Clinical Efficacy Research On Three Different Methods Of The Treatment For Osteoarthritis Of The Knee

Objective: Do the comparison on the efficacy as well as adverse effect among three methods of glucocorticoid, Sodium Hyaluronate intra-articular injection and both combined application to facilitate the treatment on mild and severe osteoarthritis of knee. To investigate the appropriate the treatment for Osteoarthritis in different stage.Material and method: Total 361 cases of osteoarthritis of knee for the experiment completed. According to X-ray classification, the cases come into stage I andstage II. The patients in each stage are distributed into 4 group A, B, C and D randomly, and naturally sub-group into 8: IA, IB, IC, ID and IIA, IIB, IIC IID. Group A, B, C received 3 treatments: glucocorticoid (Group A), sodium hyaluronate (Group B), and combined application of the above two(Group C), in the meanwhile with physical exercise. Group D performs physical exercise alone as control. They were evaluated by WOMAC, and improved degree observed and take the gap before and after treatment to do the efficacy comparison, evaluate the result and difference of adverse effect, SPSS10.0 is performed for the statistic analysis.Result: Stage I OA Treatment Result: 1) Group A,B,C,D are all effective; 2) Group A,B,C are better than Group D; 3) Group A has quick effect, but lasts shortly; 4) Group B,C have longer effect.Stage II OA Treatment Result: 1) Group IIA, IIB, IIC, IID all are effective; 2) Group IIB, IIC have better result than Group IID; Group IIA is equivalent to Group IID; 3) Group IIBJIC have no significant difference after 5 weeks'treatment; 4) Group IIC has better effect than Group IIA; 5) Group IIA, IIB, IIC have obvious recurrence after ceasing. This indicates Group IIA, IIB, IIC have weak lasting to severe osteoarthritis of knee.Adverse effect :Group A,D have no adverse effect occurred, group B,C have least adverse effect.Conclusion: 1) The effect of mild OA treatment is equivalent to sodium hyaluronate and glucocorticoid during early period; glucocorticoid is with faster effect, while it lasts shortly. The symptom has obvious recurrence after separate use. Sodium hyaluronate has relative late effect but lasts longer. Combined application of the above both, its effect will be faster and more lasting, so it is highly recommended for the mild OA at early stage.2) For severe OA treatment, sodium hyaluronate or combined application is effective during short period, but injection with glucocorticoid is relatively low. Lasting of the 3 methods are not satisfied, because all have obvious recurrence after ceasing.3) Physical exercise treatment has stable effect, and recommends using under doctor's appropriate instruction.4) All groups have least adverse effect.