Differential approach to diagnosis and treatment of tendinites, enthesites and degenerative arthropathies

Abstract

Aim. To improve the results of treatment of periarticular tissue diseases and degenerative arthropathies at the expense of differential use of modern technologies.

Materials and methods. During the period of 2010–2017, examination and treatment of 10608 patients, suffering from the locomotor diseases, was carried out. There were 5792 (54,6 %) patients with degenerative arthropathies and 4816 (45,4 %) patients with tendinites and enthesites of different localization.

Results. The long-term results of treatment with chondroprotector Alflutop, used in complex therapy of 1969 (33,9 %) patients with arthropathies were studied for the period from 1 to 3 years. Pain syndrome was arrested after 4–5 injections. After 8–9 injections of this preparation, no pain syndrome was revealed, movement amplitude in the joint increased, patients returned to their previous work, Lequesne index declined and varied within the range of 3–6 scores. When using hyaluronic acid, pain syndrome was arrested in most cases after 2 injections. After the third injection of preparation, no pain factor was registered, movement amplitude in the joint increased, patients returned to their previous work, Lequesne index declined and varied within 3–6 scores. The long-term results from 1 to 5 years were studied in 1179 (20,3 %) patients.

Conclusions. One-year remission with combined application of chondroprotector and hyaluronic acid was 76,5 %. Two-year and longer remission was 47,6 %. Diagnostic algorithm for locomotor diseases was developed and approach to conservative therapy was differentiated.

Keywords

Arthrosis / tendinitis / enthesitis / chondroprotectors / intra-articular introduction

References

[1] Котенко К.В., Епифанов В.А. Боль в суставах. М.: ГЭОТАР-Медиа 2018; 1-560.

[2] Насонова В.А. Клиническая оценка нестероидных противовоспалительных препаратов в конце XX века. РМЖ 2003; 17: 714-718.

[3] Удальцев Е.Ю., Зайдман А.М. Посттравматический остеоартроз: современные возможности диагностики, консервативной терапии и профилактика. Барнаул: Азбука 2011; 1-223.

[4] Узбиков Р.М. Оценка качества жизни пациентов с выраженным гонартрозом. Материалы XIII Международной научно-практической конференции. М.: Академический 2017; 23-25.

[5] Чичасова Н.В. Лечение дегенеративных и посттравматических поражений хрящевой ткани. РМЖ 2005; 3: 1-8.

[6] Lane N.E. Osteoarthritis of the Hip. N Engl J Med 2007; 357: 1413-21.

RIGHTS & PERMISSIONS

Samartsev V.A., Kadyntsev I.V.