Five-year results of clinical use of arthromedullary bypass for knee osteoarthritis

Aim. To study the results of arthromedullary bypass (AMB) in arthroscopic treatment of gonarthrosis at 5 years after the intervention. Material and methods. 152 patients aged 42 to 80 years with osteoarthritis of the knee joint participated in the study. 67 control patients underwent arthroscopy of the joint only, 85 patients underwent additional AMB. Treatment efficacy was also compared in subgroups of patients selected for similar clinical and demographic factors. Outcomes were assessed over 60 months using the Lequesne and WOMAC indices, and the frequency of anti-inflammatory medication was noted. Results. Significant joint improvement was noted after 3 months and was maintained throughout the follow-up period. The incidence of joint stiffness, swelling, and nighttime joint pain decreased by 58, 69, and 75% in bypassed patients, respectively, and by 28, 25, and 54% in controls, respectively, (p < 0.01). Medication was required in 32% of control patients and 13% of AMB patients (p<0.05). Bypass surgery had a 17% higher success rate compared to controls (p < 0.05). In the matched subgroup with AMB, the reduction in the incidence of joint stiffness, edema and nocturnal pain after 5 years was 82, 74 and 83%, respectively, versus 35, 35 and 61% in controls (p < 0.01–0.05).. In the control group, 32% of patients required analgetics and NSAIDs, while only 5% did in the bypass group (p < 0.05). The success rate for bypass surgery was 35% higher than in the control subgroup (p < 0.05). Conclusion. The use of AMS in the treatment of gonarthrosis rapidly improves the condition of the affected joints, maintains a long-term five-year effect, and reduces the risk of invasive surgical interventions.

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