ANTI-INFLAMMATORY DRUGS IN MANAGEMENT OF KNEE OSTEOARTHRITIS
Keywords:Osteoarthritis, Non-steroidal anti-inflammatory drugs, Intra-articular injections, Hyaluronic acid
Objective: To compare the outcome of intra-articular hyaluronic acid injection with oral non-steroidal antiinflammatory drugs in knee osteoarthritis in terms of mean pain score.
Study Design: Randomized controlled trial.
Place and Duration of Study: Outpatient orthopedics department of Combined Military Hospital, Rawalpindi from February 2015 to July 2016.
Patients and Methods: A total of 60 patients with knee osteoarthritis were enrolled as per inclusion and exclusion criteria by non-probability consecutive sampling. Thirty patients were assigned to group “A” and were given intra-articular injection of hyaluronic acid 20 mg (2 ml) into the knee joint aseptically for five consecutive weeks. Group “B”, having thirty patients, was given oral non-steroidal anti-inflammatory drug Celecoxib
200mg/Naproxen 500mg twice daily after meals for twelve weeks. Outcome measure was mean pain score using visual analogue scale at twelve week follow-up.
Results: Statistically significant improvement in mean pain score on visual analogue scale at twelve week followup was found in patients of group “A”, with improvement in score from 7.2 ± 0.92 at the start of the study to 5.6 ± 1.23 at twelve week follow-up (p<0.001). No statistically significant results were obtained in patients with group “B” having pain score on visual analogue scale of 7.4 ± 0.94 at the start of the study to 7.3 ± 0.95 at twelve week follow-up (p= 0.373).
Conclusion: The use of intra-articular injection of hyaluronic acid in knee osteoarthritis potentially offers a significantly greater clinical improvement in terms of pain relief, especially in radiological grades 1 to 3. Nonsteroidal anti-inflammatory drugs, on the other hand, are of lower comparative efficacy in the treatment of knee osteoarthritis pain.