| Abstrakt: |
Background: Osteoarthritis (OA) is the most common chronic progressive joint disease that takes place when the cartilage or a low friction surface between joints breaks down leading to pain, stiffness and swelling. The aim of this study was to determine the comparative efficacy and safety of intraarticular corticosteroid (Depomedrol 80mg) and intra articular hyaluronic acid (HA) in knee osteoarthritis. A randomized single blind comparative trial was carried out in a physical medicine and rehabilitation outpatient department. Method: 150 patients with knee osteoarthritis, who were followed for 6 months, were randomized to receive intra articular injection of either Hyaluronic acid or corticosteroid. With the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the visual analog pain scale, an independent, blinded evaluator assessed the patients two times. Assessment included recording of: visual analog scores (VAS) for pain; WOMAC scoring, duration of stiffness; range of movement; joint effusion; local heat; synovial thickening; joint-line and periarticular tenderness. Results: The mean age of the patients in the Hyaluronic acid group was 71.4 ± 1.4 years and corticosteroid group was 69.5±1.7 years. Both the groups treated with Hyaluronic acid and corticosteroid demonstrated improvements from baseline WOMAC scores (a median decrease from 52 to 38 points and from 55 to 40 points, respectively; p < 0.01 for both). The scores on the visual analog scale improved for patients receiving Hyaluronic acid (median, 66 to 50 mm; p < 0.01) but not for the patients who received the corticosteroid (median, 72 to 60 mm; p = 0.28). However, no significant differences between the two treatment groups were found with respect to the WOMAC or visual analog scale results. Women demonstrated a significant improvement in only one of the six possible outcome-treatment combinations (the WOMAC scale), whereas men demonstrated significant improvements in five of the six outcomes. Conclusions: No differences were detected between patients treated with intra-articular injections of Hyaluronic acid and those treated with the corticosteroid with respect to pain relief or function at six months of follow-up. Women demonstrated significantly less response to treatment than men did for both treatments on all outcome scales. Such significant gender-related differences warrant further investigation. [ABSTRACT FROM AUTHOR] |
