Treatment of knee joint osteoarthritis: improving outcomes by using a multidisciplinary approach
https://doi.org/10.18699/SSMJ20250119
Abstract
Osteoarthritis is a common degenerative disease that causes pain and results in functional insufficiency of the joint, deterioration in the quality of life and its duration. Its treatment should be aimed at reducing pain, improving joints mobility and limiting functional disorders. A clinical case of total knee arthroplasty and multidisciplinary rehabilitation aimed at reducing pain, improving its function and quality of life is presented.
Material and methods. A prospective analysis of the treatment and rehabilitation of a patient with the right knee joint osteoarthritis of the III radiological stage was carried out. The article presents the aspects of medical rehabilitation after knee arthroplasty in the settings of the Federal Center for Traumatology, Orthopedics and Endoprosthetics of Minzdrav of Russia, Cheboksary.
Results. A year after the operation, movement in the right knee joint was fully restored, there is no pain syndrome. The patient leads an active lifestyle.
Conclusions. Total knee arthroplasty improved patient’s quality of life and functioning. She has no pain syndrome when walking even long distances in a year after the surgery. A multidisciplinary approach to treatment has demonstrated substantial clinical benefits.
About the Authors
N. S. Nikolaev
Federal Center of Traumatology, Orthopedics and Endoprosthetics of Minzdrav of Russia; I.N. Ulianov Chuvash State University
Russian Federation
Russian Federation
Nikolay S. Nikolaev, doctor of medical sciences, professor
428000; Fedora Gladkova st., 33; 428015; Moskovsky ave., 15; Cheboksary
V. N. Diomidova
I.N. Ulianov Chuvash State University; City Clinical Hospital No 1 of Minzdrav of Chuvashia
Russian Federation
Russian Federation
Valentina N. Diomidova, doctor of medical sciences, professor
428015; Moskovsky ave., 15; 428028; Traktorostroiteley ave., 46; Cheboksary
N. V. Zhuravleva
I.N. Ulianov Chuvash State University; Central City Hospital of Minzdrav of Chuvashia
Russian Federation
Russian Federation
Nadezhda V. Zhuravleva, candidate of medical sciences
428015; Moskovsky ave., 15; 428003; Cheboksary, Lenina ave., 47; Cheboksary
E. А. Guryanova
I.N. Ulianov Chuvash State University; Postgraduate Doctors Training Institute of Minzdrav of Chuvashia
Russian Federation
Russian Federation
Evgeniya A. Guryanova, doctor of medical sciences, professor
428015; Moskovsky ave., 15; 428018; Mikhaila Sespelya st., 27; Cheboksary
I. V. Cherkаsova
Federal Center of Traumatology, Orthopedics and Endoprosthetics of Minzdrav of Russia
Russian Federation
Russian Federation
Irina V. Cherkаsova
428000; Fedora Gladkova st., 33; Cheboksary
References
1. Petruccio A.V., Young J.J., Wilfong J.M., Denise Power J., Canizares M., Badley E.M. Osteoarthritis year in review 2023: Osteoarthritis Cartilage. 2024;32(2):159–165. doi: 10.1016/j.joca.2023.11.012
2. Vitaloni M., Bottovan Bemden A., Sciortino Contreras R.M., Scotton D., Bibas M., Quintero M., Monfort J., Carné X., Abajo F., Oswald E., ... Verges J. Global management of patients with knee osteoarthritis begins with quality of life assessment : a systematic review. BMC Musculoskelet Disord. 2019;20(1):493. doi: 10.1186/s12891-019-2895-3
3. Feda J., Miller T., Young J.L., Neilson B., Rhon D.I. Measures of sleep are not routinely captured in trials assessing treatment outcomes in knee osteoarthritis – A scoping systematic review and call to action. Osteoarthr. Cartil. Open. 2023;5(4): doi: 10.1016/j.ocarto.2023.100400
4. Fertelli T.K., Tuncay F.O. Fatigue in individuals with knee osteoarthritis: Its relationship with sleep quality, pain and depression. Pak. J. Med. Sci. 2019;35(4):1040–1044. doi: 10.12669/pjms.35.4.383
5. Hant M.A., Charlton J.M., Escullier J.F. Review of the year of osteoarthritis 2019: mechanics. Osteoarthritis Cartilage. 2020;28(3):267–274. doi: 10.1016/j.joca.2019.12.003
6. Ren Y., Hu J., Tan J., Tang X., Li Q., Yang H., Liu C., He Q., Zou K., Sun X., Tan B. Morbidity and risk factors of symptomatic knee osteoarthritis among the Chinese population: analysis of a nationwide longitudinal study. BMC Public Health. 2020;20(1):1491. doi: 10.1186/s12889-020-09611-7
7. Afanas’ev Yu.I., Aleshin B.V., Barsukov N.P., Vinnikov Ya.A., Danilov R.K., Katinas G.S., Kotovskii E.F., Shapovalova E.Yu. Histology, embryology, cytology : textbook. Moscow: GEOTAR-Media Publ. 832 p. (In Russian).
