Short-term Efficacy Of Sodium Hyaluronate And Glucocorticoid Injection In Patients With Knee Osteoarthritis Of Different Severity

Objective:To analyze the short-term effects of injection of sodium hyaluronate and glucocorticoid in patients with knee osteoarthritis of different severity.Methods:188 cases of patients knee osteoarthritis(knee osteoarthritis,KOA)who were admitted to our hospital from October 2017 to June 2018 were divided into three groups according to WOMAC knee function score,with 60 cases mild,72 cases moderate and severe 56 cases severe.According to K-L grade of knee X-ray,48 cases were classified as grade I,49 cases as grade II,45 cases as grade III and 46 cases as grade IV.The unified treatment for all patients was: the first 2.5ml injection of(Sodium Hyaluronate,SHA)into the articular cavity.The second week SHA 2.5ml combined with compound betamethason injection(CBI)1ml into the articular cavity,the third week with SHA 2.5ml into the articular cavity for three consecutive weeks.The WOMAC score and Lequesne index were used to analyze the knee joint function score and improvement rate before the first injection and after the SHA+CBI injection.Results:The Lequesne index and WOMAC score of mild,moderate and severe patients decreased gradually after continuous HA and combined injection(P<0.05).The Lequesne index improvement rates of mild patient after SHA injection and SHA+CBI combined injection were 36.44% ±8.46% and 49.26% ±13.75%,respectively,which could be regarded as effective.The improvement rate of moderate patients after injection of SHA was 23.09% ±12.61%,which was ineffective,and the improvement rate after SHA+CBI combined injection was 30.66% ±14.95%,which could be regarded as effective.Theimprovement rates after SHA injection and SHA+CBI combined injection in severe patients were 10.50% ±8.78% and 11.07% ±6.52%,respectively,which could be regarded as ineffective.According to the evaluation standard of WOMAC score,the improvement rate after SHA and SHA+CBI combined injection in mild patients was more than 25%,which could be regarded as effective.The improvement rate of moderate patients after SHA injection was 13.06% ±10.21%,which could be regarded as ineffective,while the improvement rate after SHA+CBI combined injection was 27.49% ±13.61%,which could be regarded as effective.The improvement rate of SHA injection and SHA+CBI combined injection was less than 25% in severe patients,which could be regarded as ineffective.The correlation analysis between WOMAC function score and X-ray K ≥ L grade showed that81.3% of patients with grade I X-ray were mild KOA,53.1% of patients with grade II X-ray were moderate,66.7% of patients with grade III were moderate,and 87.0% of patients with grade IV were severe KOA.For patients with different X-ray K ≥ L grades,Lequesne index and WOMAC score decreased gradually after continuous SHA and SHA+CBI combined injection(P<0.05).Among them,the improvement rate of Lequesne index after SHA injection and SHA+CBI combined injection in grade I and II patients was more than 30%,which was regarded as improvement,and the improvement rate after SHA injection and SHA+CBI combined injection in IIIand IV patients was less than 30%,respectively,which was regarded as ineffective.The improvement rate of WOMAC score after SHA injection and SHA+CBI combined injection in grade I and II patients was more than 25%,which was considered effective,and the improvement rate of SHA injection and SHA+CBI combined injection in III and IV patients was less than 25%,which was regarded as ineffective.Conclusion:For patients with mild or X-ray grade I and II KOA,both articular injection of SHA and SHA+CBI combined glucocorticoids were effective,and the combined injection was better than the single injection of SHA.In moderate patients,SHA injection alone was not effective,but SHA+CBI combined injection was effective.For patients with severe or X-ray grade III or IV KOA,sodium hyaluronate injection alone or glucocorticoid injection combined were not effective.