RU2182832C1 - Method for administering conservative therapy of deforming knee joint osteoarthroses - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves exposing the joint to polarized light for 2 min acting upon articulation slits, superior entropion, the area of the proper knee pan ligament and the most painful areas. Chondroprotective preparation is introduced into the articulation cavity. EFFECT: enhanced effectiveness of treatment. 1 tbl

Description

 The invention relates to medicine, namely to orthopedics, and can be used in the treatment of deforming osteoarthritis (DOA) of the knee joints.

 A known method of using chondroprotective agents, in particular glycosaminoglycans (arteparone, mucartrin, rumalon, alfluton, etc.) for the treatment of DOA [I. V. Grandfather et al. Osteoarthritis. Ways of pharmacological correction. - Kharkov, 1992 .-- S. 63; D. Mitrovich. Drug therapy of osteoarthritis: status and prospects // Ter. Archive, 1993. - T. 65. - 5. - S. 69 - 72]. Chondroprotective agents stimulate biosynthetic processes in chondrocytes, increase the resistance of cartilage to the action of catabolism enzymes, and have a positive effect on the immunological and metabolic parameters of metabolic processes in the body. In the treatment with chondroprotectors, both intramuscular and intraarticular administration of drugs is used. Many authors (V. A. Radchenko et al., 1991) have proved the higher efficiency of intra-articular administration of chondroprotectors.

 However, chondroprotective agents often have to be used for exacerbation of DOA. Against the background of aseptic inflammation, increased permeability in the blood ---> joint direction, decreased function of lymphatic drainage, stable and increased intraarticular pressure due to the immobility of the joint, the effect of the drugs weakens. N.R. Eckenberger [Die Therapie der Gonarthrose mit Arteparon. Rheumamedizin, 1983, 5, p.32-40] showed higher efficacy in the treatment of gonarthrosis with arteparone after prior therapy with physiotherapy (UHF, microwave, electrical stimulation, mud baths).

 These types of physiotherapy are contraindicated in individuals with hypertension, tumor-like diseases, mastopathy, etc. (Handbook of Physiotherapy, 1992, p. 205).

 The anti-inflammatory, analgesic and repair-stimulating effect of laser radiation is known (V. I. Korepanov. Guide to laser therapy, 1995), the polarized light of which has no contraindications. Polarized light propagates in one direction, its wavelength is longer than that of ultraviolet radiation, and its energy range is lower than that of a laser beam, which explains its harmlessness to the human body (Guide. Lasers in a clinic of medicine, M., 1996, p . 379). In addition, polarized light directly affects weakened cells, stimulates regenerative processes, and strengthens the immune system.

 However, polarized light per se is not a pathogenetic means of influencing hyaline cartilage altered with DOA.

 The objective of the invention is to increase the effectiveness of the intra-articular action of chondroprotective drugs with DOA of the knee joints by acting on the joint before the introduction of chondroprotectors with polarized light.

 Stimulation of the action of chondroprotectors with intraarticular injection can increase their effectiveness in DOA of the knee joints during the period of exacerbation: severe pain, joint immobility, synovitis, and the use of polarized light does not have contraindications characteristic of electrophysiotherapy.

The task is achieved as follows:
In the position of the patient on the back, the Zepter Bionic lamp, emitting monochromatic light in the range of 400-2000 nm, was exposed to the affected joint. Radiation was carried out at the following points of the knee joint: 2 minutes per joint space from the inside and outside, 2 minutes to the upper inversion, 2 minutes to the area of the patellar ligament, and 2 minutes to the most painful areas of the joint (most often the internal condyle of the tibia). The total exposure time was 10-12 minutes. After that, under aseptic conditions, the applied chondroprotector was introduced from standard points into the joint cavity. The combined effect of the Bionic lamp and chondroprotectors was carried out every other day from 5 to 10 times, depending on the type of chondroprotector.

 Clinical example.

 Patient K., born in 1937 (outpatient card 3777), was treated at a trauma center 2 in Murmansk with a diagnosis of DOA of the right knee joint, decompensated form, 2 tbsp .; concomitant diagnosis: Uterine fibromyoma, node of the right lobe of the thyroid gland. Clinical, functional and X-ray examination of the patient (Zabolotnykh I.I. Examination of the ability to work and rehabilitation of patients and disabled with primary deforming osteoarthritis // Methodical recommendations. - L., 1986, - 25 pp .; G. Dubrovin, P. Kovalev. ., Storozhenko N.V. The system for assessing the severity and effectiveness of treatment of deforming osteoarthritis of large joints. // Collected Scientific Works. - Kursk, 2000. - P. 232-233) determined the severity of the disease at 22 points. A course of treatment of knee-jointed arterial arteries with a polarized light from a Bionic lamp and intra-articular administration of mucartrin was performed. Procedures were carried out every other day. The exposure to light was carried out on the lateral parts of the joint, the region of the patellar ligament, the upper joint inversion and the inner condyle. Each section was irradiated for 2 minutes, the total time was 10 minutes. After each irradiation, mucartrin in a dose of 1 ml was injected into the joint cavity. The course of treatment was 10 procedures. When examined after a month, the severity of the disease according to the same parameters is 15 points. Clinical observation showed persistent remission (2.5 years), the severity of the disease remains 14 points.

 In this way, treatment was performed in 20 patients with DOA of the knee joints. The control group of patients (26 people) was administered intra-articular chondroprotective administration according to the usual scheme (see table).

 The clinical effect was determined by the leading signs of DOA (pain, crunch, synovitis, range of motion) and was evaluated in points. Clinical observation of patients for more than 3 years consisted of a periodic clinical, functional and radiological examination and assessment of the severity of the disease in points. It was revealed that in patients with combined intraarticular administration of chondroprotectors and preliminary irradiation with polarized light in the indicated mode, a positive effect was obtained within 10-12 days, which is 1.5-2 times faster than in the control group. Persistent remission was obtained in 90% of patients (18 people), which is 28.5% more than in the control group.

 Thus, the task was achieved by potentiating the intra-articular administration of chondroprotectors by pre-exposure to the joint with a polarized light of the Bionic lamp in this mode, and irradiation was not a contraindication for concomitant diseases of elderly patients.

Claims (1)

 A method of conservative treatment of deforming arthrosis of the knee joints by intra-articular administration of chondroprotective drugs, characterized in that prior to their introduction, they additionally affect the joint with polarized light for 2 minutes on the joint spaces, upper inversion, the region of the patellar ligament and the most painful areas.

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