8. Shil’ko S.V., Ermakov S.F. The role of the liquid phase and porous structure of cartilage in forming the biomechanical properties of joints. Part 1. Rossiyskiy zhurnal biomekhaniki = Russian Journal of Biomechanics.2008;12(2):31–40. (In Russian).
9. Wang M.N., Liu L., Zhao L.P., Yuan F., Fu Y.B., Xu X.B., Li B. Research of inflammatory factors and signaling pathways in knee osteoarthritis. Zhongguo Gu Shang. 2020;33(4):388–392. doi: 10.12200/j.issn.1003-0034.2020.04.020
10. Xie J., Huang Z., Yu X., Zhou L., Pei F. Clinical implications of macrophage dysfunction in the development of osteoarthritis of the knee. Cytokine Growth Factor Rev. 2019;46:36–44. doi: 10.1016/j.cytogfr.2019.03.004
11. Xie J., Huang Z., Pei F. The role and progress of innate immunity in the pathogenesis of osteoarthritis. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019;33(3):370–376. doi: 10.7507/1002-1892.201810068
12. Dickson B.M., Roelofs A.J., Rochford J.J., Wilson H.M., de Bari C. The burden of metabolic syndrome on osteoarthritic joints. Arthritis Res. Ther. 2019;21(1):289. doi: 10.1186/s13075-019-2081-x
13. Bricca A., Harris L.K., Jäger M., Smith S.M., Juhl C.B., Skou S.T. Benefits and harms of exercise therapy in people with multimorbidity : A systematic review and meta-analysis of randomised controlled trials. Ageing Res. Rev. 2020;63:101166. doi: 10.1016/j.arr.2020.101166
14. Yokoyama M., Iijima H., Kubota K., Kanemura N. Exploring the modification factors of exercise therapy on biomechanical load in patients with knee osteoarthritis : a systematic review and meta-analysis. Clin. Rheumatol. 2023;42(7):1737–1752. doi: 10.1007/s10067-023-06553-4
15. Radaikina O.G., Vlasov A.P., Polozova E.I., Radaikina E.V., Shepeleva O.I. Use of physiotherapeutic methods in the treatment of diseases with articular syndrome (literature review). Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskiye nauki = University Proceedings. Volga Region. Medical Sciences. 2019;(4):15–29. (In Russian). doi: 10.21685/2072-3032-2019-4-2
16. Arkhipova A.V., Zhuravleva N.V., Guryanova E.A., Diomidova V.N. Rehabilitation of patients with оsteoarthritis of the knee using magnetic therapy. Ann. Rheum. Dis. 2022;8(1):1850–1851. doi: 10.1136/annrheumdis-2022-eular.583
17. Bindu S., Mazumder S., Bandiopadhyay U. Nonsteroidal anti-inflammatory drugs (NSAIDs) and organ damage: current perspective. Biochem. Pharmacol. 2020;180:114147. doi: 10.1016/j.bcp.2020.114147
18. Cooper C., Shapourlat R., Al-Dagri N., Herrero-Beaumont G., Bruyer O., Rannu F., Roth R., Ubelhart D., Reginster J. Sicherheitperorale nicht-selektive NSAIDs bei osteoarthritis: Was steht in der literatur? Medikamente gegen das altern. Drugs Aging. 2019;36(Suppl 1):15–24. doi: 10.1007/s40266-019-00660-1
19. Arden N.K., Perry T.A., Bannuru R.R., Bruyère O., Cooper C., Haugen I.K., Hochberg M.C., McA-lindon T.E., Mobasheri A., Reginster J.Y. Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines. Nat. Rev. Rheumatol. 2021;17(1):59–66. doi: 10.1038/s41584-020-00523-9
20. Javadi Hedayatabad J., Kachui A., Taher Chaharjui N., Waziri N., Mehrad-Majd H., Emadzadeh M., Abolgasemyan M., Ebrahimzadeh M.J. Effect of eaton compared to hyaluronic acid on pain and function in patients with knee osteoarthritis : systematic review and meta-analysis. Arch. Bone Jt. Surg. 2020;8(3):343–354. doi: 10.22038/abjs.2020.46925.2292
