Sodium Hyaluronate,Betamethasone Combination Of Clinical Effects And Pathological Features Of Osteoarthritis Analysis

ObjectiveOsteoarthritis is a chronic joint disease which is characterized by degeneration and destruction of articular cartilage and bone hyperplasia, in the early stage with acute synovitis mainly presents pain and effusion. Except the application of non-steroidal anti-inflammatory drugs, the most commonly treatment are local injection of hormone and intra articular of sodium hyaluronate(SH) in clinic,but simultaneous usement of them is merely reported in the worldwide. This study attempts to establish osteoarthritis with synovitis in rabbits with injection of Baosong and sodium hyaluronate, comparing the rabbit synovial joints in gross morphology, HE staining, immunohistochemical pathology with control group, and combine with the clinical cases statistic results to investigate the clinical significance of the combination of two drugs for osteoarthritis.Methods1. Establish rabbit model of osteoarthritis with synovitis which used papain.2. The modeling18rabbits were randomly divided into three groups:combination group with injection of betamethasone0.05ml/kg and SH0.2ml, SH group with only SH0.2ml and control group with sterile saline0.3ml.Three groups were injected once a week for four consecutive times, the last time two weeks after the injection were killed.3. Observe the general morphology of synovial in rabbit right knee.4. Histopathological observation: each group synovial tissue slices were HE staining;5. Immunohistochemistry: synovial tissues were stained with immunohistochemical sp method to detect the expression of MMP-1.6.Clinical cases statistics:132cases of out-patients who were diagnosed osteoarthritis with acute synovitis in the knee,132cases were randomly divided into treatment of SH group and the combined group with SH and diprospan, After once a week treatment, observe the degree of pain and swelling and do the control studies.Results1.Successfully established osteoarthritis with synovitis model in rabbits. Articular cartilage in combinantion group had little joint fluid, synovial performed normal.The synovial in SH group had congestion while the control group presented synovial hypertrophy, joint swelling effusion.2. Histological manifestations:1). Joint Group:mild knee synovial cell proliferation with scattered lymphoplasmacytic infiltration;2).SH Group:significant cell proliferation in synovial.3).Control group:severe cell proliferation,inflammation flocculent exudate and majority of vascular production.3. Immunohistochemical expression:1)Joint Group:a small amount of expression of MMP-1in synovial; MMP-1synovial cell percentage is (5.24±2.48)%2).SH groups:MMP-1was expressed in every layer of synovial, MMP-1cell percentage is (8.65±4.54)%3).Control group:MMP-1was highly expressed especially in vascular layer,the cell percentage is (14.65±6.19)%4. Clinical cases statistic:the combination treatment of diprospan and SH caneffectively relieve joint pain, improve joint mobility. ConclusionThe use of intra-articular injection of papain can successfully induce rabbit osteoarthritis.The combination of diprospan and SH can effectively relieve inflammation of synovial,lessen the expression of MMP-1.In clinic they can significantly alleviate the suffering of patients.To obtain the trust of patients, establish a good compliance, for subsequent long-term treatment of osteoarthritis opportunity to gain the necessary, and such treatment can be hormones on minimize the damaging effects of cartilage, reducing long-term complications of steroid injections, the clinical results were satisfactory.