Intraosseous hypertension is a key factor of pain syndrome in gonarthrosis

The dynamics of intraosseous pressure (IOP) is described in the process of surgical treatment of patients with gonarthrosis of the first (14), second (12) and third (27) stages according to N.S. Kosinskaya. Mean age of patients - 54,5±5 years. Duration of the disease was from 5 to 12 years. 19 patients were subjected to decompression subchondral osteoperforation and fan-like tunnelization of the articular parts of femoral and tibial bones, and also oblique longitudinal tunnelization of the patella (Patent No. 2193363, RF). In case of gonarthrosis with the biomechanics of joint loading disordered (34 patients) high decompression correcting osteotomy of leg bones was used with the help of the utility model of the Ilizarov fixator (Patent No. 2212204, RF). As a result of the studies made it has been established that intraosseous transient hypertension is a clinical test which determines the character of articular pains. The greatest decrease of IOP was observed in patients with the third stage of the disease after decompression tunnelization and in those with the second stage of gonarthrosis after decompession correcting osteotomy. The results of the studies made and the data of literature allow to conclude that performance of decompression surgeries at different stages of gonarthrosis is justified from pathogenetic point of view.