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Video about the MIBRAR® Method
What is gout
Gout is a systemic disease caused by the deposition of sodium monourate crystals (uric acid) in joints and soft tissues. Each gouty attack is a microcatastrophe for the joint: crystals damage the cartilage, synovial membrane, and subchondral bone. Recurrent attacks lead to irreversible joint destruction.
Stages of Gout
1. Asymptomatic Hyperuricemia
Uric acid above 360 µmol/L, but no attacks yet. Crystals are already beginning to deposit. Lasts for years. At this stage — diet and urate-lowering therapy if necessary.
2. Acute Gouty Arthritis
Sudden attack: joint is red, hot, sharply painful, swollen. Impossible to touch. Most commonly the 1st metatarsophalangeal joint (gout = «foot trap»). Also: ankle, knee, elbow, wrist. Attack duration: 3-10 days without treatment.
3. Intercritical Period
No symptoms between attacks, but crystals continue to accumulate. Without treatment, intervals between attacks shorten.
4. Chronic Tophaceous Gout
Tophi — nodules of uric acid crystals in soft tissues (fingers, ears, elbows, Achilles tendon). Chronic arthritis. Joint destruction on X-ray (punched-out erosions). At this stage — MIBRAR® for restoration of damaged joints.
Affected Joints
1st Metatarsophalangeal Joint (90%)
«Podagra» — classic location of the first attack. Pain is so severe that the patient cannot wear shoes or even tolerate the weight of the bedsheet.
Ankle and Knee
Frequent locations, especially in recurrent gout. Massive effusion, limited motion.
Elbow and Wrist
Involvement of upper extremities — in long-standing and severe gout. Tophi on hand fingers and in the olecranon area.
Diagnosis
Blood Uric Acid
Normal: less than 360 µmol/L (6 mg/dL). Target level in gout: less than 300 µmol/L. Note: during an acute attack, the level may be normal!
Polarized Light Microscopy
Gold standard — joint aspiration with examination of synovial fluid. Sodium monourate crystals: needle-shaped, negative birefringence. 100% specificity.
Joint Ultrasound
«Double contour» sign — crystal deposition on the cartilage surface. Tophi. Sensitivity 85%. Non-invasive first-line method.
Dual-Energy CT (DECT)
Visualizes urate deposits in all joints simultaneously. High sensitivity and specificity. Indicated for uncertain diagnosis.
Role of MIBRAR® in Gout
Important: MIBRAR® does not treat gout as a systemic disease — for this, urate-lowering therapy (allopurinol, febuxostat) and diet are required. MIBRAR® restores joints damaged by gout attacks.
1. Uric Acid Control
Before MIBRAR®, uric acid levels must be stably below 360 µmol/L. Without this, the regenerated cartilage will be damaged by new crystal deposits.
2. Cartilage Regeneration
Intra-articular injection of CGF + Lipogems® into damaged joints. Stem cells differentiate into chondrocytes, restoring the cartilage covering. Growth factors stimulate repair of subchondral bone.
3. Synovial Membrane Restoration
Gout inflammation damages the synovial membrane. CGF normalizes its structure and function, reducing the tendency for recurrent synovitis.
Gout Damages Joints — MIBRAR® Restores
Each attack destroys cartilage. Do not wait for irreversible changes.
Book a ConsultationQuestions about Gout
MIBRAR® does not treat gout as a metabolic disease — for this, urate-lowering therapy and diet are needed. MIBRAR® restores joints destroyed by gout attacks: regenerates cartilage and synovial membrane.
After stabilizing uric acid below 360 µmol/L and absence of acute attack for at least 4 weeks. Otherwise, crystals will damage the regenerated tissue.
Limit: red meat, organ meats, seafood, alcohol (especially beer), fructose. Increase: dairy products, cherries, water (2-3 liters per day). Diet reduces uric acid by 10-15%.
In early stages — yes. MIBRAR® regenerates cartilage and synovial membrane. In severe tophaceous gout with bone erosions — partial function restoration, but full regeneration is difficult.