AB0963 HOW OFTEN DO DOCTORS TREAT PATIENTS WITH LOCAL DAMAGE TO THE PERIARTICULAR SOFT TISSUES IN REAL CLINICAL PRACTICE?

Abstract

Background: Damage of the periarticular soft tissues (DPST)-tendinitis, entesitis, bursitis, etc. are one of the most common reasons for patients to contact rheumatologists and orthopedic surgeons. Objectives: To evaluate the frequency and localization of DPST in real clinical practice, as well as the effectiveness of therapy for this pathology in the acute period. Methods: 68 outpatient orthopaedic surgeons evaluated the frequency of initial patient recourse due to DPST within one month. The study did not include patients with systemic rheumatic diseases such as spondyloarthritis. The localization of DPST and the dynamics of clinical manifestations were evaluated in 1227 patients (women 42.5%, cf. age 51.3±15.5 years). Non-steroidal anti-inflammatory drugs (NSAIDs), mainly meloxicam, were used as a first-line treatment for DPST. The results of treatment were evaluated after 10-14 days with repeated visits of patients. Results: 7766 cases of primary outpatient treatment by orthopedic surgeons were evaluated. DPST was the cause of treatment in 1227 (15.8%) patients. This was the third highest incidence after acute injuries (37.2%) and knee osteoarthritis (20.6%). In patients with DPST, the most common lesions were in the knee area (knee entesopathy, prepatellar bursitis, pes anserinus area tendinitis/bursitis)-21.2%, the foot (plantar fasciitis)-16.9%, the shoulder (tendinitis of the rotator cuff)-16.4%, and the elbow (lateral and medial epicondylitis)-15.3%. After treatment, there was a significant decrease in the severity of pain during movement-from 6.58±1.61 to 2.48±1.60 points on the numerical rating scale (p<0.001), a decrease in the intensity of pain at rest, at night and during palpation, as well as the severity of functional disorders. The need for local injection of glucocorticoids occurred in 22.1% of patients. Significant improvement was observed in all DPST localities, with 68.1% of patients rating the treatment result as “good” and “excellent”. Adverse reactions were observed in 15.0% of patients, and no serious complications were reported. Conclusion: DPST is the third most frequent reason of recourse to a doctor after acute injuries and osteoarthritis of large joints in the practice of outpatient orthopedic surgeons. The use of NSAIDs in the maximum therapeutic dose for 10-14 days allows for significant improvement in DPST of different localization.