SURGICAL TREATMENT OF PATIENTS WITH OSTEOARTHRITIS OF THE KNEE JOINTS

Abstract

Introduction. Osteoarthritis affects 7 % of the world’s population. The number of affected people worldwide increased by 48 % from 1990 to 2019. At the initial stages of knee osteoarthritis treatment, conservative treatment and corrective osteotomies are used. Corrective osteotomies in the area of the knee joint have shown excellent results for the treatment of limited arthrosis with a predominant lesion of the medial part of the joint in relatively young patients. However, despite the good results reported in the literature, patient satisfaction usually deteriorates over time, and some inevitably require further treatment with total knee arthroplasty in cases of progression of osteoarthritis.
 The aim of the study. On the basis of a retrospective analysis of surgical treatment of patients with osteoarthritis of the knee joints, justify the differentiated use of surgical interventions.
 Materials and methods. The article considers a differentiated approach to peri-articular osteotomies and primary endoprosthesis in gonarthrosis, in particular, in the focus of the endoprosthesis selection algorithm, based on related factors, such as the stage of the disease, the patient’s age, and the presence of concomitant complications, including the presence or absence of aseptic necrosis, contractures, instability ligamentous apparatus and defects of the condyles of the tibial bone. 391 knee joints were operated on in 383 patients.
 Results. In general, good results were obtained in 65 % (210 people) of endoprosthetics. The patients felt well, did not feel pain, did not limp, the range of motion was restored within normal limits, there was no deformation of the joint, the axis of the limb was correct, the joint was stable. Satisfactory results were obtained in 35 % (114 people), the patients felt well, did not feel pain, moderate lameness remained, range of motion was limited to no more than 800, there was no joint deformation, the axis of the limb was correct, the joint was stable. No unsatisfactory results were obtained.
 Conclusions. The developed differentiated approach to operative treatment of patients with osteoarthritis of the knee joints allowed to obtain 65 % good and 35 % satisfactory results.
 The prospect of further development in this direction continues due to the improvement of the design of endoprostheses and the technique of surgical intervention