FIELD: medicine; orthopaedics.
SUBSTANCE: invention can be used for the conservative treatment of osteonecrosis while maintaining the integrity and shape of the cartilaginous layer of the articular surface. A course of extended epidural analgesia is administered for 7 days, followed by a subsequent course of extended epidural analgesia three months later. For the entire time between courses of extended epidural analgesia, adjuvant therapy is used. Tolperisone is taken orally once at night in a daily dose of 450 mg for 3 months. Sulodexide, is taken 1 ampoule per day for 15–20 days, then the therapy with the medicinal product is continued, one capsule is taken twice a day, before meals for three months. Purified micronized flavonoid fraction is used at a dose of 1,000 mg daily for three months. Two weeks after removing the catheter from the epidural space, the patient is given a single dose of zoledronic acid at a dose of 5 mg. Cholecalciferol is used at a dose of 570 mg, 1 capsule of 2,000 IU/day, and ossein-hydroxyapatite complex, one tablet twice a day for the entire treatment period. During the treatment with the medicinal products, therapeutic physical exercises with limited load are performed. Walking on crutches or using an unloading orthosis for the first three months is required.
EFFECT: method ensures interruption of the pathological process in the early stages of osteonecrosis before the collapse of the cartilage layer through an integrated approach, including multiple courses of long-term epidural analgesia carried out against the background of osteotropic therapy in combination with a course of vascular therapy.
1 cl, 9 dwg, 2 ex
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Authors
Dates
2024-01-30—Published
2023-05-22—Filed