The disease osteoarthritis (ICD 10 code from M15 to M19) refers to degenerative-dystrophic diseases of the joints. It is characterized by primary degeneration of articular cartilage with subsequent changes in the articular surfaces and the development of marginal osteophytes (bone growths), which leads to joint deformation. Manifestations of minor reactive synovitis are secondary to degenerative changes in cartilage. At the Yusupov Hospital, doctors diagnose the disease using the latest equipment from leading European and American manufacturers.
Leading specialists in the field of orthopedics, rheumatology, and medical rehabilitation collectively determine patient management tactics. Doctors use non-drug therapies and medications that are highly effective and have minimal side effects. A multidisciplinary approach allows you to quickly achieve positive results.
Osteoarthritis is the most common form of joint pathology. This disease accounts for 60 to 70% of all rheumatic diseases. Complete disability in patients with osteoarthritis rarely occurs, except for patients suffering from osteoarthritis of the hip joint. The disease often causes temporary disability. Primary generalized osteoarthritis has a code in ICD 10 No. M15.
Osteoarthritis is detected equally often in men and women, with the exception of disease of the distal interphalangeal joints, which occurs 10 times more often in women. Clinical manifestations of arthrosis begin mainly at the age of 40-50 years, in women during menopause. X-ray signs of joint damage are detected much earlier.
General information
Osteoarthrosis of the knee joint (syn. gonarthrosis , arthrosis deformans , osteoarthritis ) is a degenerative-dystrophic disease of polyetiological origin, which is characterized by damage (degeneration) of articular cartilage and the metaphyseal/subchondral layer of the femur and tibia, accompanied by the formation of marginal osteophytes (osteocartilaginous growths) and reactive synovitis .
In addition to articular cartilage, ligaments, muscles, menisci and synovial membrane are involved in the pathological process. The main manifestation of the disease is pain/restriction of movement in the joint. ICD-10 code: M17. The knee joints are the largest joints in the human body and bear the greatest load; have a complex structure in the formation of which the femur and shin bones, menisci, ligaments and synovial membrane are involved.
Deforming osteoarthritis of the knee joint is one of the common reasons why patients turn to traumatologists/orthopedists. According to epidemiological studies, osteoarthritis of the knee joint occurs in 8-12% of the adult population: symptomatic gonarthrosis in people under 40 years of age occurs in 5%; over 45 years old – 16.7%; after 60 years in 12.1%, while the disease in all age groups develops 1.3 times more often in women. In almost 38% the disease is accompanied by temporary loss of ability to work. There is a trend towards rejuvenation of the disease; the incidence of knee OA is increasing especially rapidly in people of relatively young working age, in particular among people leading an active lifestyle and playing sports. Rapid progression of the disease over several years is accompanied by a high risk of permanent loss of ability to work and disability.
Active substances related to code M19.9
Below is a list of active substances related to ICD-10 code M19.9 (names of pharmacological groups and a list of trade names associated with this code).
