Chronic vein insufficiency correction in patients with lower extremities varicosity and knee osteoarthritis

Abstract

Introduction. Chronic vein diseases in general and varicose veins of the lower extremities in particular represent a serious medical and social problem.The aim was to study the influence of the therapy of venous outflow disorders on the treatment results of osteoarthritis of the knee joints in patients with varicose veins in combination with osteoarthritis of the knee joints.Materials and methods. The study included 105 patients with varicose veins combined with knee osteoarthritis who had previously received treatment for osteoarthritis of the knee joints but had not received or had received extremely irregular therapy for varicose veins. The follow-up period for the patients was 12 months. The patients underwent the first course of phlebotropic drugs for 2 months from the start of the study. Then this course was repeated twice at 3-month intervals. The standard phlebotropic drug was a micronized purified flavonoid fraction. Compression knitwear was recommended in all patients. Class 2 stockings or tights with an ankle pressure of 23–32 mmHg were used in the vast majority of cases. Treatment of osteoarthritis included the use of nonsteroidal anti-inflammatory drugs, disease-modifying agents (chondroitin sulfate, glucosamine sulfate), and physical therapy.Results. The VCSS scale reduced the degree of chronic venous insufficiency in the clinical group. At inclusion in the study, the average score in the clinical group was 7.1 ± 1.9, after 6 months the result was 6.1 ± 1.5, and after 12 months – 6.0 ± 1.2 points. In the control group, where patients did not receive therapy for varicose veins, there were no dynamics. The results of joint syndrome against the background of correction of venous outflow disturbances – decrease of Leken and WOMAC index values, decrease of pain syndrome according to the visual analogue scale. All this led to a decrease in the patients' need for taking analgesics.Conclusions. Out of 100 patients with joint pathology, 68 patients were diagnosed with varicose veins. These diseases aggravate each other, but we can assume that the venous pathology is primary. A vicious circle is set in motion – progression of osteoarthritis due to the disturbances of venous outflow, and varicosity due to the deterioration of muscular-venous pump functioning.