Substantiation of the method of local deep hypothermia for the relief of synovitis of the knee joint in patients with osteoarthritis

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Abstract

BACKGROUND: In patients with osteoarthritis, the long course of synovitis changes the nature of the inflammatory process, it becomes more resistant and resistant to a number of therapeutic techniques. In the arsenal of a practicing doctor, there are no reliable and affordable therapeutic methods that reliably provide relief of synovitis in the knee joint and objectively monitor the effectiveness of the therapy. Among the numerous methods of application in the treatment of diseases and injuries of the musculoskeletal system, low-molecular technologies with anti-inflammatory and analgesic effects are distinguished. One of these methods is local deep hypothermia.

AIM: To substantiate the use of different low-temperature modes of local deep hypothermia in patients with knee osteoarthritis aggravated by synovitis, to study clinical efficacy and safety.

MATERIALS AND METHODS: The study included 90 patients with osteoarthritis of the knee joints, burdened with synovitis. To determine the therapeutic parameters of local deep hypothermia, all patients were divided into three groups of 30 people. The effectiveness of the performed local deep hypothermia was assessed by the dynamics of the algofunctional Leken index, the intensity of joint pain on a 100-point Visual Analogue Scale (VAS) in millimeters and a decrease in the need for nonsteroidal anti-inflammatory drugs (NSAIDs).

RESULTS: Technical and clinical parameters have been developed for carrying out the local deep hypothermia technique: area, cooling depth, rate of heat removal from the joint, duration of reproduction and number of procedures. Against the background of the performed local deep hypothermia, patients in three groups showed significant positive dynamics on the VAS and algofunctional Leken index, and in all three groups the difference between the initial and final values of these parameters was statistically significant (p <0.001). The use of local deep hypothermia allowed a significant part of patients to refuse to take NSAIDs, or to reduce the need to 50 mg and take episodically according to need. In our study, we did not record a recurrence of synovitis in all three groups during the first 3 months, which was 100%. After 12 months, the duration of remission in group I was 10.0%, in group II patients — 73.3% and in group III patients — 86.6%.

CONCLUSION: Local deep hypothermia improves the effectiveness of synovitis treatment and can be recommended as an independent method for the treatment of patients with osteoarthritis of the knee aggravated by synovitis. The recommended local deep hypothermia exposure is 90 min, which allows for the longest period of remission of synovitis in the knee joint.

About the authors

Vasily P. Tereshenkov

Peoples' Friendship University of Russia named after Patrice Lumumba

Email: bizuy105@rambler.ru
ORCID iD: 0000-0002-9502-4106

MD, cand. sci. (med.), associate professor

Russian Federation, 6 Miklukho-Maklaya street, Moscow 117196

Oleg A. Shevelev

Peoples' Friendship University of Russia named after Patrice Lumumba; Federal Scientific and Clinical Center of Resuscitation and Rehabilitation

Email: shevelev_o@mail.ru
ORCID iD: 0000-0002-6204-1110
SPIN-code: 9845-2960

MD, dr. sci. (med.), professor

Russian Federation, 6 Miklukho-Maklaya street, Moscow 117196;

Nikolay V. Zagorodniy

Peoples' Friendship University of Russia named after Patrice Lumumba; National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov

Email: zagorodniy51@mail.ru
ORCID iD: 0000-0002-6736-9772
SPIN-code: 6889-8166

MD, dr. sci. (med.), professor, associate member of Russian Academy of Sciences

Russian Federation, 6 Miklukho-Maklaya street, Moscow 117196

Nadezhda A. Khodorovich

Peoples' Friendship University of Russia named after Patrice Lumumba

Email: khodorovich_na@rudn.university
ORCID iD: 0000-0002-1289-4545
SPIN-code: 6237-9153

MD, dr. sci. (med.), professor

Russian Federation, 6 Miklukho-Maklaya street, Moscow 117196

Alexander A. Akhpashev

Peoples' Friendship University of Russia named after Patrice Lumumba;
Academy of Postgraduate Education of the Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies

Author for correspondence.
Email: akhpashev@gmail.com
ORCID iD: 0000-0002-2938-5173
SPIN-code: 9965-1828

MD, cand. sci. (med.), associate professor

Russian Federation, 6 Miklukho-Maklaya street, Moscow 117196

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2. Fig. 1. Dynamics of the duration of remission in patients with knee osteoarthritis complicated by synovitis after hypothermia.

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