- Active ingredients
- Aminophylline + Diphenhydramine + Indomethacin
Pharmacological group: NSAIDs - Acetic acid derivatives and related compounds in combination with other drugs - Amtolmetin guacil
Pharmacological group: NSAIDs - Acetic acid derivatives and related compounds - Bovhyaluronidase azoximer
Pharmacological group: Enzymes and antienzymes - Valdecoxib
Pharmacological group: NSAIDs - Coxibs - Hyaluronic acid
Pharmacological groups: Correctors of bone and cartilage tissue metabolism, Regenerants and reparants - Hydrocortisone
Pharmacological groups: Glucocorticosteroids, Ophthalmic drugs - Glucosamine + Chondroitin sulfate
Pharmacological group: Correctors of bone and cartilage metabolism in combination with other drugs - Dexamethasone
Pharmacological groups: Glucocorticosteroids, Ophthalmic drugs - Dexketoprofen
Pharmacological group: NSAIDs - Propionic acid derivatives - Diclofenac + Misoprostol
Pharmacological group: NSAIDs - Acetic acid derivatives and related compounds in combination with other drugs - Diclofenac + Pyridoxine + Thiamine + Cyanocobalamin
Pharmacological groups: Vitamins and vitamin-like drugs in combination with other drugs, NSAIDs - Acetic acid derivatives and related compounds in combination with other drugs - Dimethyl sulfoxide
Pharmacological group: Dermatotropic agents - Bile
Pharmacological group: Local irritants - Ibuprofen
Pharmacological group: NSAIDs - Propionic acid derivatives - Indomethacin
Pharmacological groups: Ophthalmic drugs, NSAIDs - Acetic acid derivatives and related compounds - Ketoprofen
Pharmacological group: NSAIDs - Propionic acid derivatives - Ketoprofen lysine salt
Pharmacological group: NSAIDs - Propionic acid derivatives - Cat's claw bark extract
Pharmacological group: General tonics and adaptogens - Lidocaine + Tolperisone
Pharmacological group: n-cholinergics (muscle relaxants) in combination with other drugs - Mabuprofen
Pharmacological group: Other non-narcotic analgesics, including non-steroidal and other anti-inflammatory drugs - Meloxicam
Pharmacological group: NSAIDs - Oxicams - Meloxicam + Chondroitin sulfate
Pharmacological groups: Correctors of bone and cartilage tissue metabolism in combination with other drugs, NSAIDs - Oxycams in combination with other drugs - Methylprednisolone
Pharmacological group: Glucocorticosteroids - Naproxen
Pharmacological group: NSAIDs - Propionic acid derivatives - Naproxen + Esomeprazole
Pharmacological groups: Proton pump inhibitors in combination with other drugs, NSAIDs - Propionic acid derivatives in combination with other drugs - Nimesulide
Pharmacological group: Other non-narcotic analgesics, including non-steroidal and other anti-inflammatory drugs - Niflumic acid
Pharmacological group: Other non-narcotic analgesics, including non-steroidal and other anti-inflammatory drugs - Capsicum fruit extract
Pharmacological group: Local irritants - Prednisolone
Pharmacological group: Glucocorticosteroids - Salicylamide
Pharmacological group: NSAIDs - Salicylic acid derivatives - Tenoxicam
Pharmacological group: NSAIDs - Oxicams - Tolperisone
Pharmacological group: Drugs affecting neuromuscular transmission - Tolperisone + Lidocaine
Pharmacological group: n-cholinergics (muscle relaxants) in combination with other drugs - Phenylbutazone
Pharmacological group: NSAIDs - Butylpyrazolidines - Celecoxib
Pharmacological group: NSAIDs - Coxibs - Etoricoxib
Pharmacological group: NSAIDs - Coxibs
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Pathogenesis
The pathogenesis of osteoarthritis (OA) is based on pathological changes in the molecular structure of hyaline cartilage, in which processes of remodeling (synthesis/degradation) of the basis of cartilaginous tissue, the extracellular matrix . A key role in this process is played by highly differentiated cells of cartilage tissue - chondrocytes , which begin to produce low-molecular proteins of the interstitial cartilage tissue (matrix), which reduces the shock-absorbing properties of the knee joint cartilage.
of proteoglycans in the surrounding cartilage matrix and react negatively to their changes. It is known that the state of cartilage tissue is determined by the balance of anabolic/catabolic processes. At the same time, the speed/intensity of catabolic processes increases under the influence of cytokines (interleukin-1, tumor necrosis factor-α), metalloproteinases (stromelysin, collagenase), cyclooxygenase-2 , which are produced by chondrocytes, cells of the subchondral bone and synovial membrane. Also in the process of restoration of cartilage tissue, a significant role is played by the reparative activity of chondrocytes, which is based on insulin-like/transforming growth factors and morphogenetically altered cartilage/bone proteins.
As a result of the increase in degenerative processes, the cartilage loosens/softens, cracks appear, and the articular surfaces of the bone, due to the destruction of cartilage tissue, begin to experience an unevenly distributed increased mechanical load. This contributes to the appearance of a zone of dynamic overload in the subchondral bone, which causes redistribution disturbances of microcirculation, the development of subchondral osteosclerosis , changes in the curvature of joint surfaces, and the formation of osteophytes (marginal osteochondral growths).
