Boyeva I. The selection of individual therapeutical tactics in patients suffering from knee joints osteoarthrosis according to clinical instrumental comparison

Objective - clinical laboratory course of knee joints osteoarthritis (OA) under the influence of antiinflammatory therapy; aim - improvement of diagnostic quality and knee joints OA treatment; methods - clinical, questionary, instrumental, laboratory tests, statistical; novelty and results - close direct correlations between clinical, laboratory and ultrasonic parameters in patients with knee joints OA have been determined for the first time. On the basis of the correlation analysis 16 clinical and laboratory and instrumental parameters were selected which were considered to be the basis for the point scale of degree of OA activity determination. Three groups of patients with different degree of AO activity were marked out which differed significantly according to clinical and laboratory and instrumental parameters. Essential difference in treatment efficiency in patients with different degree of AO activity was determined. To individualize therapeutic approaches to patients with knee joints OA two methods of therapy choice were developed. The first method is efficiency therapy forecast depending on degree of activity determined according to the point scale. The second method is efficiency therapy forecast that provides mathematical model use on the basis of three traits that determine paracetamol therapy. This joint stiffness according to WOMAC is more than 50 mm, synovial membrane thickening, level of tumor necrosis factor -? exceeding 2 pg/ml; it was introduced in patient care institutions of Donetsk, Dnepropetrovsk, Kiev regions, and also pedagogical process of Donetsk Medical University; field of application - medical diagnostic process of rheumatologic, therapeutic departments and pedagogical process of therapeutic departments of medical universities.