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A 62-year-old woman and 59-year-old man presented with the signs of degenerative gonarthritis. They had no issues of breathing, pulse and blood pressure. They had no consciousness and also did not report any sensory disorder.
Which of the following methods could be the suitable management option for this case?
Degenerative
gonarthritis is a disorder caused by damage in the joint cartilage and the
surrounding ligaments and muscles, responsible for joint movement. It is
characterized by weakness of joints and severe abrasion in cartilage resulting
in stiffness, reduced range of work, pain and functional dependency.
Sociopsychological issues may also result because of prolonged pain and
functional disorder. Research evidence depicts that mechanical joint traction
of knee using external fixing device is useful in patients with degenerative
gonarhthritis. It increases joint space and cartilage thickness along with
improvement in overall function. However, joint traction is difficult to apply
as it used surgical methods disturbing daily life activities.
Among 2 cases of
degenerative gonarthritis, the pain decreased after applying the continuous
traction treatment in them. It increases the gap between joints, offers muscle
relaxation and inhibits protective muscle reflection thus the ability to
perform physical functions and working range of joints improved.
The
participants' pain intensity was evaluated by Visual analogue scale (VAS)
scores. The pain scores were 8 and 7 points for male and female patient
respectively. The short form 36-item health survey (SF-36) was used to measure
the QoL. The survey contained eight sections and 36 questions related to public
health. The eight different sections are pain, vigour, physical function,
general and mental health, mental health, social function, limitations of
physical roles and constraints of emotional roles. The male participant
indicated an SF-36 score of 81 points whereas female participant indicated an
SF-36 score of 78 points.
The
patients were requested to bend their joints of hip and knee at 60 degrees in
the supine position. To tow the tibia in cephalocaudal direction, application
of the continuous knee joint traction was done and strap was used to secure it.
For continuous 20 minutes, traction and force equivalent to 6% of the patient's
weight was applied. The treatment was administered 20 min once a day and five
times a week for at least 4 weeks. After the treatment, VAS scores decreased
from point 8 to point 1 and point 9 to point two whereas SF-36 scores increased
from point 81 to point 93 and point 78 to point 96 in both male and female patients
respectively.
The present study reported the 2 cases of
individuals who received continuous knee joint traction for degenerative
gonarthritis of the knee. The results of the study showed a significant
decrease in pain after applying the treatment. Positive effects of external
fixing device were observed on reducing pain. The present study results were
consistent with results of the previous surveys. Continuous traction decreases
pain by relaxing muscles, inhibiting protective muscle reflection and by
stimulating dynamic muscle contractions. Furthermore, the increase in the joint
space is also one of the reasons behind the pain reduction.
The results of the present case report
suggested that continuous knee joint traction is useful for the treatment of
patients with degenerative gonarthritis of the knee. Continuous knee joint
traction considerably improves QoL and gait.
J Phys Ther Sci. 2018 Jun; 30(6): 848–849.
Case study of the continuous knee joint traction treatment on the pain and quality of life of patients with degenerative gonarthritis
Dong-Kyu Lee et al.
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