A significant role in the pathogenesis is played by synovitis , characterized by moderately expressed exudative/proliferative reactions in the form of hyperplasia and mononuclear infiltration of the synovial membrane, most manifested in places of attachment to cartilage with subsequent transition to lipomatosis / sclerosis . Exudative-proliferative reactions in the synovial membrane and subchondral bone occur against the background of a disorder of regional microcirculation and hemodynamics with the gradual development of tissue hypoxia . osteophytosis appear in the subchondral bone , and the structure of the changes becomes irreversible. The pathogenesis of OA is schematically presented below.
Treatment
Treatment of ankle arthrosis involves an integrated approach. This includes drug therapy, traditional medicine, massage and exercise therapy. It is important to remember that positive results of therapy will show if treatment is started in a timely manner. Otherwise, the patient faces restriction of movement and complete destruction of the joint, ankle cartilage, and disability.
Medication
Drug therapy is characterized by an integrated approach and involves the prescription of a number of drugs, taking into account the course of the pathological process.
The course of drug therapy includes:
- In order to relieve pain and relieve inflammation, non-steroidal anti-inflammatory drugs are prescribed. Most often, doctors prescribe Ibuprofen, Diclofenac, Flurbiprofen - all drugs can be in the form of tablets, injections, or ointments.
- In order to normalize the natural production of synovial fluid in the joint and improve the general condition of cartilage tissue, chondroprotectors are prescribed - Dune, Artra, Chondrolon, Structum. The course of therapy can vary from 1 to 3 months when taking tablets and 14-21 days when injections are given into the joint.
- To relieve inflammation and pain, doctors prescribe injections of drugs from the group of corticosteroid hormones. On average, 3-5 injections are given over 7-14 days.
- In order to improve joint mobility and blood flow, nutrition of cartilage, a course of laser irradiation and sessions of magnetic therapy, ultrasound or electrophoresis with medications are prescribed.
In the absence of positive dynamics from a course of drug therapy or in the case of a severe degree of destruction of the joint and cartilage tissue, surgical intervention and installation of artificial prostheses are practiced.
ethnoscience
In addition to traditional therapy, many doctors and herbalists recommend using recipes from the arsenal of traditional medicine. On their own, they will not have a pronounced effect, but as a supplement they will enhance the effect of tablets and injections, massage and exercise therapy.
We recommend you read an interesting article: “How to treat arthrosis of the ankle joint at home?”
The course of traditional medicine provides the following recipes:
- Recipe based on mumiyo resin: Dissolve 0.5 g of mumiyo in a few drops of rose or tea tree oil and rub with gentle movements into the area of the affected joint. Wrap in plastic and a warm scarf, leaving overnight until morning.
- Potato-based lotions: Grate the raw root vegetable on a coarse grater, squeeze out the excess liquid and apply to the affected joint for half an hour.
- Decoction of comfrey herb Mix 1 glass of vegetable oil and the same amount of crushed comfrey plant - simmer everything over low heat, not allowing it to boil for 7-8 minutes. After removing from the stove, allow to cool and filter. Rub it into the affected joint 3-5 times throughout the day.
- Chicken egg shell You should add dried and crushed chicken egg shells to your food. The main thing is not to add more than 1 tsp per day.
All recipes are natural and safe, but in any case it is important to take into account the individual tolerance of a particular component and coordinate their use with your doctor.
Exercise therapy
Next, we will consider a set of exercises for grades 1 and 2 of the severity of arthrosis, since when diagnosing stage 3, any load, even within the framework of exercise therapy, is contraindicated.
