Substantiation of the Preclinical Stage of Gonarthritis. Prospects for Early Chondroprotective Therapy

The relevance of the problem . Late diagnosis of gonarthritis (GA) based on radiological criteria determines a decrease in the effectiveness of chondroprotective drugs (CD). The aim is to identify early changes in the hyaline cartilage of the knee joints and evaluate the effectiveness of chondroprotective therapy at an early stage of the disease. Materials and methods . 186 patients with high risk of GA were examined. All patients signed an informed consent. 119 patients took CD for two years, 67 patients did not receive therapy. The control group consisted of 31 healthy people without GA risk factors. Initially and 2 years later, everyone underwent ultrasound examination of the knees. The dynamics of the minimum thickness of hyaline cartilage (HC) was evaluated. Results . After 2 years, the HC height in the control group decreased to (2.84±0.16) mm and had no statistically significant differences from the initial value. In the comparison group in which patients did not take CD, HC decreased by (0.24±0.15) mm, which is 2.7 times more than in the group of patients receiving CD and 4.8 times more than in the control group ( p = 0.01). In the group receiving CD, the minimum thickness of HC decreased by (0.09±0.12) mm and was comparable with the indicators of the control group ( p = 0.49). Conclusions . In patients at high risk of GA, an initially low minimum cartilage thickness is determined, and its intensive loss is noted, compared with the control. The use of CD in patients at high risk of GA prevents the loss of HC at an early preclinical stage.