Treatment of patients of older age groups with gonarthrosis against the background of excess weight in the conditions of martial law

Abstract

In press

The pandemic of overweight, aging of the population, medical achievements, the impact of progress and a high level of injuries lead to an increase in the prevalence of gonarthrosis. During 2022–2025, 100 patients (60 women and 40 men) were examined in the conditions of the polyclinic "Communal Non-Profit Enterprise of the Kharkiv Regional Council "Regional Clinical Hospital"", divided into three groups according to treatment methods, over 65 years of age, with a body mass index of over 25 kg/m² and a diagnosis of gonarthrosis of the II–III degree, functional insufficiency of the joint I–II. Patients were prescribed: therapy for weight loss and restoration of functional capabilities; nonspecific anti-inflammatory drugs (in the form of local therapy (diclofenac gel 1% 2–4 g or ketoprofen gel 2.5% 3–5 cm per joint area) 2 times a day for 2 weeks; and oral tableted drugs (ibuprofen 400 mg or paracetamol with caffeine 200 mg 2 times a day after meals) for 5–7 days, repeated as needed for 2–3 days); omez 20 mg 1–2 hours before bedtime simultaneously with nonspecific anti-inflammatory drugs. Patients signed informed consent for treatment and participation in the scientific study. In groups I and II, chondroitin sulfate and glucosaminosulfate 1500 mg per mouth for 90 days, joint orthoses, and in group III - a cane or crutches. In group I, after 3 months, a 2% hyaluronic acid preparation was administered intra-articularly once. Control examinations were performed at 3, 6, and 12 months. Relative improvement in the condition of patients in all groups compared to baseline was obtained. According to the osteoarthritis severity index of the universities of Western Ontario and McMaster in groups I and II, the results were good and satisfactory, and unsatisfactory in group III. According to the Lequen index, pain in group I was moderate, in group II – severe, and in group III – very severe. The developed diagnostic and treatment model allowed providing individualized therapy even in conditions of limited resources during martial law.

Keywords: degenerative-dystrophic diseases, elderly people, body mass index, Leken algofunctional index, Western Ontario and McMaster universities osteoarthritis severity index, joint orthoses.