Сравнительный анализ эффективности артроскопии и комплексной терапии при лечении дегенеративных разрывов менисков у больных с остеоартрозом коленного сустава

Abstract

Aim: to evaluate the efficacy of conservative treatment in patients with degenerative meniscal tear (DMT) in the setting of knee osteoarthritis (OA) as an alternative to combined treatment. Patients and Methods: a prospective comparative study included 236 patients aged 45–65 years with DMT in the setting of stage I–III OA according to the Kellgren-Lawrence classification (70 of them — men). Group 1 consisted of 122 patients (86 of them — women) who underwent combined treatment: arthroscopy for DMT of the knee joint and complex therapy in the postoperative period: NSAIDs (celecoxib), a combined drug from the group of symptom-modifying slow-acting drugs SYSADOA (chondroitin sulfate + glucosamine sulfate), exercise therapy, physiotherapy. Group 2 (n=114) received only complex therapy. Control tests (pain assessment on the visual analog scale (VAS), WOMAC scale, life quality assessment on the EQ-5D scale, treatment satisfaction) were performed 10 and 20 weeks after the therapy initiation. Results: there was a statistically significant (p<0.05) improvement in VAS and WOMAC indicators, which continued to decline by week 20 after 10 weeks of both combined and conservative treatment. Also, it did not depend on gender, age, concomitant pathology, but on the body mass index and OA stage according to the Kellgren-Lawrence classification, which was confirmed by the results of the correlation analysis. Patients’ treatment satisfaction and improvement in their life quality were noted in 50% of patients in both groups. Conclusion: arthroscopic meniscectomy should not be indicated as the first treatment stage in patients with DMT during OA. Complex therapy, including the use of drugs from the NSAID and SYSADOA groups at the recommended doses, has demonstrated high treatment efficacy and safety of patients with DMT during OA. KEYWORDS: knee arthritis, degenerative meniscus tear, arthroscopy, celecoxib, chondroitin sulfate, glucosamine sulfate, life quality. FOR CITATION: Bessarab M.S., Krasnov G.O., Charchyan A.M., Khoroshkov S.N. et al. Comparative analysis of the arthroscopy efficacy and complex therapy in the treatment of degenerative meniscal tears in patients with knee osteoarthritis. Russian Medical Inquiry. 2021;5(2):71–77. DOI: 10.32364/2587-6821-2021-5-2-71-77.