Patients with osteoarthritis of the knee: management in the outpatient setting

Abstract

The article discusses the treatment of osteoarthritis. To prevent serious structural and functional changes, it is extremely important to start therapy in the early stages of the disease. Symptomatic slow-acting drugs for the treatment of osteoarthritis (SYSADOA) are an important class in the pharmacological arsenal of OA treatment. The results of the use of this group of drugs in numerous clinical studies have demonstrated good effectiveness in the long-term achievement of the goal. The SYSADOA class (chondroprotectors) includes many different drugs, including glucosamine, chondroitin, diacerein, and soy unsaponifiable avocado substances. Particular attention is paid to the injectable forms of chondroprotective drugs, data from experimental and clinical studies confirming their effectiveness. The authors discuss the issue of intra-articular administration of drugs for knee osteoarthritis and the choice of optimal access. Intra-articular drug delivery has a number of advantages over systemic delivery, including increased local bioavailability, reduced systemic exposure, fewer side effects, and reduced cost. To minimize side effects, it is important to determine the injection site and to have some preparation in the correct placement of the needle during these procedures. To improve the accuracy of intraarticular injections, various imaging methods can be used, but ultrasound of the musculoskeletal system is the most practical. The article presents the data of personal experience of choosing access under the control of ultrasound. Taking into account the anatomy of the knee joint, performing an intra-articular injection from the inside into the upper inversion is the most affordable and optimal. The article presents the data of a clinical example of the introduction of chondroprotectors through the selected access.