Med. praxi. 2024;21(5):320-323 | DOI: 10.36290/med.2024.052

Léčba gonartrózy III. stupně u polymorbidní pacientky

MUDr. Helena Zedková

Ambulance praktického lékaře MUDr. Františka Uhlářová, s. r. o., Třinec

Osteoarthritis is a multifactorial disease that affects a large portion of the population. It is reported that the image of osteoarthritis is visible in X-ray examinations in up to 60% of examined individuals over 65. It is one of the most common causes of morbidity. Osteoarthritis accounts for up to 20% of visits to a general practitioner's office. In younger individuals, it can be a cause of disability. It is a multifactorial degenerative joint disease in which there is a disruption in the renewal of joint cartilage. The joint cartilage loses its luster, softens, and fissures form on its surface. Gradually, the cartilage becomes less resilient and losses occur. The subchondral bone becomes sclerotic, and osteophytes form at the edges of the joint. Secondarily, surrounding soft tissues, especially ligaments, are affected. Knee osteoarthritis (gonarthrosis) can affect the medial, lateral femorotibial, or femoropatellar area. It causes pain, typically at the beginning of movement, the pain intensifies and is influenced by the weather. Movement is limited, and axial deformities are often visible. We distinguish four degrees of gonarthrosis based on X-ray findings. Treatment includes regimen measures, pharmacotherapy, and surgical treatment. Analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs), other non-opioid, and possibly opioid analgesics can be used. The most effective treatment is often with NSAIDs, which suppress the inflammatory component of the process. A suitable representative from the group of analgesics with anti-inflammatory effects is aceclofenac, which preferentially acts on COX-2. It is taken orally, quickly absorbed, and its bioavailability is almost 100%. Aceclofenac is well tolerated and is gentler on the gastrointestinal tract compared to most NSAIDs. The case study illustrates the treatment procedure for a poly morbid patient with gonarthrosis and chronic vertebrogenic algic syndrome of the lumbar spine.

Keywords: osteoarthritis, gonarthrosis, nonsteroidal antiphlogistics.

Accepted: November 20, 2024; Published: December 2, 2024  Show citation