| Exercise | Repeat number |
| Lie down on a flat floor and in this position, alternately move your toe toward you/away from you, replacing it with your heel. | In the first stage of arthrosis, you can perform 10-15 exercises on each leg; in the second stage, limit yourself to 5-10 repetitions |
| Rotate first with toe, then with heel clockwise/counterclockwise | At the first stage of arthrosis, 10-12 times in each direction will be enough; at the second stage, we reduce the widow's |
| Rotate the foot inward and outward—right and left | At the first stage, 10-15 turns will be enough, at the second we cut it in half |
| Sit on a chair, perform foot movements as when walking, alternately lifting the heel, moving to the toe | At the first stage of arthrosis, it is enough to perform 10–15 times, divided into 2 approaches. For the second degree of the pathological process, divide the number by two |
| Sit on a chair and use your toes to crumple the fabric. | At the first stage, 10-15 times on each leg is enough, at the second stage, divide the number in half |
| We practice walking - first on the outside of the foot, then on the inside | 2-3 minutes on each side. This exercise is carried out only in the first stage of ankle arthrosis. |
| Heel-to-toe rolls - you can place a soft roller under your feet, which will enhance the effectiveness of the exercise due to a slight massage effect | Carry out 2-3 approaches, no more than 10 times per approach |
The main thing is to carry out all the exercises constantly, and if they cause pain, stop them immediately. Each exercise should be agreed upon in advance with your doctor.
Massage
Massage is practiced when diagnosing arthrosis of the ankle joint only at the first and second stages of the pathological process; at the third stage, massage, like exercise therapy, is prohibited.
At the very beginning, the massage session begins with warming up the legs, after placing a soft roller under the Achilles tendon. After warming up, proceed to rubbing with light massaging movements - straight or transverse rubbing, performing each of them no more than 2-4 times. The massage ends with concentric stroking. Each movement starts from the bottom and moves up to the calves, moving through the Achilles tendon.
Bibliography:
- https://moinogi.ru/artroz-golenostopnogo-sustava/
- https://diseases.medelement.com/disease/12767
- https://medum.ru/mkb-posttravmaticheskij-osteoartroz
- https://sustavzone.ru/sustavi/artroz/artroz-golenostopnogo-sustava
Classification
The classification of OA is based on several factors. According to the etiology of the disease, there are:
- Idiopathic ( primary gonarthrosis ), occurring without any external causes.
- Secondary gonarthrosis , which occurs against the background of diseases of various origins.
According to the clinical and radiological classification, the following are distinguished:
- Osteoarthritis of the knee joint 1st degree. X-ray examination reveals a mild narrowing of the joint space and slight subchondral osteosclerosis . OA of the knee joint of the 1st degree clinically manifests itself as pain during/after walking, which occurs at rest; there are no restrictions on movement in the joint. Pain is less likely to appear after standing for a long time.
- Osteoarthritis of the knee joint, grade 2. X-rays reveal a narrowing of the joint space that is 2–3 times greater than normal; subchondral sclerosis is more pronounced osteophytes are detected in the area of the intercondylar eminence/along the edges of the joint space . Clinically, grade 2 OA manifests as moderate pain, limitation of joint movements, lameness, muscle wasting, and slight deformation of the frontal axis of the limb.
- Osteoarthritis of the knee joint grade 3. Radiographically, significant deformation of the articular surfaces of the epiphyses and sclerosis with areas of local osteoporosis / subchondral necrosis , the joint space is practically absent, loose articular bodies / extensive bone growths are determined. It manifests itself as severe pain and persistent contractures, severe joint instability, limb deformity (valgus/varus), and atrophy of the lower leg muscles.
Causes
Osteoarthritis of the knee joint is a polyetiological disease. Among the main reasons are:
- Factors of traumatic origin ( bruises /injuries of the knee joint, local dislocations , damage to the ligamentous apparatus (sprains/ruptures); injuries to the menisci with ruptures, displacements; fractures of the diaphysis of the tibia/femur, fused with deformity; surgical interventions).
- Congenital anomalies of the osteoarticular apparatus/muscles of the knee joint (hypermobility of the joint, deformity of the lower leg, valgus/varus deformity, weakness of the femoral muscles, congenital dislocation of the patella, osteoarticular dysplasia, etc.).
- Metabolic ( hemochromatosis , obesity , ochronosis , Gaucher / Wilson ).
- Endocrinological ( hypothyroidism / hyperparathyroidism , acromegaly , diabetes mellitus ).
- Inflammatory diseases of joints/bones ( arthritis of any etiology, gout , Paget's disease , hemarthrosis ).
- Diseases caused by calcium pyrophosphate deposition ( apatite arthropathy / chondrocalcinosis ).
- Neurodystrophic changes in joints/bones ( Charcot's joints ).
