Abstract
This retrospective
study explored the association between osteoarthrosis and joint
erythema-swelling and evaluated inflammation-targeted nursing interventions in
40 patients with osteoarthrosis. Patients were divided into erythema-swelling
group (n=20, with persistent joint redness and swelling) and
non-erythema-swelling group (n=20, without such symptoms), with each group
further split into intervention (n=11) and control (n=9) subgroups.
Intervention subgroups received inflammation-targeted nursing (cryotherapy
protocols, activity modification, synovial fluid monitoring), while controls
received routine care. Primary outcomes included osteoarthrosis severity
(Kellgren-Lawrence grade) comparison between groups and post-intervention
erythema-swelling resolution rate at 4 weeks. Secondary outcomes included
visual analog scale (VAS) pain score, joint circumference change and C-reactive
protein (CRP) levels. Results showed erythema-swelling group had significantly
higher initial Kellgren-Lawrence grade (3.0±0.8 vs 1.8±0.7, p<0.01).
Intervention subgroups in both groups showed higher resolution rate
(erythema-swelling group: 81.8% vs 33.3%; non-erythema-swelling group: 100% vs
66.7%, p<0.05). Inflammation-targeted nursing reduces joint
erythema-swelling in osteoarthrosis patients, with particular benefit in severe
cases.
Keywords: Osteoarthrosis; Febrile group and Non-febrile group; Kellgren-lawrence
grade
Introduction
Joint
erythema-swelling, though less common in osteoarthrosis than inflammatory
arthritis, affects 30-40% of moderate-to-severe cases and indicates active
synovitis or intra-articular inflammation1. This symptom correlates with disease progression, as
synovial inflammation accelerates cartilage degradation and osteophyte
formation2. This study investigates the
osteoarthrosis-erythema-swelling association and evaluates targeted nursing
interventions, addressing the lack of inflammation-focused protocols for this
population3.
Methods
Study design and
participants
Retrospective analysis of 40 patients with
radiographically confirmed osteoarthrosis (knee: 29 cases, hip: 11 cases).
Inclusion criteria: age 45-80 years; Kellgren-Lawrence grade I-IV;
erythema-swelling defined as joint redness with circumference increase ≥5mm
lasting >72 hours. Exclusion criteria: septic arthritis, crystal
arthropathies and recent intra-articular injections.
Grouping & interventions
Control subgroups: Routine care (pain
assessment, general mobility advice).
Intervention subgroups:
Added inflammation-targeted interventions:
Cryotherapy protocols: 15-minute cold pack
application (10°C) 3x/day, with protective barrier to prevent skin damage. Activity
modification: Identifying and avoiding inflammation-triggering activities
(prolonged weight-bearing, repetitive motion). Synovial fluid monitoring:
Teaching patients to assess effusion via palpation and document changes for
timely medical review. Anti-inflammatory medication timing: Coordinating
non-steroidal anti-inflammatory drug (NSAID) administration with peak
inflammation periods.
Outcome measures primary: Initial Kellgren-Lawrence grade
comparison between groups; 4-week erythema-swelling resolution rate. Secondary:
VAS pain score (0-10), joint circumference change (mm) and serum CRP levels
(mg/L).
Statistical analysis
SPSS 26.0 used for
independent t-tests, χ² tests and Mann-Whitney U test. p<0.05 was
significant.
Results
Osteoarthrosis-erythema-swelling association and
baseline data
Significant correlation
between osteoarthrosis severity and erythema-swelling presence (r=0.64,
p<0.01). Erythema-swelling group had higher initial CRP and VAS scores (Table
1).
Table 1: Baseline
Characteristics
|
Characteristics |
Erythema-Swelling Group (n=20) |
Non-Erythema-Swelling Group (n=20) |
p-value |
|
Age (years, x̄±s) |
64.3±8.9 |
62.5±7.8 |
0.48 |
|
Male gender, n(%) |
11(55.0) |
10(50.0) |
0.76 |
|
Affected joint (knee/hip) |
16/4 |
13/7 |
0.36 |
|
Kellgren-Lawrence grade (x̄±s) |
3.0±0.8 |
1.8±0.7 |
<0.001 |
|
Initial VAS score (x̄±s) |
7.2±1.5 |
4.1±1.3 |
<0.001 |
|
Initial CRP (mg/L, x̄±s) |
26.8±9.7 |
11.5±5.3 |
<0.001 |
|
Joint circumference (mm, x̄±s) |
528.6±32.5 |
492.3±28.7 |
<0.001 |
Table 2: 4-Week
Erythema-Swelling Resolution Rate
|
Group |
Intervention (n=11) |
Control (n=9) |
p-value |
|
Erythema-Swelling Group |
9(81.8%) |
3(33.3%) |
0.012 |
|
Non-Erythema-Swelling Group |
11(100%) |
6(66.7%) |
0.037 |
Secondary outcomes
Intervention subgroups
showed greater improvement in all secondary measures (Table 3).
Table 3: Secondary Outcomes at
4 Weeks
|
Outcome |
Erythema-Swelling Group |
Non-Erythema-Swelling Group |
p-value (intervention effect) |
|
VAS score |
Intervention:3.1±1.2 |
Intervention:2.0±0.9 |
<0.001 |
|
Control:5.8±1.6 |
Control:3.5±1.1 |
- |
|
|
Joint circumference reduction (mm) |
Intervention:18.5±5.3 |
Intervention:4.2±2.1 |
<0.001 |
|
Control:7.2±3.8 |
Control:1.8±1.5 |
- |
|
|
CRP (mg/L) |
Intervention:12.3±4.8 |
Intervention:9.5±3.7 |
0.002 |
|
Control:21.6±7.5 |
Control:13.8±5.2 |
- |
Discussion
This study confirms
severe osteoarthrosis correlates with higher incidence of joint
erythema-swelling, supporting the role of synovial inflammation in disease
progression4. The elevated CRP levels in the erythema-swelling
group align with evidence that low-grade inflammation drives cartilage
breakdown in advanced osteoarthrosis5.
Inflammation-targeted
interventions reduced symptoms primarily through cryotherapy, which inhibits
prostaglandin synthesis and reduces vascular permeability6. Activity
modification prevented further mechanical irritation of synovial membranes,
while synovial fluid monitoring enabled early intervention for recurrent
effusions7. The significant reduction in joint circumference
and CRP levels confirms the anti-inflammatory effect of nursing interventions.
Notably, the
non-erythema-swelling intervention subgroup-maintained symptom-free status,
highlighting preventive value in mild osteoarthrosis8. Limitations
include small sample size and lack of synovial biopsy data; future studies
should correlate clinical findings with histopathological changes.
Conclusion
Joint erythema-swelling
correlates significantly with osteoarthrosis severity. Inflammation-targeted
nursing interventions effectively resolve erythema-swelling, reduce pain and
lower inflammatory markers. These strategies are critical for managing
inflammatory flares in osteoarthrosis patients.
References