EVALUATION OF RESULTS OF THE FIRST EXPERIENCE OF COMBINED SURGERY FOR VARICOSE VEINS AND KNEE OSTEOARTHRITIS
Objective: To analyze the results of the first experience of performing simultaneous operations for saphenous varicose veins of the lower extremities and knee osteoarthritis. Methods: The results of simultaneously performed combined phlebectomy and arthroscopic knee surgery in patients with varic...
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| Format: | Article |
| Language: | English |
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Avicenna Tajik State Medical University
2022-09-01
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| Series: | Паёми Сино |
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| Online Access: | https://doi.org/10.25005/2074-0581-2022-24-3-331-343 |
| _version_ | 1827925418654564352 |
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| author | O. NEMATZODA A.D. GAIBOV O.F. SOLIEV KH.A. TOSHPULOTOV S.G. ALI-ZADE A.K. BARATOV |
| author_facet | O. NEMATZODA A.D. GAIBOV O.F. SOLIEV KH.A. TOSHPULOTOV S.G. ALI-ZADE A.K. BARATOV |
| author_sort | O. NEMATZODA |
| collection | DOAJ |
| description | Objective: To analyze the results of the first experience of performing simultaneous operations for saphenous varicose veins of the lower extremities and knee osteoarthritis.
Methods: The results of simultaneously performed combined phlebectomy and arthroscopic knee surgery in patients with varicose veins (VV) were analyzed. A total of 15 female patients (mean age 52.8±1.9 years) were included in the study. In 5 patients, Clinical Class II, according to the Clinical Etiological Anatomical Pathophysiological (CEAP) classification, published in 1994 for chronic venous disease, was noted, and in 10 – class III. In 13 (86.7%) cases, there was a bilateral dilatation of the saphenous veins; and in 12 patients, there was a combined dilatation of both the Great Saphenous Vein (GSV) and Small Saphenous Vein (SSV). Perforator venous insufficiency was present in 5 patients. Among those examined, in 5 cases, clinical and laboratory findings of the КOA grade II, according to the Kellgren and Lawrence system (1957) for OA classification, were noted, and in 10 patients – grade III. Overweight was observed in 9 patients, and the mean weight was 77.5±3.8 kg. Assessment of the function of the knee joints before and three months after the operation was carried out according to Lequesne's algo-functional index (AFI).
Results: The mean diameter of the GSV and SSV was 10.2±0.4 and 6.4±0.4 mm, respectively, and the diameter of insufficient perforating veins was 4.1±0.3 mm. The malleolar circumference before surgical treatment was 37.7±1.5 cm. In all cases, patients had pain and discomfort during the night (n=5 with movement and n=10 without), morning stiffness (n=9), and increased pain when walking a certain distance (n=8) or at the beginning of the movement (n=7). A positive correlation was found between pain and discomfort with age (r=0.53), KOA stage (r=0.70), malleolar circumference (r=0.58) and a negative correlation with body weight (r=-0.55) and recurrence of VV(r=-0.68). All patients complained of walking difficulties, and as a result, their walking distance was reduced. A direct correlation was found between walking distance and body weight (r=0.71), KOA stage (r=0.84), malleolar circumference (r=0.81), pain and discomfort during the night (r=0.66). In addition, in all cases, there was a decrease in daily life activities – the ability to climb one flight of stairs up or down at a moderate effort, squatting or kneeling, and limited ability to walk on uneven ground. The mean operative time of the combined operation's first step (phlebectomy) and arthroscopic knee surgery was 125.5±25.5 and 58.2±10.5 minutes, respectively. The development of postoperative seroma in the wound area was observed in only one case. The average hospital stay was 7.2±1.2 days, and sutures were removed within 10-12 days. A follow-up examination of patients after 1 and 3 months revealed a significant decrease in all the above parameters of Lequesne's AFI and malleolar circumference to 32.0±1.3 cm.
