Cardiovascular Surgery
doi: 10.25005/2074-0581-2022-24-2-193-203
THE ROLE OF KNEE OSTEOARTHRITIS IN THE DEVELOPMENT OF VARICOSE VEINS IN THE LOWER EXTREMITIES
1Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan
2Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
3Department of Traumatology, Orthopedics and Military Surgery, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
4Department of Surgical Diseases № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
Objective: To evaluate the role of arthritis of the knee joint in the development and progression of varicose veins of the lower extremities.
Methods: An observational cross-sectional cohort study was conducted on 180 patients. There were 56 (31.1%) males and 124 (68.9%) females with VVs of the lower extremities. The VVs' clinical features were studied according to the presence or absence of knee osteoarthritis. The study group (SG) included 88 patients with KOA in combination with VVs. The control group (CG) comprised 92 people suffering from VVs and not having a degenerative joint disease of the knee. Both groups of patients were comparable in terms of basic demographic parameters, disease duration and body mass index.
Results: In the SG, oedema and skin trophic changes of the lower limbs (lipodermatosclerosis, eczema) were observed in 39 and 21 cases, respectively. The number amounts to 68.2%, which was 33.4% more compared to the percentage of the CG cases (34.8%, n=32). In the presence of KOA, a varicose transformation of both saphenous veins and their tributaries was more often noted in 36 (40.9%) cases, whereas in CG patients, VVs development occurred only in 6 (6.5%) cases. On the contrary, an isolated varicose transformation of the great saphenous vein (GSV) and its tributaries was more common among CG compared to SG patients, at 93.5% and 55.7%, respectively. Among the examined cohort, the incidence of isolated disease of the small saphenous vein (SSV) and insufficiency of its ostial valve had no significant difference between SG and CG patients and occurred in 3.4% and 6.5% of cases, respectively. In SG patients, concurrent incompetence of the ostial valves of the GSV and SSV (n=39; 44.3%) and insufficiency of leg perforating veins (n=60; 68.2%) were more often noted. In the CG, perforator reflux and incompetence of the communicating veins were present only in 6 (6.5%) and 32 (34.8%) patients, respectively. The mean GSV ostial diameter in SG and CG patients was significantly different and amounted to 12.1±1.4 mm and 8.2±0.9 mm, respectively. Varicose dilatation of the superficial veins of both lower extremities was most often noted in the SG than in CG, 90.9% and 39.1% of the patients, respectively. There was a direct correlation between the KOA stage and such factors as VVs class (r=0.58; p<0.001), the laterality of lower limbs involvement (r=0.63; p<0.001) and disease recurrence (r= 0.59; p<0.001).
Conclusion: Degenerative joint disease of the knee, in which the locomotor function of the limb is impaired, can act as one of the risk factors for the development or progression of varicose transformation of the superficial veins of the lower extremities. Therefore, further research is needed to study the lower limb biomechanics in patients with VV, with and without KOA.
Keywords: Varicose veins, knee osteoarthritis, venous hypertension, ostial valve incompetence.
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Authors' information:
Nematzoda Okildzhon
Candidate of Medical Sciences, Leading Researcher of the Republican Scientific Center for Cardiovascular Surgery
Researcher ID: F-8729-2018
Scopus ID: 56469644700
ORCID ID: 0000-0001-7602-7611
SPIN: 2408-9107
Author ID: 929575
E-mail: sadriev_o_n@mail.ru
Gaibov Alidzhon Dzhuraevich
Corresponding Member of National Academy of Sciences of the Tajikistan, Doctor of Medical Sciences, Full Professor, Professor of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
Researcher ID: AAC-9879-2020
Scopus ID: 6602514987
ORCID ID: 0000-0002-3889-368X
SPIN: 5152-0785
Author ID: 293421
E-mail: gaibov_a.d@mail.ru
Kurbanov Saybilol Khushvakhtovich
Doctor of Medical Sciences, Professor of the Department of Traumatology, Orthopedics and Military Surgery, Avicenna Tajik State Medical University
Researcher ID: ABЕ-2853-2020
ORCID ID: 0000-0002-2853-2020
Author ID: 584471
E-mail: 9282718@mail.ru
Toshpulotov Khurshed Abdumutalibovich
Applicant, Republican Scientific Center for Cardiovascular Surgery
ORCID ID: 0000-0002-1735-795X
E-mail: rncssh@mail.ru
Ali-Zade Sukhrob Gaffarovich
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-2456-7509
SPIN: 6854-5343
Author ID: 258253
E-mail: suhrob_a@mail.ru
Baratov Alisher Kenjaevich
Candidate of Medical Sciences, Associate Professor, Endovascular Surgeon, Department of Endovascular Surgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: AAE-6818-2019
Scopus ID: 8249648700
ORCID ID: 0000-0002-8072-5751
SPIN: 6576-1680
Author ID: 268956
E-mail: alishbar@rambler.ru
Information about support in the form of grants, equipment, medications
The authors did not receive financial support from manufacturers of medicines and medical equipment
Conflicts of interest: No conflict
Address for correspondence:
Nematzoda Okildzhon
Candidate of Medical Sciences, Leading Researcher of the Republican Scientific Center for Cardiovascular Surgery
734003, Republic of Tajikistan, Dushanbe, Sanoi str., 33
Tel.: +992 (915) 250055
E-mail: sadriev_o_n@mail.ru
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