Experience in the treatment of enthesopathies by the method of local injection therapy
https://doi.org/10.51793/OS.2024.27.2.003
Abstract
Background. The peculiarity of enthesopathies, or periarthropathies, is that, being an area of constant biomechanical stress and influencing adjacent hard and soft tissues, the enthesis forms an inflammatory impulse, leading to the development of inflammation in the synovial membrane adjacent to the enthesis. One of the pathogenetically substantiated steps in the treatment of enthesopathies is the method of periarticular administration of a chondroprotector. This method allows you to influence various parts of the inflammatory process and influence cellular respiration.
Objective. To study the effect of local injection therapy with a metabolic specific stimulator of connective tissue repair on the course of periarthropathies.
Materials and methods. 10 patients (6 women and 4 men aged 54.3 ± 0.4 years) were treated for enthesopathies by injection using a metabolically specific stimulator of connective tissue repair. Eight patients were diagnosed with "unilateral trochanteritis" and instrumentally confirmed, and two patients were diagnosed with "bilateral epicondylitis." Injections were performed periarticularly, 2 ml every 3 days, for a total of 5 injections. To evaluate the results, we used the VAS pain intensity scale, and also compared the range of motion in the hip and elbow joint before and after treatment. There were three control points in total before the start of treatment, at the end of treatment and 14 days after the last administration of the drug.
Conclusion. It has been shown that when the drug is administered locally, the reparative stage and the outcome of inflammation in the tendon part of the muscles begin to predominate. Clinically, this is observed in the form of improved function and elimination of pain.
About the Author
Anastasiya V. Sertakova
Federal State Budgetary Educational Institution of Higher Education Saratov State Medical University named after V. I. Razumovsky of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Anastasiya V. Sertakova, Cand. Of Sci. (Med.), orthopedist, researcher of innovative projects in traumatology and orthopedics at the Research Institute of Traumatology, Orthopedics and Neurosurgery, assistant at the Department of Pathological Physiology named after A. A. Bogomolets,
112, Bolshaya Kazachya str., Saratov, 410012.
References
1. Karateyev A. Ye., Lila A. M., Zagorodniy N. V., Pogozheva Ye. Yu. Damage to periarticular soft tissues in real clinical practice: frequency, nature, effectiveness of non-steroidal anti-inflammatory drugs. Terapevticheskiy arkhiv. 2019; 91 (12): 21-28. DOI: 10.26442/00403660.2019.12.000377. (In Russ.)
2. Abdulganieva D. I., Kirillova E. R., Fajrushina I. F., Gajnullina G. R., Abdrakipov R. Z., Muhina R. G., Muhametshina E. I. Enthesopathies in spondyloarthritis. Nauchno-prakticheskaya revmatologiya. 2021; 59 (3): 316-325. (In Russ.)
3. Benjamin M.., Kumai T., Milz S., Boszczyk B. M., Boszczyk A. A., Ralphs J. R. The skeletal attachment of tendons – tendon "entheses". Comp Biochem Physiol A Mol Integr Physiol. 2002; 133 (4): 931-945. DOI: 10.1016/s1095-6433(02)00138-1.
4. Benjamin M., Moriggl B., Brenner E., Emery P., McGonagle D., Redman S. The "enthesis organ" concept: Why enthesopathies may not present as focal insertional disorders. Arthritis Rheum. 2004; 50: 3306-3313. DOI: 10.1002/art.2056616.
5. McGonagle D., Stockwin L., Isaacs J., Emery P. An enthesitis based model for the pathogenesis of spondyloarthropathy: additive effects of microbial adjuvant and biomechanical factors at disease sites. Rheumatology (Oxford). 2001; 28: 2155-2159.
6. Sudoł-Szopińska I., Kwiatkowska B., Prochorec-Sobieszek M., Maśliński W. Enthesopathies and enthesitis. Part 1. Etiopathogenesis. J Ultrason. 2015; 15 (60): 72-84. DOI: 10.15557/JoU.2015.0006.
7. Karateyev A. Ye. Musculoskeletal pain: identification of clinical phenotypes and a rational approach to treatment. Al'manakh klinicheskoy meditsiny. 2019; 47. DOI: 10.18786/2072-0505-2019-47-042. (In Russ.)
8. Nasonov Ye. L., Yakhno N. N., Karateyev A. Ye. i dr. General principles of treatment of musculoskeletal pain: interdisciplinary consensus. Nauchnoprakticheskaya revmatologiya. 2016; 54 (3): 247-265. (In Russ.)
9. Mantel P. Y., Schmidt-Weber C. B. Transforming growth factor-beta: recent advances on its role in immune tolerance. Methods Mol Biol. 2011; 677: 303-338. DOI: 10.1007/978-1-60761-869-0_21.49.
10. Van Lent P. L., Blom A. B., van der Kraan P., Holthuysen A. E., Vitters E., van Rooijen N., Smeets R. L., Nabbe K. C., van den Berg W. B. Crucial role of synovial lining macrophages in the promotion of transforming growth factor beta-mediated osteophyte formation. Arthritis Rheum. 2004; 50 (1): 103-111. DOI: 10.1002/art.11422.50.
11. Lories R. J., Luyten F. P. Bone morphogenetic protein signaling in joint homeostasis and disease. Cytokine Growth Factor Rev. 2005; 16 (3): 287-298. DOI: 10.1016/j.cytogfr.2005.02.009.
12. Regulatory documentation: Pharmacopoeia article for the substance-liquid "bioactive extract from small sea fish". https://zdravmedinform.ru (In Russ.)
13. Danilov A. B., Zotkin Ye. G. Medical duo: osteoarthritis and osteochondrosis – theconsensus of a neurologist and a rheumatologist. Effektivnaya farmakoterapiya. 2022; 18 (5): 44-48. (In Russ.)]
14. Shirokova I., Prozherina Yu. Osteoarthritis in the XXI century: challenges and solutions. Remedium. 2017; 10: 33-6 (in Russ.) DOI: 10.21518/1561-5936-2017-10-33-36
15. Menshikova I. V., Sorotskaya V. I. Treatment of osteoarthritis of large and small joints using an injectable chondroprotector of complex action. Lechaschi Vrach. 2021; 4 (24): 66-71. (In Russ.) DOI: 10.51793/OS.2021.14.17.012
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For citations:
Sertakova A.V. Experience in the treatment of enthesopathies by the method of local injection therapy. Lechaschi Vrach. 2024;(2):17-20. (In Russ.) https://doi.org/10.51793/OS.2024.27.2.003
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