Conclusion: Combined phlebectomy with arthroscopic knee surgery in VV comorbid with KOA results in a significant improvement in symptomatic KOA patients with increased walking distance and daily activity with no significant complications. |
| first_indexed | 2024-03-13T05:25:31Z |
| format | Article |
| id | doaj.art-9c0529fefcea4c7c807558c7a90bb3c8 |
| institution | Directory Open Access Journal |
| issn | 2074-0581 2959-6327 |
| language | English |
| last_indexed | 2024-03-13T05:25:31Z |
| publishDate | 2022-09-01 |
| publisher | Avicenna Tajik State Medical University |
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| series | Паёми Сино |
| spelling | doaj.art-9c0529fefcea4c7c807558c7a90bb3c82023-06-15T08:24:18ZengAvicenna Tajik State Medical UniversityПаёми Сино2074-05812959-63272022-09-0124333134310.25005/2074-0581-2022-24-3-331-343EVALUATION OF RESULTS OF THE FIRST EXPERIENCE OF COMBINED SURGERY FOR VARICOSE VEINS AND KNEE OSTEOARTHRITISO. NEMATZODA0A.D. GAIBOV1 O.F. SOLIEV2KH.A. TOSHPULOTOV3S.G. ALI-ZADE4A.K. BARATOV5Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of TajikistanAvicenna Tajik State Medical University, Dushanbe, Republic of TajikistanAvicenna Tajik State Medical University, Dushanbe, Republic of TajikistanRepublican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of TajikistanAvicenna Tajik State Medical University, Dushanbe, Republic of TajikistanRepublican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of TajikistanObjective: To analyze the results of the first experience of performing simultaneous operations for saphenous varicose veins of the lower extremities and knee osteoarthritis. Methods: The results of simultaneously performed combined phlebectomy and arthroscopic knee surgery in patients with varicose veins (VV) were analyzed. A total of 15 female patients (mean age 52.8±1.9 years) were included in the study. In 5 patients, Clinical Class II, according to the Clinical Etiological Anatomical Pathophysiological (CEAP) classification, published in 1994 for chronic venous disease, was noted, and in 10 – class III. In 13 (86.7%) cases, there was a bilateral dilatation of the saphenous veins; and in 12 patients, there was a combined dilatation of both the Great Saphenous Vein (GSV) and Small Saphenous Vein (SSV). Perforator venous insufficiency was present in 5 patients. Among those examined, in 5 cases, clinical and laboratory findings of the КOA grade II, according to the Kellgren and Lawrence system (1957) for OA classification, were noted, and in 10 patients – grade III. Overweight was observed in 9 patients, and the mean weight was 77.5±3.8 kg. Assessment of the function of the knee joints before and three months after the operation was carried out according to Lequesne's algo-functional index (AFI). Results: The mean diameter of the GSV and SSV was 10.2±0.4 and 6.4±0.4 mm, respectively, and the diameter of insufficient perforating veins was 4.1±0.3 mm. The malleolar circumference before surgical treatment was 37.7±1.5 cm. In all cases, patients had pain and discomfort during the night (n=5 with movement and n=10 without), morning stiffness (n=9), and increased pain when walking a certain distance (n=8) or at the beginning of the movement (n=7). A positive correlation was found between pain and discomfort with age (r=0.53), KOA stage (r=0.70), malleolar circumference (r=0.58) and a negative correlation with body weight (r=-0.55) and recurrence of VV(r=-0.68). All patients complained of walking difficulties, and as a result, their walking distance was reduced. A direct correlation was found between walking distance and body weight (r=0.71), KOA stage (r=0.84), malleolar circumference (r=0.81), pain and discomfort during the night (r=0.66). In addition, in all cases, there was a decrease in daily life activities – the ability to climb one flight of stairs up or down at a moderate effort, squatting or kneeling, and limited ability to walk on uneven ground. The mean operative time of the combined operation's first step (phlebectomy) and arthroscopic knee surgery was 125.5±25.5 and 58.2±10.5 minutes, respectively. The development of postoperative seroma in the wound area was observed in only one case. The average hospital stay was 7.2±1.2 days, and sutures were removed within 10-12 days. A follow-up examination of patients after 1 and 3 months revealed a significant decrease in all the above parameters of Lequesne's AFI and malleolar circumference to 32.0±1.3 cm. Conclusion: Combined phlebectomy with arthroscopic knee surgery in VV comorbid with KOA results in a significant improvement in symptomatic KOA patients with increased walking distance and daily activity with no significant complications.https://doi.org/10.25005/2074-0581-2022-24-3-331-343varicose veinsknee osteoarthritisphlebectomyvein strippingarthroscopic knee surgerycombined operations. |
| spellingShingle | O. NEMATZODA A.D. GAIBOV O.F. SOLIEV KH.A. TOSHPULOTOV S.G. ALI-ZADE A.K. BARATOV EVALUATION OF RESULTS OF THE FIRST EXPERIENCE OF COMBINED SURGERY FOR VARICOSE VEINS AND KNEE OSTEOARTHRITIS Паёми Сино varicose veins knee osteoarthritis phlebectomy vein stripping arthroscopic knee surgery combined operations. |
| title | EVALUATION OF RESULTS OF THE FIRST EXPERIENCE OF COMBINED SURGERY FOR VARICOSE VEINS AND KNEE OSTEOARTHRITIS |
| title_full | EVALUATION OF RESULTS OF THE FIRST EXPERIENCE OF COMBINED SURGERY FOR VARICOSE VEINS AND KNEE OSTEOARTHRITIS |
| title_fullStr | EVALUATION OF RESULTS OF THE FIRST EXPERIENCE OF COMBINED SURGERY FOR VARICOSE VEINS AND KNEE OSTEOARTHRITIS |
| title_full_unstemmed | EVALUATION OF RESULTS OF THE FIRST EXPERIENCE OF COMBINED SURGERY FOR VARICOSE VEINS AND KNEE OSTEOARTHRITIS |
| title_short | EVALUATION OF RESULTS OF THE FIRST EXPERIENCE OF COMBINED SURGERY FOR VARICOSE VEINS AND KNEE OSTEOARTHRITIS |
| title_sort | evaluation of results of the first experience of combined surgery for varicose veins and knee osteoarthritis |
| topic | varicose veins knee osteoarthritis phlebectomy vein stripping arthroscopic knee surgery combined operations. |
| url | https://doi.org/10.25005/2074-0581-2022-24-3-331-343 |
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