21. Novacik A., Schwedowski D., Dallo I., Novacik J. Overview of first-line and second-line pharmacotherapies for osteoarthritis with special focus on intraarticular treatment. Int. J. Mol. Sci. 2022;23(3):1566. doi: 10.3390/ijms23031566
22. Hong M., Cheng C., Sun X., Yan Y., Zhang Q., Wang W., Guo W. Efficacy and safety of intraarticular platelet-rich plasma in osteoarthritis knee : a systematic review and meta-analysis. Biomed. Res. Int. 2021;2021:2191926. doi: 10.1155/2021/2191926
23. Department of Evidence and Standards Development, Ontario Health Quality. Arthroscopic treatment of the knee joint: updating the actual data. Ont. Health Technol. Assess Ser. 2014;14(13):1–43.
24. Wainwright T.V., Jill M., MacDonald D.A., Middleton R.G., Reed M., Sahota O., Yates P., Jungquist O. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Acta Orthop. 2020;91(1):3–19. doi: 10.1080/17453674.2019.1683790
25. Bannuru R.R., Osani M.K., Weissbrot E.E., Arden N.K., Bennell K., Bierma-Zeinstra S.M.A., Kraus V.B., Lohmander L.S., Abbott J.H., Bhandari M., ... McAlindon T.E. OARSI recommendations for non-surgical management of knee, hip and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578–1589. doi: 10.1016/j.joca.2019.06.011
26. Büttner M., Mayer A.M., Büchler B., Betz U., Drees P., Susanne S. Economic analyses of fast-track total hip and knee arthroplasty : a systematic review. Eur. J. Orthop. Surg. Traumatol. 2020;30(1):67–74. doi:10.1007/s00590-019-02540-1
27. Nikolaev N.S., Petrova R.V. Physical rehabilitation of patients after endoprosthetics of large joints of the lower extremities. Cheboksary: Chuvash Book Publishing House, 2020. 192 p. (In Russian).
28. Order of the Ministry of Health of the Chuvash Republic No. 1383 of August 10, 2021 “On the organization of medical rehabilitation of the adult population in the Chuvash Republic”. (In Russian).
29. Konnyu K.J., Thoma L.M., Cao W., Aaron R.K., Panagiotou O.A., Bhuma M.R., Adam G.P., Balk E.M., Pinto D. Rehabilitation for total knee arthroplasty : A systematic review. Am. J. Phys. Med. Rehabil. 2023;102(1):19–33. doi: 10.1097/PHM.0000000000002008
30. Kulchitskaya D.B., Fesyun A.D., Samoilov A.S., Kolbakhova S.N., Gushchina N.V., Astakhova K.A. The use of rehabilitation programs for patients in the early recovery period after total knee arthroplasty. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul’tury = Problems of Balneology, Physiotherapy, and Exercise Therapy. 2022;99(2):32–36. (In Russian). doi: 10.17116/kurort20229902132
31. Hsieh C.J., DeJong G., Vita M., Zeymo A., Desale S. Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial. JAMA Netw. Open. 2020;3(9):e2016571. doi: 10.1001/jamanetworkopen.2020.16571
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For citations:
Nikolaev N.S., Diomidova V.N., Zhuravleva N.V., Guryanova E.А., Cherkаsova I.V. Treatment of knee joint osteoarthritis: improving outcomes by using a multidisciplinary approach. Сибирский научный медицинский журнал. 2025;45(1):174-183. (In Russ.) https://doi.org/10.18699/SSMJ20250119
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