Background. Osteoarthritis (GA) in patients with varicose veins of the lower limbs (VVLL) is more common than in the population, and degenerative changes in the knee joints deteriorate clinical course of such vascular pathology. The purpose and objectives: to assess the effect of GA on the course and efficiency of surgical techniques in VVLL treatment, highlight prognostic criteria. Materials and methods. The study included 302 patients (227 men and 75 women aged 29–72 years old), 16 % of which had previous phlebothrombosis and II, III, IV, V and VI classes of venous insufficiency occurred in 10, 14, 37 16 and 23 %, respectively. 263 patients underwent endovenous laser coagulation, and 39 had the traditional phlebectomy and ligation of perforating veins. Results. GA was diagnosed in 18 % of patients with VVLL, more common in men of older age, and involved the great saphenous vein with gate extension and was combined with arteriosclerosis of the lower limbs vessels, which was accompanied by more severe classes of venous insufficiency, while the clinical laboratory manifestations of varicose veins is influenced by disease stage, changes of meniscal horns, the presence and severity of subchondral sclerosis, osteocystosis, synovitis, Baker’s cysts, intra-articular Shtaydi and Hoff bodies. The effectiveness of the results of surgical treatment in patients with GA was worse, while full vein occlusion in a month after the endovenous laser ablation observed occurred in 2.8 times less cases, the number of complications was 7.3 times more frequent that was defined by subchondral sclerosis, osteousuras, Baker’s cysts and intra-articular Hoff’s bodies. Conclusions. The presence of GA is a risk factor for more severe clinical course in leg varicose veins, a negative prognostic negative factor for surgical treatment of the disease and complications number.

varicose; veins; gonarthrosis; clinical course; treatment

Fox JD, Baquerizo-Nole KL, Freedman JB, Liu S, Van Driessche F, Yim E, Kirsner RS. Ankle range of motion, leg pain, and leg edema improvement in patients with venous leg ulcers. JAMA Dermatol 2016;152(4):472-4. doi: 10.1001/jamadermatol.2015.5637.

Markovic-Denic L, Zivkovic K, Lesic A, Bumbasirevic V, Dubljanin-Raspopovic E, Bumbasirevic M. Risk factors and distribution of symptomatic venous thromboembolism in total hip and knee replacements: prospective study. Int Orthop 2012;36(6):1299-305. doi: 10.1007/s00264-011-1466-5.

McAndrew CM, Fitzgerald SJ, Kraay MJ, Goldberg VM. Incidence of postthrombotic syndrome in patients undergoing primary total knee arthroplasty for osteoarthritis. Clin Orthop Relat Res 2010;468(1):178-81. doi: 10.1007/s11999-009-0929-0.

Meissner MH. What is effective care for varicose veins? Phlebology 2016;31(1):80-7. doi: 10.1177/0268355516632999.

Parker CN, Finlayson KJ, Shuter P, Edwards HE. Risk factors for delayed healing in venous leg ulcers: a review of the literature. Int J Clin Pract 2015;69(9):967-77. doi: 10.1111/ijcp.12635.

Pavlović MD. Drug treatment of chronic venous diesease. Wien Med Wochenschr 2016;166(9-10):312-9. doi: 10.1007/s10354-016-0480-z.

Rabe E, Berboth G, Pannier F. Epidemiology of chronic venous diseases. Wien Med Wochenschr 2016;166(9-10):260-3. doi: 10.1007/s10354-016-0465-y.

Salikhov IG, Lapshina SA, Miasoutova LI, Kirillova ER, Mukhina RG. Osteoarthrosis and peripheral vein diseases of lower extremities: characteristics of concomitant pathology. Ter Arkh 2010;82(5):58-60.

Sisto T, Reunanen A, Laurikka J, Impivaara O, Heliövaara M, Knekt P, Aromaa A. Prevalence and risk factors of varicose veins in lower extremities. Eur J Surg 2015;161(6):405-14.

Tezuka M, Kanaoka Y, Ohki T. Endovenous laser treatment for varicose veins. Nihon Geka Gakkai Zasshi 2015;116(3):155-60.