Skip to main content

Advertisement

Log in

Case Series Analysis of Chronic Venous Insufficiency Patients to Determine Associated Arthrosis

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

An association between chronic venous insufficiency (CVI) and osteoarthrosis (OA) of the knee and ankle–foot joints was well known a few decades ago but subsequently forgotten. Clinical observations of the association of CVI and OA led us to prospectively study 197 consecutive patients to establish this relationship. A total of 197 patients presenting at the out-patient department of a tertiary care referral from April 2019 to March 2020 were considered after ethics committee approval. Patients were studied by clinical history, X-ray imaging, and color Doppler examination. All patients underwent definitive, obliterative treatment of the superficial venous reflux. Standard adjuvant treatment was given, and patients were re-assessed at 3 and 6 months. Outcomes were measured to find an association with CVI and OA. A direct association was found between severity of CVI and OA. Relief of symptoms of CVI and improvement in quality of life was seen at the end of 6 months. Differential diagnosis for CVI in patients complaining of knee pain, heavy legs, and swelling should always be considered and investigated. Early treatment for CVI can help preserve knee function and joint architecture. Phleboarthrosis is a real condition, and its recognition assumes greater importance with increase in life expectancy and lifestyle expectations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Abelyan G, Abrahamyan L, Yenokyan G (2018) A case-control study of risk factors of chronic venous ulceration in patients with varicose veins. Phlebology 33(1):60–67. https://doi.org/10.1177/0268355516687677

    Article  PubMed  Google Scholar 

  2. Arnoldi CC, Linderholm H, Müssbichler H (1972) Venous engorgement and intraosseous hypertension in osteoarthritis of the hip. J Bone Joint Surg Br 54(3):409–421

    Article  CAS  PubMed  Google Scholar 

  3. Arnoldi CC, Lemperg K, Linderholm H (1975) Intraosseous hypertension and pain in the knee. J Bone Joint Surg Br 57(3):360–363

    Article  CAS  PubMed  Google Scholar 

  4. Rabe E, Berboth G, Pannier F (2016) Epidemiologie der chronischen Venenkrankheiten [Epidemiology of chronic venous diseases]. Wien Med Wochenschr 166(9–10):260–3. German. https://doi.org/10.1007/s10354-016-0465-y

  5. Helal B (1965) The pain in primary osteoarthritis of the knee. Its causes and treatment by osteotomy. Postgrad Med J 41(474):172–81. https://doi.org/10.1136/pgmj.41.474.172

  6. Dodd H, Cockett FB (1956) The pathology and surgery of veins of the lower limb. E. & S. Livingstone, London

    Google Scholar 

  7. Ciubotaru V (2018) Phlebogonarthrosis: a clinical and physiopathological reality. Phlebolymphology No. 94 25(1): P1–120

  8. Mazieres B, Andrieu S, Subreville C et al (2001) SAT0070 Knee osteoarthritis (koa) and varicose veins (vv): a case-control study of 600 patients. Ann Rheum Dis 60:A175–A176

    Google Scholar 

  9. Gies J, Maugeis De Bourguesdon J (1961) Value of the present day treatments of gonarthrosis. Rev Rhum Mal Osteoartic 28:255–8. French

  10. Robecchi A, Einaudi A, Impallomeni G (1952) Osservazioni e ricerche sui fattori eziopatogenetici dell’artrosi del ginocchio, con particolare riguardo ai disturbi della circolazione venosa [Etiopathogenetic factors in arthrosis of the knee, with special reference to venous circulatory disorders]. Minerva Med 43(101):1366–76. Undetermined Language

  11. Findlay DM (2007) Vascular pathology and osteoarthritis. Rheumatology 46(12):1763–1768. https://doi.org/10.1093/rheumatology/kem191

    Article  CAS  PubMed  Google Scholar 

  12. Mcmaster, Paul E (1937) Bone atrophy and absorption. JBJS 19(1): 74–83

  13. Bernstein MA (1933) Experimental production of arthritis by artificially produced passive congestion. J Bone Jt Surg 15:661

    Google Scholar 

  14. Harrison MH, Schajowicz F, Trueta J (1953) Osteoarthritis of the hip: a study of the nature and evolution of the disease. J Bone Joint Surg Br 35-B(4):598–626. https://doi.org/10.1302/0301-620X.35B4.598

  15. Christensen SB, Reimann I, Henriksen O, Arnoldi CC (1982) Experimental osteoarthritis in the rabbit. A study of 133xenon washout rates from the synovial cavity. Acta Orthop Scand. 53(2):167–74. https://doi.org/10.3109/17453678208992196

  16. Darwin C (1888) The descent of man, 2, 51. John Murray, London

    Google Scholar 

  17. Imhof H, Breitenseher M, Kainberger F, Trattnig S (1997) Degenerative joint disease: cartilage or vascular disease? Skeletal Radiol 26(7):398–403. https://doi.org/10.1007/s002560050254

    Article  CAS  PubMed  Google Scholar 

  18. Pedersen NW, Kiaer T, Kristensen KD, Starklint H (1989) Intraosseous pressure, oxygenation, and histology in arthrosis and osteonecrosis of the hip. Acta Orthop Scand 60(4):415–417. https://doi.org/10.3109/17453678909149309

    Article  CAS  PubMed  Google Scholar 

  19. Gillot C, Uhl J-F, Ovelar J, Merino J (2019) Anatomy of the bony perforators veins of the knee. Ann Med 51(sup1):60–60. https://doi.org/10.1080/07853890.2018.1561943

    Article  PubMed Central  Google Scholar 

  20. Varghese R, Patel M, Rajarshi M. Wound care practices for infected venous leg ulcers and prudent use of antibiotics vascular diseases; abstract published in the Hungarian Journal of Vascular diseases XXVI, 2019/3 page 16. Presented at conference “Another Phlebology” held on 4–5 October 2019, Hungary

  21. Varghese R, Patel M, Rajarshi M. Role of vitamin d3 in the management of pain in c5- 6 chronic venous disease (CVI): need to include as an integral part in the treatment protocol; abstract published in the Hungarian Journal of Vascular diseases XXVI, 2019/3 page 17. Presented at conference “Another Phlebology” held on 4–5 October 2019, Hungary

  22. Ulloa JH (2019) Micronized purified flavonoid fraction (MPFF) for patients suffering from chronic venous disease: a review of new evidence. Adv Ther 36(Suppl 1):20–25. https://doi.org/10.1007/s12325-019-0884-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Mishra A (2019) Effect of Sertraline, Dosulepin, and Venlafaxine on non-BDNF neurotrophins in patients with depression: a cohort study. J Clin Psychopharmacol 39(3):220–225. https://doi.org/10.1097/JCP.0000000000001022

    Article  CAS  PubMed  Google Scholar 

  24. Reid IR, Birstow SM, Bolland MJ (2017) Calcium and cardiovascular disease. Endocrinol Metab (Seoul) 32(3):339–349. https://doi.org/10.3803/EnM.2017.32.3.339

    Article  CAS  PubMed  Google Scholar 

  25. Aaron RK, Racine J, Dyke JP (2017) Contribution of circulatory disturbances in subchondral bone to the pathophysiology of osteoarthritis. Curr Rheumatol Rep 19:49. https://doi.org/10.1007/s11926-017-0660-x

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Malay Patel.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 166 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Patel, M., Varghese, R. & Rajarshi, M. Case Series Analysis of Chronic Venous Insufficiency Patients to Determine Associated Arthrosis. Indian J Surg 85 (Suppl 1), 106–111 (2023). https://doi.org/10.1007/s12262-021-02969-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-021-02969-x

Keywords

Navigation