Главная Тезисы Артроскопия в травматологии и ортопедии Arthroscopy as one of the complex treatment methods of osteoarthritis of the knee joint

Arthroscopy as one of the complex treatment methods of osteoarthritis of the knee joint


The importance of the problem of surgical treatment.tactics optimization with osteoarthritis of the knee joint is substantiated by the fact that during decades the basic method of this pathology treatment was the conservative one.

The aim of the work is to improve diagnostics, forecasting and treatment of patients with osteoarthritis of the knee joint at various stages of disease using technologies for arthroscopy.

Materials and methods: during the period from 2001 to 2005 the total number of 895 arthroscopy operations of the knee joints was executed. With 200 patients the signs of deforming arthrosis were determined. Operation treatment was conducted using arthroscopic equipment by STORZ Company. All patients got diagnostic arthroscopy followed by endoscopic surgery measures that allowed the prediction of the further course of disease. In the process of arthroscopy patients demonstrated the signs of the II-III degree osteoarthritis manifested by defects of articular cartilage, various deteriorations and dystrophic changes of tegumental cartilage of femoral and shin bones and chondromalacia of the patella. The tactics of patients' treatment with osteoarthritis includes sanation arthroscopy and lavage of joint cavity which pathogenetic activity consists in leaching of cartilage breakdown products and inflammation enzymes from the joint. Depending upon the depth of cartilage tegument damage we conducted shaving of surfaces under load, subchondral forage and abrasive arthroplasty. With Koenig disease the volume of arthroscopic aid included the removal of free dissecand and focus area forage (4 cases). Two patients with osteochondritis dissecans had mosaic bone and cartilage auto-transplantation of cartilage defects using the instrument kit by Arthrex OATS Company and opencast methods. In pre- and post- operation period patients had complex medicine and physical therapeutic treatment. It was due to the complex treatment that we observed the significant improvement of patients' status including pain syndrome reduction, movement range increase and synovitis regress.

Immediate and distant results of treatment were stated to be good in 70 per cent of cases that allowed a conclusion making as for the high curative and forecasting effect of arthroscopic intrusion with deforming arthrosis of the knee joint.

Klimovitskyy V.G., Goncharova L.D., Shchikota R.A., Stinskyy B.V. 
Research Institute of Traumatic Surgery and Orthopedics of the Gorky Donetsk State Medical University, 
Municipal Hospital No. 7, City of Enakiyevo, Ukraine



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