The effectiveness of complex therapy using the injectable form of chondroitin sulfate and sodium hyaluronate with osteoarthritis of the knee joint

Aim. The study on the effectiveness of complex therapy for osteoarthritis (OA) of the knee joint was conducted in real clinical practice. Materials and methods. The survey involved 125 patients aged from 50 to 70 years (25 men and 100 women) with a diagnosis of knee joint OA (the III roentgenologic Kellgren-Lawrence stage).The average age of the patients was 62 +/- 3.21, the average duration of the disease 9.4 +/- 2.8 years. Patients were randomly assigned to three groups of 35 people, the control group had 20 patients. Group 1 patients received non-steroidal anti-inflammatory drugs (NSAIDs) + Injectran(Chondroitin sulfate) 200 mg intramuscularly (I.M.) every other day No. 25.In group 2, patients received NSAIDs + Fermatron 1% 2 ml with an interval of 7 days intra-articularly (I.A.) No. 3. In group 3 NSAIDs + Injectran 200 mg (I.M.) every other day No. 25 + Fermatron 1% 2 ml with an interval of 7 days (I.A.) No. 3. In the control group (20 people), patients received only NSAIDs. Evaluation of the symptoms was carried out using the WOMAC index before the start of thetherapy, after 8 and 12 weeks of treatment. The intensity of pain while walking was estimated on a visual analogue scale. Results. In the groups that received Injectran (I; group 1) or Fermatron (F; group 2), the dynamics of pain while walking reduction was comparable and had slightly more than 30% in both groups, the figures are reliable in comparison withinitial data (p<0.01). In group 3, where both Injectran + Fermatron (I+F) were used, the pain while movingdecreased by more than 50% in comparison with initial data, i.e. combined use of two medications at the same time allowed to improve the results of treatment by 1.5 times.Patients' need for NSAIDs before and after therapy was also investigated. In all the groups, patients were able to reduce the dose of NSAIDs.ln the control group, 80% of patients had the same dose of NSAIDs by the end of the 8th week, whereas in group 3 (I+F) - only 5.7%, in group 2 (F) - 17.1%, in group 1 (I)-11.5%. Intergroup differences are valid (p<0.001). The number of patients who completely withdraw NSAIDs was the largest in group 3 (I+F; 22.8%), which is 2 times more than in group 2 (F; 11.4%) and 4 times more than in group 1 (I; 5.7%), the differences are valid (p<0.01). Conclusion. By the end of the therapy, the decline in the WOMAC index was mostly in group 3 (I+F) - more than 50%, in the 1st (I) and 2nd (F) groups - more than 40%, in the control group - 20%. After 12 weeks in all the groups there was a tendency to maintain and even increase the effect of the therapy.