Predisposing factors for the development of the disease include: excess body weight, old age, low physical activity, postmenopause, high load on the knee joints (miners, athletes, dancers), prolonged microtrauma, weakening of the skeletal periarticular muscles.
Coxarthrosis [arthrosis of the hip joint]
ICD-10 International Classification of Diseases M00-M99 Diseases of the musculoskeletal system and connective tissue M00-M25 Arthropathy M15-M19 Arthrosis
M16
Coxarthrosis [arthrosis of the hip joint]
— M16.0 Primary coxarthrosis bilateral - M16.1 Other primary coxarthrosis - M16.2 Coxarthrosis as a result of dysplasia bilateral - M16.3 Other dysplastic coxarthrosis - M16.4 Post-traumatic coxarthrosis bilateral - M16.5 Other post-traumatic coxarthrosis - M16.6 Other secondary coxarthrosis bilateral - M16.7 Other not secondary coxarthrosis - M16.9 Coxarthrosis, unspecifiedFull interpretation of the ICD code M16: ICD code M16 / International Classification of Diseases / Diseases of the musculoskeletal system and connective tissue / Arthropathy / Arthrosis / Coxarthrosis [arthrosis of the hip joint]
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- M16.0Primary coxarthrosis bilateral
- M16.1 Other primary coxarthrosis
- M16.2 Coxarthrosis as a result of dysplasia, bilateral
- M16.3 Other dysplastic coxarthrosis
- M16.4 Post-traumatic coxarthrosis, bilateral
- M16.5 Other post-traumatic coxarthrosis
- M16.6 Other secondary coxarthrosis, bilateral
- M16.7 Other secondary coxarthrosis
- M16.9 Coxarthrosis, unspecified
Code M16 “Coxarthrosis [arthrosis of the hip joint]” is part of the alphanumeric code system of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10).
The subgroup of codes M16 belongs to the group of codes M15–M19 “Arthrosis”. This group is part of the code block M00–M25 “Arthropathy”. This block is included in Class XIII “Diseases of the musculoskeletal system and connective tissue”.
Symptoms
Symptoms of osteoarthritis of the knee joint manifest themselves as pain and dysfunction of the knee joint, but their severity is determined by the severity of the pathological process.
Deforming osteoarthritis of the 1st degree is manifested by minor pain in the knee joint during movement, which increases towards the end of the day. A characteristic symptom is the so-called “starting pain” - a feeling of pain in the joint that occurs during the first steps after lifting the body from a sitting position. As a rule, the pain syndrome decreases/disappears after the start of walking, but appears again against the background of increased load. Less commonly, patients complain of a feeling of stiffness in the joint in the morning, a feeling of “tightening” in the popliteal fossa, and slight swelling of the knee joint. Visually the knee is not changed. The development of synovitis at this stage is extremely rare.
Deforming arthrosis of the knee joint of the 2nd degree manifests itself with a more intense pain syndrome, localized in the area of the anterior internal surface of the joint, which occurs against the background of minor loads and sharply increases with prolonged walking, standing or increased loads.
After a long rest, the pain disappears and reappears with movement. A crunching sound may occur while driving. Characterized by a decrease in the range of motion in the joint and the appearance of sharp pain with maximum flexion of the leg. There is a change in the configuration of the joint, frequent persistent synovitis with the accumulation of a larger volume of fluid.
Symptoms of osteoarthritis of the knee joint at the third stage are manifested by almost constant pain in the knee joint, both while walking and at rest. Sometimes the pain gets worse at night. Flexion/extension of the joint is significantly limited; often the patient can straighten the leg completely. Visually, the joint is deformed/increased in volume, sometimes there is valgus / varus deformity (X- or O-shaped legs). The gait becomes unstable and waddles; in some cases, patients must use crutches/canes to move. In severe cases, joint jamming syndrome may occur, which appears to block movements in the joint.
Deforming osteoarthritis of the ankle joint: how does it appear?
The ankle joint does not have its own vascular system, therefore, with metabolic disruptions caused by aging, intense training or other factors, the nutrition of the cartilage tissue is also disrupted. Due to the lack of “building materials” and important microelements, intracellular metabolism decreases, cartilage recovers poorly and slowly, and its basic structure gradually changes.
