DIAGNOSTIC SYSTEM FOR FUNCTIONAL STUDIES IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE JOINT

Abstract

Osteoarthritis of the knee joint is one of the most common joint-degenerative diseases. Its frequency increases with age. It is caused by both internal and external risk factors. Osteoarthritis in the knee joint is typically identified through the observation of pathological changes, which may include damage to the articular cartilage, abnormal bone formation, reactive changes in the synovial membrane, and the presence of pathological synovial fluid. Degenerative changes in the joint progress gradually. Functional patient dysfunction also progresses and often leads to disability. The disease is diagnosed with clinical and X-ray examinations: magnetic resonance, bone scintigraphy, arthroscopy and others. In the future, markers of articular cartilage destruction products in body fluids will be the key to determining the time of onset of the disease, its progression and the progress of treatment. High hopes in the treatment of osteoarthritis of the knee joint are related to gene therapy (Kwiatkowski, Płomiński, 2004). Conservative treatment includes: specialized kinesitherapy programs, weight loss in combination with topical or oral non-steroidal anti-inflammatory drugs (Katz, Arant, Loeser, 2021). The aim of this study is to prepare a diagnostic system of modern methods for functional tests, to assess the condition of patients with osteoarthritis of the knee joint. The following methods of functional tests are considered: centimetry (measuring centimeter displacement of the lower limb circumference to monitor changes in swelling and muscle hypo/hypertrophy); goniometry (measuring the volume of movement in the knee joint in flexion and extension with a goniometer); pain assessment on a visual-analog scale (VAS from 0 to 10); manual muscle test – for muscle strength assessment; knee functional assessment questionnaire (Knee Society Knee Score); rotation test for edema testing; measurement of Q-angle (patellofemoral angle); knee flexion catheter test; eccentric step test (15cm ladder). The dysfunctions that are characteristic of osteoarthritis of the knee joint include pain, swelling, limited range of motion in the knee joint, myo-articular contractures, muscle imbalance, muscle hypotrophy, altered patellar femoral Q-angle, dynamic instability, impaired neuromuscular control, locomotive dysfunction (walking, climbing, and descending stairs), and others. The correct selection of functional tests is essential for the effective conduct of kinesitherapy to assess the available dysfunction as well as the progression of recovery. Functional studies can also serve as a corrective measure for the physiotherapy program, in cases where no improvement is observed in some of the evaluated indicators. A diagnostic system for functional tests has been prepared in patients with osteoarthritis of the knee joint. The diagnostic system provides objective information about the patient's current condition before, during and after kinesitherapy. It is an indicator of the correct selection of kinesitherapy methods, dosage, and the effectiveness of the procedures. The study examined various innovative functional tests for osteoarthritis of the knee joint. Each of the tests has its own methodology and specificity.