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[Is gonarthrosis with varus deformity a clinical entity]
Insights
Patients with varose deformity exhibit altered bone metabolism, including higher calcium retention and distinct X-ray findings. This suggests gonarthrosis with varose deformity may be a unique clinical entity affecting localized bone processes.
Area of Science:
- Orthopedics
- Metabolic Bone Disease
- Rheumatology
Background:
- Varose deformity, particularly genu varum, is associated with articular diseases.
- Bone metabolism alterations may play a role in the pathogenesis of varose deformity and related joint conditions.
- Understanding these metabolic changes is crucial for diagnosing and managing associated conditions like gonarthrosis.
Purpose of the Study:
- To investigate individual bone metabolism in patients with varose deformity compared to healthy controls and patients with other articular diseases.
- To analyze urinary excretion of hydroxyproline, nitrogen, phosphorus, and calcium balance after intravenous calcium administration.
- To correlate clinical and radiological findings with metabolic profiles in genu varum patients.
Main Methods:
- Bone metabolism studies involving intravenous calcium administration.
- Analysis of urinary hydroxyproline, nitrogen, phosphorus, and calciuria.
- Radiological examination (X-ray) for bone structure changes (sclerosis, necrosis, osteophytes).
- Epidemiological analysis including body mass index (Broca formula) and age of onset of knee pain.
Main Results:
- Subjects with genu varum showed decreased urinary hydroxyproline and nitrogen excretion after calcium administration.
- This group exhibited the lowest urine output, reduced calciuria, and highest calcium retention.
- Patients with gonarthrosis and varose deformity excreted significantly less phosphorus post-calcium infusion compared to controls.
- X-rays revealed more pronounced bone changes (sclerosis, necrosis, osteophytes) in genu varum patients.
- Overweight (83.3%) and onset of knee pain around age 50 were common; varicose syndrome and phlebitis were also prevalent.
Conclusions:
- Patients with gonarthrosis and varose deformity demonstrate unique bone metabolic patterns, including high calcium retention and altered phosphorus excretion.
- Distinct radiological findings in genu varum suggest a localized bone process.
- Gonarthrosis associated with varose deformity may represent a distinct clinical entity separate from other degenerative joint diseases.
- Further research is warranted to elucidate the specific mechanisms and implications of these findings.
Abstract:
Studies were conducted in a group of patients with varose deformity. The present paper gives the results of indicidual bone metabolism studies conducted on 663 healthy controls and patients with articular disease without genu varum or with varose deformity. In subjects with genu varum intravenous administration of calcium causes the urinary elimination of hydroxyproline and nitrogen to fall. Among the groups under investigation this group of patients excretes the least amount of urine, has a relatively low calciuria and shows the highest retention rate of intravenously administered calcium. Patients with gonarthrosis associated to varose deformity excrete, a day after intravenous administration of calcium, the relatively least amounts of phosphorus, as compared to the healthy controls and other degenerative joint diseases without genu varum. Although the retention of intravenous calcium in the studied group resembles that seen in the process of generalized osteomalacia, no coinciding signs of osteomalacia c ould be found in subjects with gonarthrosis and varose deformity. X-ray examination of patients with genu varum revealed more marked changes in the bone structure, namely sclerosis, necrosis and osteophytes of shapes and sizes other than in gonarthrosis without varose deformity. Epidemiological analysis of 30 patients showed 83.3% of patients to have overweight type I to III according to the Broca formula. Pains in the knee joints started appearing at the mean age of 50 years. A large part of the patients showed the presence of serious varicose syndrome and relapsing phlebitis of the lower limbs. Although the clinical and X-ray pictures make it possible to conisder a larger amount of disease types, we assume that gonarthrosis with varose deformity may be regarded as an isolated clinical entity which refers primarily to a localized bone process.