Algorithm of management of patients of older age groups with arthrosis of the knee joint with excess weight under martial law

Abstract

In press

The provision of medical care to the civilian population under martial law has undergone significant changes due to the reorientation towards urgent care, the lack of polyclinic doctors and difficulties in accessing them, the mandatory receipt of an electronic referral from the fami­ly doctor, the destruction of hospitals, difficulties with logistics, the functional limitations of patients regarding the ability to move independently and the expectation of a long-term, sometimes several-day examination, the psychological state of patients, lack of funds. In the structure of the population of Ukraine, a relative increase in the percentage of sick older age groups was observed due to the emigration of the able-bodied population and children, the death of men and women, both military and civilian, mainly of working age, a decrease in the birth rate, which led to an increase in the burden of chronic pathology, and an increase in disability rates from the pathology of the musculoskeletal system. In addition, forced hypodynamia and the restriction of a balanced diet with an emphasis on eating food with a high carbohydrate content, the constant psychological pressure of the possibility of death, led to an increase in the number of overweight or obese people. This further complicated the course of chronic diseases in general and gonarthrosis in particular and limited the ability to move without assistance. All of the above led to difficulties in the process of establishing a final diagnosis, the appointment of treatment and subsequent medical examination was delayed or did not occur at all. Therefore, determining the tactics of managing patients of older age groups with excess body weight or obesity and gonarthrosis under martial law by creating an algorithm of actions for medical workers and patients is relevant.

Keywords: degenerative-dystrophic diseases, overweight, body mass index, Leken index, Western Ontario & McMaster Universities Osteoarthritis index, protocol EuroQol-5D.