The pain in primary osteoarthritis of the knee. Its causes and treatment by osteotomy

Helal, Basil

doi:10.1136/pgmj.41.474.172

Cited by 47 publications

(7 citation statements)

References 9 publications

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“…However, good results have been presented independently of the correction of position achieved by osteotomy (Appel and Friberg 1972). The relief of pain has in these cases been attributed to the release of internal venous congestion resulting from the osteotomy (Helal 1965).…”

Section: Discussionmentioning

confidence: 97%

Proximal osteotomy of the tibia in the treatment of osteoarthritis of the knee

Isolauri

Lapinsuo

Aho

et al. 1983

Arch. Orth. Traum. Surg.

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A total of 50 patients with osteoarthritis of the knee joint treated by proximal osteotomy of the tibia were followed up 1-5 years after operation. Fusion occurred within an average of 24 weeks. The subjective result of the treatment was good or fair in 44/50 patients. The results were the same 1-2 years and 4-5 years postoperatively. Half the patients showed some significant general disease, most usually hypertension or cardiac disease. Although the patients' subjective condition was significantly better after than before operation, the treatment did not improve or maintain their working capacity. Preoperatively 29 patients worked, while this number was reduced to 12 at the time of follow-up, and two of the latter patients had been trained for new occupation.

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Section: Discussionmentioning

confidence: 97%

Proximal osteotomy of the tibia in the treatment of osteoarthritis of the knee

Isolauri

Lapinsuo

Aho

et al. 1983

Arch. Orth. Traum. Surg.

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“…прошлого века и в дальнейшем авторы подчеркивали роль внутрикостной гипертензии как в развитии остеоартроза, так и в усилении болевого синдрома [12][13][14]. А для снижения выраженности болевого синдрома предлагалось применение остеотомии [15]. По данным V. Ciubotaru [16], в результате нарушения венозного оттока развивается ограниченный воспалительный процесс в надкостнице, остеопороз, остео фитоз и повреждение хряща.…”

Section: патогенезunclassified

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

Щеглов

Alontseva

2022

Ambulatornaya khirurgiya

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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.

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“…29 These are probably involved in the perception of intramedullary pressure and may have a proprioceptive function. Pain may be caused by changes in intramedullary pressure 30 and stimulation of the periosteum. 31 Recently, Ahmed and Gillespie (personal communication) using monoclonal antibody techniques, have shown the presence of unmyelinated nerve fibres in the membrane found between loose implants and bone.…”

Section: Discussionmentioning

confidence: 99%

Intra-Articular Local Anaesthesia for Pain After Hip Arthroplasty

Crawford

Ellis

Gie

et al. 1997

The Journal of Bone and Joint Surgery. British volume

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We investigated 15 patients with painful hip arthroplasties using intra-articular injection of bupivicaine. Fourteen had pain relief and 13 of them were subsequently found to have loosening of one or both components. The relief of pain after total hip arthroplasty by intra-articular injection of bupivicaine indicates that a satisfactory result is probable after revision surgery with refixation of the components.

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The pain in primary osteoarthritis of the knee. Its causes and treatment by osteotomy

Cited by 47 publications

References 9 publications

Proximal osteotomy of the tibia in the treatment of osteoarthritis of the knee

Proximal osteotomy of the tibia in the treatment of osteoarthritis of the knee

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

Intra-Articular Local Anaesthesia for Pain After Hip Arthroplasty

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