Managing osteoarthritis in the early stages of the disease

Osteoarthritis (OA) is one of the most common rheumatic diseases that leads to degeneration of hyaline cartilage, synovial inflammation, and structural changes in joints. The main risk factors for developing OA are obesity, age, genetic predisposition, injury, and mechanical overload. Diagnosis of OA is based on clinical symptoms, examination data, and X-ray signs, but the early stages of the disease often remain unrecognized. A clinical case of a 52-year-old patient with primary OA of the knee joints, interphalangeal joints of the hands and feet is presented. A combination of burdened heredity, morbid obesity, menopause, prolonged wearing of high-heeled shoes, changes in the arches of the foot (flat feet), irrational intense sports activity led to the manifestation of OA. Comprehensive treatment included long-term administration of chondroitin sulphate at a dose of 1 000 mg/day, individually tailored therapeutic exercises, foot orthotics, and the development of a healthy diet, which led to a reduction in fat mass and an increase in muscle mass. After 1.5 years of therapy, improvement was achieved: a 23 kg reduction in body weight, complete relief of joint pain syndrome, normalisation of the initially elevated level of oligomeric matrix protein in the cartilage, and no radiographic progression of OA. It was this comprehensive personalised therapy at the stage of OA manifestation that made it possible to achieve good results in managing the disease at an early stage and prevent its further progression.

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