EUROMEDICA  Hanover 1-2  Juni 2007	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover Russian Academy of Natural Sciences, Moscow

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The prophylaxy and the treatment of the osteoarthritis of the hip is one of the most actual problem of modern orthopedy.

The aim of this study was to research the change of level of proinflammatory cytokines in blood serum and synovial content in patients with different grades of hip osteoarthritis.

In conformity with the aim we have examined 84 patients with a mean age of 42,5 years (18 to 64), who were treated as outpatients and in traumatology department at Municipal Clinical Hospital Nr.33 named after professor A.A. Ostroumov between 1998 and 2006. There were 38 (45,2 %) men and 46 (54,8 %) women. All patients were divided into 4 groups in conformity with the grade of osteoarthritis. The first group consisted of 7 (8,3 %) patients with grade-I osteoarthritis. The second group included 24 (28,6 %) patients with grade-II disease. Those 43 (51,2 %) with grade-III changes were in the third group. 10 (11,9 %) Patients with grade-IV osteoarthritis were attributed to the fourth group. The control group consisted of 12 results of investigations of synovial content and blood serum of people without osteoarthritis and with complaints of pain in the hip, who were assessed in traumatology department. At the same time these patients had not any pathology of the hip or any other degenerative and inflammatory processes seemed to be significant to change the results of the study. The research of proinflammatory cytokines in blood serum and synovial content of the hip was carried out with immunofermental method. To assess general state of the patient, disorders of blood functions and success of application therapy we used physical examinations, X-rays studies, electrophysical, laboratory investigations, pathohistological and immunological studies. We performed the analysis of the findings with using PC “Pentium IV “, Microsoft Windows 2000 Server-system, Microsoft Excel and Microsoft Access programs. In conformity with the results of the study we have worked out the method of successive conservative treatment of hip osteoarthritis-arthritis based on the complex application of chondroprotective agents, anti-inflammatory drugs, polyvitamins, “prosthesis of synovial content ”, intra-articular therapy with oxygen, exercise and physiotherapy, using of rodon-oil drug and special orthopedic shoes accordingly to the grade of disease.

At follow-up, these findings of comparative investigation of the levels of proinflamatory cytokines in blood serum and in synovial content in patients with different grades of osteoarthritis and after the conservative treatment have shown, that the level of IL-6 in blood serum was increased in grade-1, grade-11, grade-111 osteoarthritis, and level of IL-1beta was increased only in grade-1 and grade-11 changes and was decreased in grade111. At the same time the level of TNF-alfa was high during all stages of pathological process. Marked quantitative levels of IL-1 and TNF-alfa in all grades of osteoarthritis were defined in carried out examination data of synovial content. Thus, our findings have revealed, that the level of proinflammatory cytokines in blood and synovial content was shown to be an effective way of evidence of progress of pathological process in the hip. This fact is useful to diagnose the development and progress of degenerative changes in the joint in time and to control the success of application therapy and to make methods of operative treatment more correctly.