RU2093217C1 - Method of treatment of degenerative dystrophic and posttraumatic diseases of joints - Google Patents

Abstract

FIELD: medicine; traumatology and orthopedics. SUBSTANCE: synovial membrane inside joints is irradiated by helium-neon laser light of 0.2-1.5 mW power for 5-10 min, once in the course of 3-7 days. EFFECT: more efficient treatment.

Description

 The invention relates to medicine, in particular to clinical medicine.

 Of the existing methods of laser therapy of joint diseases, the following analogs can be given as an example. Copyright certificate SU N 1146064 "Method for the treatment of arthrosis", the authors I.L. Pshetakovsky and T.V. Shutova. Before laser irradiation, acupuncture points and the affected area are exposed to air under pressure for 6-10 minutes, while the first procedure reduces the pressure under this skin area by 500-700 mm Hg. Art. and in subsequent procedures, they lower the pressure by 250-300 mm Hg. moreover, in the first, fourth and last procedures affect the acupuncture points of general action, and the rest on the affected area. The course of treatment is up to 25 sessions.

The author’s certificate SU N 1296177, A 61 N 5/06, 1987 was selected for the prototype. A Kassirsky needle is inserted into the pathological bone site, the mandrin is removed, the fiber is inserted through the needle, connected to the laser system and irradiated with monochromatic polarized radiation in the red spectral region with a length waves 632.8 nm, with a power density at the output of the optical system of 1 1.4 mW / cm ² (radiation power of 0.5 0.7 mW). Irradiation is carried out for 30 to 90 s with a repetition of the session after 48 hours. On average, 5 8 radiation sessions are provided per treatment course.

 The disadvantage of the prototype is the need for puncture of the bone (often with degenerative joint diseases, puncture of the joint with rinsing of the cavity, intra-articular administration of drugs, the possibility of which is excluded in the prototype), 5 8-fold course of treatment, which makes it rather traumatic.

 New in the present work is the intra-articular introduction of the fiber and irradiation with the helium-neon laser light directly of the synovial membrane in degenerative-dystrophic and post-traumatic joint diseases.

 The method is as follows. Under aseptic conditions, a joint is punctured, a fiber is inserted through a needle, connected to an LG-115 laser unit and laser irradiation is performed with a wavelength of 632.8 nm, with a radiation power of 0.2 to 1.5 mW at the output of the fiber, for 5 10 min in continuous mode, 1 time in 3 7 days. On average, 1 3 radiation sessions are provided per treatment course.

 Example 1. Patient C. Diagnosis based on clinical data, nuclear magnetic tomography, x-ray picture: post-traumatic deforming arthrosis of the III stage flexion-extensor contracture, hallux valgus deformity of the left knee joint. At the beginning of treatment, the patient undergoes a thermal imaging examination of the joints, rheovasography of the lower extremities, CRP, and ROE-blood.

 The initial data are as follows.

 On thermograms, the lower limbs are poorly visualized due to a gross microcirculation disorder on both limbs. There is evidence for inflammatory changes in the area of the left knee joint.

 According to rheovasography, vascular hypotension on both sides with initial inconstant signs of venous dysfunction. SRB "+", ROE 18 mm / hour.

 The patient is punctured from the upper-external access of the left knee joint. A fiber is introduced, connected to the laser unit LG-115 (Falm-1) and laser irradiation is carried out with a wavelength of 632.8 nm and a radiation power of 0.5 0.7 mW for 5 minutes.

 After the first session of irradiation of the synovial membrane, the following data were obtained.

 On thermograms, the restoration of microcirculation in the distal extremities and the disappearance of signs of inflammation in the left knee joint. SRB "-", ROE 10.

 After the first session, the patient notes the disappearance of pain.

 After 5 days, a second session of intraarticular laser therapy was performed.

 Control examination.

 Thermograms of the lower extremities show an improvement in dynamics consisting in the disappearance of signs of inflammation in the region of the left knee joint. According to rheovasography, a moderate increase in the level of pulse blood filling is noted on the left. SRB "-", ROE 8.

After the second session, the patient notes the absence of pain, the disappearance of flexion contracture (10 ^o ) of the left knee joint.

Example 2. Patient B. Diagnosis based on an anamnesis of the disease, clinic, x-ray data: post-traumatic deforming arthrosis of the right knee joint within 20 ^o .

 Six years ago, after an injury, surgery was an arthrotomy, meniscectomy, plastic surgery of the anterior cruciate ligament. Twice a year, outpatient, inpatient intra-articular administration of hormonal drugs.

 Upon admission, the patient is concerned about pain, restriction of movement in the knee joint.

 On the thermogram there is a deformation of the thermal pattern of the right knee joint, there are no signs of synovitis and pronounced inflammatory changes in the area of the knee joints. ROE 14 mm / hour, L 9.8, SRB "+".

 The patient is punctured from the upper-external access by the right knee joint. A fiber is introduced, connected to the LG-115 laser unit (Falm-1 apparatus) and laser irradiation is carried out with a wavelength of 632.8 nm and a power of 0.5 0.7 mW for 10 min.

 After the first session, flexion contracture disappeared. After 5 days - the second session of laser therapy.

Control examination
On the thermogram, microcirculation in the distal extremities is wealthy. The right knee joint without visible pathology. ROE 8mm / hour, L 9.4, SRB "-".

 The patient notes a complete absence of pain, flexion contracture, the gait is correct. The introduction of hormonal drugs into the joint cavity was not performed.

 The technical result is a reduction in treatment time, a decrease in the drug load on the patient’s body due to direct helium-neon irradiation of the synovial membrane of the affected joint.

Claims (1)

 A method of treating degenerative-dystrophic and post-traumatic joint diseases by exposure to helium-neon laser radiation, characterized in that the irradiation is carried out intraarticularly directly on the synovial membrane with a power of 0.2 1.5 mW for 5 to 10 minutes, every 3 to 7 days.