Object of research -primary knee osteoarthritis (KOA) and bone tissue disorders (systemic osteoporosis (SOP) and osteopenia);purpose- to increase the efficacy of treatment of older women with primary KOA and bone tissue disorders based on studies of the risk factors and course of the disease; methods- general and clinical analyses, questioning, functional tests, genetic, instrumental and statistical analyses; updates and results-new information was added to the scientific data on the frequency of primary gonarthrosis, bone tissue disorders and combination of bone&joint disease (CBJD) in older women which confirmed their significant increase with age and lower rate of bone tissue disorders in women with primary KOA compared to healthy women; scientific data on the risk factors for primary KOA, SOP and CBJD were clarified, which confirmed significant effects of the age over 50, obesity, late menarche and menopause duration of more than 10 years on the risk of KOA and significant effects of age over 60, obesity, late menarche and menopause duration of more than 10 years on the risk of CBJD; it was demonstrated for the first time that in the Ukrainian female population the heterogeneity of polymorphisms distribution 156751A>G of the gene ESR1 and +1245 G/T gene Col1a1 did not affect the risk of KOA and CBJD; scientific data on the impact of the risk factors of primary KOA and SOP on pain syndrome severity were extended,which confirmed that obesity contributed to knee pain syndrome, limited functionality and deterioration in the quality of life in patients with KOA, but not in patients with CBJD; it was found that late menarche and early or late menopause did not change the risk and knee pain syndrome severity in patients with KOA and in women with CBJD; for the first time, parameters of structural-functional state of bone were simultaneously analyzed using three methods of evaluation, including Dual-energy X-ray absorptiometry, calcaneus quantitative ultrasound denditomenty and digital X-ray radiogrammetry of the II-IV metacarpal bones, depending on the presence and stage of KOA, and significantly higher levels of bone mineral density (BMD) of different skeletal regions were observed in patients with KOA compared to those in women without KOA, more over disease progression is associated with the increase in BMD mainly of the axial skeleton; frequency and severity of knee pain in patients with CBJD is significantly higher and the quality of life is lower compared to those in patients without SOP; necessary assessment of BMD was confirmed at the level of the femoral neck and not at the lumbar spine in patients with primary gonarthrosis; it was confirmed that the treatment of women with primary KOA and low BMD with strontium ranelate for 12 months is safe and results in a decreased severity of knee pain, improved functional activity of patients and increased BMD whilst these changes are not observed during treatment with denosumab;implementation - introduced to clinical practice of the department of age-related pathology of the musculoskeletal system of D. F. Сhebotarev Institute of Gerontology of NAMS of Ukraine clinic, rheumatological department of the 4th Communal Lviv City Clinical Hospital, cardiology department with rheumatological beds of the Belotserkovskaya City Hospital No. 1 and therapeutic departments of Belotserkovskaya City Hospital No. 2, Makariv Central District Hospital in Kyiv region, traumatological department of the Odessa Regional Clinical Medical Center, educational process of the Department of therapy and rheumatology of the P. L. Shupyk National Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine;application - diagnostic and therapeutic process of rheumatologic, traumatologic and therapeutic departments, polyclinics, scientific and pedagogical processes in rheumatological and therapeutic departments of medical schools.
