Smolina L. Optimization treatment of gonarthrosis in the practice of family doctor

The object of study: gonarthritis. The aim of the study was to optimize the treatment of patients with gonarthritis (GA) by applying intra-articular injection of platelet autologous plasma (PAP) in combination therapy and an algorithm for predicting the course of osteoarthritis (OA) for inhibiting the process of degradation of articular cartilage and extending the remission period in the practice of a family doctor. Methods of research: clinical and anamnestic - for the evaluation of clinical manifestations of GA and the study of etiological factors of the disease; anthropometric - for assessing body and body mass index (BMI); functional (index WOMAC - Western Ontario and McMaster University Osteoarthritis) - for subjective assessment of the patient's general condition and quality of life; instrumental (X-ray of knee joints in two projections) - for evaluation of the GA stage; Laboratory (general blood test) - to exclude hidden pathology blood and anemia, C-reactive protein (CRP) - to evaluate the inflammation process in GA, VDR, LCT and FDPS - to determine their quantity and quality of genotype effects on GA); statistical (variation statistics, correlation method) - for the purpose of mathematical processing; Information-entropy analysis (Gubler, 2002) - for the purpose of analysis of random variables and gradient of truthfulness. Scientific novelty of the obtained results: for the first time the frequency of individual phenotypic and signs of Undifferentiated connective tissue dysplasia and polymorphism of VDR, LCT and FDPS genes in patients with GA was determined. On the basis of the conducted complex clinical-laboratory and genetic research for the first time the most prognostically significant factors influencing the early appearance of symptoms, course and response to treatment with GA were determined for the first time. By generalizing the results of mathematical forecasting, an algorithm for assessing the risk of forming a GA and a method for treating patients with GA has been created. For the first time in Ukraine a personified approach to the treatment of GA was proposed, the effectiveness and safety of PAP in combination therapy of GA were determined taking into account the genetic features of the patient, and the model of the prediction of the response to treatment was substantiated.