial osteotomy (HTO) more and more vital, allowing to extend the function of the own knee joint and to postpone or completely avoid total knee replacement (TKR). The aim of the study was to assess the effectiveness of НTO at 2-3 stages of knee osteoarthritis and to investigate the influence of age, body mass index (BMI) and correction angle on the nearest result of the operation. Materials and methods: during the period from 2003 to 2016, 35 HTOs were performed in 32 patients. The ratio of men to women was 2:1. The mean age was 59.0±13.1 years, a BMI of 29.04±3.57kg/m² and a correction angle of 12.5±2.78°. A visual analogue scale (VAS) was used to assess the pain severity. The Knee Society Score (KSS) was applied to assess the functional and objective state of the knee joint. The stage of the degenerative process was evaluated according to the X-ray classification of Kellgren-Lawrence. Results: The HTO was effective in patients with both 2nd and 3rd stages of knee osteoarthritis. One year after the operation, a significant reduction in VAS scores (from 72.27±11.79 mm to 7.72±6.62mm) and an improvement in functional and objective KSS scores (from 43.66±11.5mm and 54, 39±11.77mm to 86.51±10.86mm and 81.93±6.65mm) were observed. We obtained the following results of the HTO: excellent (36.4%), good (57.6%) and satisfactory (6%). The X-ray signs of progression of the disease were not revealed one year after the operation. The connection of BMI with the nearest result of the operation was revealed. (Spearman coefficient=-0.34 at p <0.05). Conclusion: HTO is more effective at the 2-nd stage of osteoarthritis of the knee compared with the third stage. Age and angle of correction do not affect the nearest result, while increased values of body mass index are associated with worse result and complications.

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High tibial osteotomy in patients with stages 2 and 3 of knee osteoarthritis. Short-term result and factors affecting the outcome

Evgenievich¹,

Anatolievich²,

Ивановна³

et al. 2018

MOJOR

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Knee arthroscopy for gonarthritis

Lisitsyn¹,

Zaremuk²,

Atlukhanov³

2019

Endosk. khir.

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Three-dimensional conformal radiation therapy for the osteoarthritis of knee joint: the radiobiological background, dose distribution analysis

Макарова¹,

Valkov²,

Третьяков³

2018

Issled. prakt. med. (Print)

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Osteoarthritis (OA) is the most frequent rheumatological pathology of the joints. Standard medical treatment does not always allow to stop the pain syndrome. The alternative method of pain treatment causes by OA is orthovoltage X-ray therapy (OVRT). It was used from 1970. The maximum dose by OVRT lies on the skin surface. Based on the modern methods of diagnosis, choosing the appropriate radiation energy, it is possible to reduce the amount of irradiation of the knee joint.The purpose. Is to present the technique of radiation planning in patients with gonarthritis and compare it with OVRT by dosimetry criteria.Materials and methods. Comparison of dose distribution plans of the orthovoltage beam was carried out according to the two-dimensional axial plan in the area of the isocenter for the energy of 200 kV from two tangential fields and a megavoltage energy beam of 6 MeV for a three-dimensional conformal radiation therapy using 3-and 6-fields isocentric irradiation techniques. To describe amounts of radiation were applied to the CTV (clinical target volume) and PTV (planning target volume). To estimate the volume distribution of the dose, bones forming the knee joint were contoured separately. The indent on the PTV was 3 mm.Results. The application of the 6-fields technique allows achieving 95% dose distribution at 93% of the volume, and 90% of the planned dose of 45 SGR covers 97% of the PTV. The average dose on the skin and the neurovascular bundle are of 150 and 240 cGy, respectively. The average radiation dose per course in critical anatomical areas is 280 cGy and 150 cGy. It can be considered that the target coverage for the compared methods is similar as for OVRT, and for 3D conformal radiation therapy plans for dose distribution of the orthogonal beam in the axial plane in comparison with dose distributions for conformal radiation techniques.Conclusion. The technique of three-dimensional conformal radiation therapy of the knee joint in OA with progressive pain syndrome can potentially lead to an increase in the analgesic eﬀect due to greater coverage with a dose of bone elements of the joint, which are a potential source of pain. Three-dimensional conformal radiotherapy megavoltage beam allows reducing the radiation load on the skin in 2.5 times, which can reduce the frequency of delayed adverse eﬀects.

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The causes of pain in osteoarthrosis and the factors of disease progression (a review of literature)

Cited by 4 publications

References 77 publications

High tibial osteotomy in patients with stages 2 and 3 of knee osteoarthritis. Short-term result and factors affecting the outcome

High tibial osteotomy in patients with stages 2 and 3 of knee osteoarthritis. Short-term result and factors affecting the outcome

Knee arthroscopy for gonarthritis

Three-dimensional conformal radiation therapy for the osteoarthritis of knee joint: the radiobiological background, dose distribution analysis

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