Chondroitin and glucosamine are synthesized less frequently and in small volumes, which are not enough to support and timely restore the joint. Hence the loss of elasticity, shock-absorbing properties and strength, and the formation of bone growths. In the future, if the disease starts and you don’t know how to treat osteochondrosis of the ankle joint, the cartilage will continue to deteriorate.
In the initial stages of the disease, symptoms of osteoarthritis of the ankle joint are rarely bothersome. Sometimes there is pain, but it goes away as quickly as it started.
Factors that can provoke OGS:
- Poor nutrition.
The body lacks protein, fatty acids and other essential substances.
- Uncomfortable shoes.
For example, high heels.
- Heredity.
- Age-related changes.
- Increased sports loads.
For example, boxing or dancing. There is also a high risk of arthrosis if you suddenly stop playing sports.
- Excess weight.
Excess weight significantly increases pressure on the joints.
- Flat feet, high stature, congenital dysplasia.
- Concomitant diseases such as diabetes, hemophilia, osteochondral disorders or vascular atherosclerosis.
It may occur due to problems with hormones or the thyroid gland. Especially at risk for women during menopause.
- Inactivity.
A lack of daily physical activity weakens muscles, which significantly increases the load on joints.
- What else potentially influences the development of ankle osteoarthritis?
- Hypothermia of the legs.
For example, your feet are cold because your shoes are not appropriate for the season.
- Carrying heavy things.
Arthrosis is especially often diagnosed among loaders.
- Injuries in the ankle area.
Any dislocations and fractures can cause cracks in the cartilage tissue. If microtrauma is not noticed and treated in time, serious consequences and diagnoses cannot be avoided.
In addition, the prerequisites include different leg lengths (due to shifting loads), damage to internal organs, and deformation of the toes. Work that requires a person to stand for a long time throughout the working day also often becomes an aggravating factor along with obesity.
Tests and diagnostics
The diagnosis of osteoarthritis of the knee joint is made on the basis of the patient’s complaints, physical examination data and the results of instrumental examination methods: radiographs in frontal and lateral projections/ultrasound of the joints, for the purpose of differential diagnosis - MRI of the knee joints. The main radiological signs of OA are: subchondral sclerosis osteophytes at the attachment points of ligaments/along the edges of joint surfaces , changes in the shape of the epiphyses/cysts in the epiphyses of the joints.
Diet
Diet for osteoarthritis of the knee joint
- Efficacy: no data
- Timing: constantly
- Cost of products: 1700-1800 rubles. in Week
With normal body weight, a balanced, nutritious diet is recommended, in accordance with age and energy expenditure. A mandatory requirement is the inclusion in the diet of natural chondroprotective products that promote the process of collagenase/hyaluronan synthesis, slow down negative structural changes in joints and normalize the structure of the cartilage tissue matrix. Products with such properties include: hard cheeses, cartilage, gelatin, chicken/pork legs, red fish and chicken meat, from which it is necessary to prepare jellied fish, jellies, fruit and berry jellies/jelly.
When body weight exceeds the norm, dietary nutrition is aimed at normalizing it. This diet is based on a reduced calorie content of the daily diet in the range of 500-600 kcal, on average to the level of 1800-2000 kcal/day, which ensures a gradual reduction in body weight at the level of 0.5-1.0 kg/week. The limit to 250-300 g is primarily limited to simple carbohydrates and refractory animal fats (up to 60 g). At the same time, the protein content remains within the physiological norm. It is recommended to practice 1-2 fasting days/week: fruit and vegetable, cottage cheese, kefir days.
The diet is limited to sugar, sweets, honey, chocolate, pastries, white bread, fatty meats, mayonnaise, fast food, high-calorie dairy products, waterfowl meat (duck/goose), animal/cooking fats, smoked meats. Any fried foods are not recommended.
