A comparative study of the results of conservative therapy, intra-articular steroid injection therapy and intra-articular hyaluronic acid injection therapy in primary osteoarthritis of knee: A prospective study in eastern Indian population
Journal Title: National Journal of Clinical Orthopaedics - Year 2018, Vol 2, Issue 3
Abstract
Background:To compare the results of intra articular steroid, intra articular hyaluronic acid and conservative therapy, in primary osteoarthritis of knee. There are many literature comparing the efficacy between hyaluronic acid and steroids, however to compare the three variables we are not aware of any studies available. Materials & Methods: 45 patients attending were selected and randomized 15 each in each group (A, B and C). The patients treated with hyaluronic acid (A) received one course of three weekly injections. The patients treated with the steroid (B) received one injection at the time of enrollment in the study. In group C, physical therapy in the form of heat and physiotherapy were taught to patients. Western Ontario and McMaster University Osteoarthritis Index and Lequesne were used to assessed the patients. Results: All the three groups were followed at 2, 4, and 6 months. In group A on first visit WOMAC average score is 70.8 which improves to 68, 61.06 and then to 64 (p- 0.00001). In group B average score before injection is 71.2; the follow up average score 60.4, 66.93, 73.86(p-0.00001). In group C patients WOMAC score in first visit is 72; the follow up average score 68.53, 74.8, 79 (p <0.00001). No significance difference were found with the lequense score. The best effect can be seen around 4 months with steep decrease in WOMAC score in group A. In group B it is seen that at 6 months the effect of corticosteroids has weaned away. In group C the improvement is slow and detoriates with further follow up. Conclusions: Methylprednisolone has a short term benefit as compare to hyaluronic acid group. In case of patients undergoing conservative therapy no significance improvement. Awareness of this pattern is useful to formulate a therapeutic plan for patients with knee Osteoarthritis.
Authors and Affiliations
Wanlamkupar Khongwir, Subhasish Saha, Tashi Khonglah
Primary modular bipolar prosthetic replacement for unstable intertrochanteric fractures in elderly
Unstable intertrochanteric fracture in elderly is a challenging surgical condition with a high risk of morbidity and mortality. The aim of this study is to evaluate the functional outcome following primary modular bipola...
Minimally invasive plate osteosynthesis of peri-articular fractures of distal tibia: A clinical study
Objectives: Treatment of distal tibial fractures using minimally invasive plate osteosynthesis (MIPO) technique may minimise damage to soft tissues and the vascular integrity of bony fragments. This is a study to assess...
Is Aperture Fixation Superior to Cortical Fixation for Quadruple Hamstring Graft in Anterior Cruciate Ligament Reconstruction?
Introduction: ACL is a commonly injured ligament of the knee. The incidence is rising due to increased motor vehicle accident. To regain full activity, its proper reconstruction is essential. Different technique develope...
A study of functional outcome of lisfranc fracture dislocations managed by various operative methods in rural south Indian population
This study is an attempt to analyse the midterm results of “functional outcome of lisfranc fracture dislocations managed by various operative methods” in rural south Indian population. Lisfranc Fracture dislocations have...
A study of results of long closed proximal femoral nailing in complex proximal femoral fractures
Introduction: Fractures of the proximal femur are a big challenge in traumatology. Patients Of all age groups are affected, but the group belonging to the 5th – 7th decades of life is involved the most. The complex proxi...