[Significance of biomechanical criteria in proper treatment planning in knee osteoarthritis]

Following the established and unequivocal criteria when choosing the treatment of knee osteoarthritis, despite possibility of precise imaging, is still very problematic. This is partly because doctors of different disciplines: general practitioners, orthopaedic surgeons, rheumatologists, physiotherapists, are involved in the treatment of this disease. For most of them the basic criteria to implement the treatment are: pain and assessment of X -ray in the supine position. As a result of that, despite slight and doubtful improvement, treatment is improperly targeted and extended. The aim of the study was to prove that the correct diagnosis, including biomechanical characteristics of the affected limb, choice of correct treatment, and observance of indications, can shorten treatment, make it more efficient and less expensive.

We analyzed of 103 patients qualified for total knee arthroplasty between 2006 and 2011. The indication was primary and advanced knee osteoarthritis in phases III and IV according to Ahlbäcka scale medial displacement of mechanical axis deviation in the lower limb with club- -foot (I to IV degrees) and with centre of rotation of angulation (CORA) in the proximal part of the tibia. Only subjects with body mass index under 25 were included in the study. Surveys were used to assess the pre -operative duration of illness, non-surgical methods of treatment and their effects. Final evaluation was made using the Visual Analogue Scale (10 -degrees) of pain (during the effort and rest) and gait efficiency 30 days after completed treatment.

The 66.5% of patients showed no significant improvement in all assessed parameters, which would justify to continuation of the therapy as described above.