Background Over the years, the number of patients with an affected hip joint has been increasing. The pathology of the illness is moving towards a younger age and often handicaps the patients. As their age increases, the symptoms become more acute and endoprosthesis is required. With the complex rheumatologic and physiotherapy treatment, a surgery intervention can be postponed in time, and the symptoms significantly reduced
Objectives To measure the effect of conducting a one-year complex drug treatment combined with a physiorehabilitation program in patients with hip joint osteoarthritis.
Methods Between 2010 and 2014, 147 patients with coxarthrosis were hospitalized and treated at the Rheumathology Ward at UMHAT “Georgi Stranski” – Pleven. 58 of them were male and 89 female, aged between 42 and 81, with active arthrosis (ESR<25 mm, fibrinogen and CRP at relevant values, AST and RF (-).
In addition to the drug therapy with NSAIDs and chondoprotectors, the patients also undergo a complex physical and rehabilitation program consisting of: electrostimulation, therapeutic massages, kinesitherapy and ergotherapy.
Functional tests and measurements were made for the purpose of the study: the movement volume in the affected joints, VAS for the pain, locomotion tests, necessity for any walking aids.
Results An individual patient file is created for every patient where his results from the tests and measurements are stored in order to track the patient's condition over the course of one year (which consists of treatment in the Rheumathology ward, treatment in the Medical Rehabiltation ward and ambulatory physiorehabilitation courses).
The Wilcoxon rank test (a statistical method for analysis and spreading of non-parametric data) was used to measure the daily activities test results. The Wilcoxon curve shifts to the right, which indicates an improvement of the patients' self-sufficiency and of their quality of life. When applying the VAS test for pain and goniometry, the average values at the beginning and at the end of the observed period are measured and compared. The results show a pain decrease by around 30%, and an increase in the joint movement volume. The ANOVA statistical analysis method was applied to the results of the locomotion test.
Conclusions The collaboration between rheumatologists and physiotherapists for treatment of patients with coxarthrosis widens the range of daily activities that the patients can perform without experiencing pain, slows down the progression of the deterioration process and makes the daily life of patients more complete and self-sufficient.
For patients who are still at working age, the duration of their temporary inability to work is decreased, and they can resume working activities sooner, or they can acquire new professional skills with a lower degree of physical stress which suits their condition and physical abilities. The advent of permanent disability for patients and early endoprosthesis are delayed.
The complex physiorehabilitational and rheumathological treatment for patients with hip joints affected by osteoarthritis is effective and leads to a significant improvement in the quality of life of patients.
Disclosure of Interest None declared