Surgical Treatment of Patients with Tophus Gout
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Herasymenko, S., Poluliakh, M., Duda, M., Babko, A., Herasymenko, A., Poluliakh, D., Pshenychnyi, T., & Huzhevskyi, I. (2022). Surgical Treatment of Patients with Tophus Gout. TERRA ORTHOPAEDICA, (2(113), 32-41.


Introduction. Modern diagnostics, comprehensive orthopedic treatment, prevention of complications and adequate rehabilitation of patients with chronic gout can reduce the frequency and severity of exacerbations, prevent the development of secondary osteoarthrosis, maintain ability to work, improve social adaptation of patients and reduce their disability.

Objective: to improve treatment results of patients with chronic tofus gout by developing indications for surgical treatment and improving existing methods of modern orthopedic treatment.

Materials and Methods. The materials of the study were based on treatment results of 58 patients with a diagnosis of chronic tofus gout, who were observed and treated in clinics of SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine” during 2012-2021. The age of patients ranged from 30 to 80 years (mean age 58.4±5.3 years). All patients were divided into two groups – main and control. The main group included patients (27 patients) who, in addition to conservative methods, underwent surgical treatment. The control group included 31 patients with chronic tofus gout who did not undergo surgery. For the development of indications and visualization of the pathological process severity, all patients underwent sonographic examination; removed tissues after surgery underwent morphological examination.

Results. The results of pathomorphological studies allowed us systematically evaluate the dynamics of morphological changes in joint tissues in tofus gout, to clarify the features of the inflammatory process and the formation of tofus, and to determine the effects of tofus impact on the structural and functional state of tissues in affected joint.

Conclusions. Surgical treatment in combination with conservative allows reducing the activity of the disease compared to the control group, to achieve a faster decrease in uric acid serum levels, reduce the number and duration of exacerbations regardless of the duration of the disease, reduce pain, improve quality of life, and reduce or avoid disability in patients.
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