Optimization of therapeutic preparation of patients with osteoarthritis to replacement arthroplasty: results of a comparative study


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Abstract

Objective: to analyze the features of the lesions of the main and comorbid joints and the possibility of their correction with the use of diacerein in patients included in the waiting list for the knee and hip replacement. Methods. The results of the follow-up of patients with 3-4 stage coxarthrosis and gonarthrosis included in the waiting list for endoprosthesis replacement are presented. Patients were divided into 2 intervention groups: group 1 - 25 patients with gonarthrosis, group 2 - 25 patients with coxarthrosis, who received additional therapy with diacerein and nimesulide. The comparison groups consisted of 15 patients with coxarthrosis and 15 patients with gonarthrosis who did not receive special preoperative treatment. The features of the course of the disease were determined based on the Lequesne algofunctional index and the WOMAC index. Results. A high incidence of affection of the comorbid (symmetrical) joints and pronounced changes in the psychological status according to the assessment of state and trait anxiety were revealed. Additional therapy with diacerein reduced the required dose of nimesulide by 38.3% in patients with coxarthrosis and by 36.0% in the gonarthrosis subgroup. The positive effect of three-month therapy with diacerein on the severity of the main manifestations of the disease was determined. In the gonarthrosis group, pain, stiffness and functional insufficiency in the main joint decreased by 15.9%, 11.7 and 11.3%, respectively (in the comorbid joint these changes were more pronounced and reached 18.7%, 21.2, and 16,5%, respectively). In patients with coxarthrosis, in the main joint these indices changed in the positive aspect by 9.8%, 15.5 and 6.0%, respectively, and by 17.4%, 24.1 and 18.3%, respectively, in the comorbid joint. Treatment with the additional use of diacerein made it possible to reduce the severity of the disease according to the Lequesne algofunctional index in the comorbid joint by 24.8%, which reduced the grade of severity of the disease by one stage. Conclusion. The use of therapy with diacerein is recommended to determine the therapeutic rehabilitation potential in osteoarthritis.

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About the authors

L. N Yeliseyeva

Kuban State Medical University

Email: Yeliseyeva@mail.ru
MD, Prof., Head of the Department of Faculty Therapy

S. V Kartashova

Kuban State Medical University

O. A Zhikhareva

Kuban State Medical University

A. Yu Blednova

Kuban State Medical University

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