Treatment
Treatment tactics Treatment goals: reduction of functional joint insufficiency, correction of therapy. Non-drug treatment Algorithm for the treatment of osteoarthritis. Stage I: - physiotherapy (thermal procedures, hydrotherapy); — physical therapy (the main task is to reduce the load on the joint and strengthen the muscles): correction of posture and length of the lower extremities, exercises with isometric loads, exercises for individual muscle groups; - local analgesics and NSAIDs (ointment, gel, cream). Drug treatment Algorithm for the treatment of osteoarthritis. Stage II: - systemic NSAIDs (non-steroidal anti-inflammatory drugs) when signs of manifest osteoarthritis occur and when signs of inflammation appear; - oral and rectal NSAIDs - ibuprofen, diclofenac, ketoprofen, lornoxicam, priroxicam, celecoxib; - chondroprotectors; - for persistent synovitis - intra-articular administration of glucocorticoids. Stage III: - if conservative treatment is ineffective - orthopedic surgery: hip or knee replacement, arthroscopy with abrasive chondroplasty. 1. Local analgesics (drugs with irritating and distracting effects) - finalgon. 2. Local NSAIDs - diclofenac, ibuprofen, ketoprofen, piroxicam. 3. Systemic NSAIDs - diclofenac (100–150 mg/day), ibuprofen (1200–2400 mg/day), ketoprofen (200–300 mg/day), naproxen (500–100 mg/day), piroxicam (20 mg/day), lornoxicam (8–16 mg/day). 4. Specific COX-2 inhibitors: celecoxib (200–400 mg/day). 1. Chondroitin sulfate (500 mg 2 times a day). 2. Hyaluronic acid derivatives for intra-articular administration (3 weekly intra-articular injections). Preventive measures: prevention of joint injuries, timely, complete treatment of arthritis. Further management: - elimination of mechanical factors (wearing orthopedic shoes, a corset or support belt, using a cane); - weight loss; - unloading of the affected joint. List of essential medications: 1. *Ibuprofen 200 mg, 400 mg tablet. 2. *Diclofenac sodium 25 mg, 100 mg, 150 mg tablet. 3. Diclofenac sodium, emulgel 1% for external use 4. Diclofenac potassium 12.5 mg tablet. 5. Ketoprofen solution for injection 100 mg/2 ml, amp. 6. Lornoxicam 4 mg, 8 mg tablet. 7. Celecoxib 100 mg, 200 mg caps. 8. Naproxen 250 mg tablet. 9. Piroxicam 10 mg tablet. 10. Chondroitin sulfate 5%, ointment 11. Phosphaden 0.05 g tablet, 2% solution for injection, amp. 12. Pentoxifylline 100 mg, dragee, solution for injection 100 mg/5 ml amp. 13. *Nadroparin calcium - solution for injection in pre-filled syringes 2850 IU anti-Xa/0.3 ml; 3800 IU anti-Xa/0.4 ml; 5700 IU anti-Xa/0.6 ml; 7600 IU anti-Xa/0.8 ml, 9500 IU anti-Xa/1.0 ml Indicators of treatment effectiveness: reduction in functional joint failure.
* – drugs included in the list of essential (vital) medicines.
List of sources
- Alekseeva L. I. Modern treatment of osteoarthritis // Pharmateka. -2012.- No. 2.- P.22-34.
- Alekseeva L.I. Recommendations for the management of patients with osteoarthritis of the knee joints in clinical practice // Attending physician. - 2015. -No. 1. - P. 64 - 69.
- Kornilov N.N., Denisov A.A. The paradigm of early gonarthrosis: a review of modern diagnostic and treatment options (part 1) // Therapeutic archive. 2021. T. 89, No. 12-2. pp. 238-243
- Kashevarova NG, Alekseeva LI, Anikin SG, et al. Osteoarthritis of the knee joints: risk factors for the progression of joint disease in a five-year prospective disease. Materials of the III Eurasian Congress of Rheumatologists, (Minsk, Republic of Belarus, May 26-27, 2021). Issues of organization and informatization of healthcare. 2016;
- Svetlova M. S. Approaches to the treatment of osteoarthritis of the knee joints in the early stages of the disease // Medical Council. 2012. No. 2. P. 3–9.
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Hello, dear friends! Today we will understand the question of what code is coxarthrosis of the hip joint according to ICD 10, what class of diseases it belongs to.
Many people know that there is such a system as ICD 10, but not everyone knows why it is needed and what benefits the doctor and patient can get from it. This will be discussed further.