To compare the results of intra articular steroid, intra articular hyaluronic acid and conservative therapy, in primary osteoarthritis of knee. There are many literature comparing the efficacy between hyaluronic acid and steroids, however to compare the three variables we are not aware of any studies available.
Materials & Methods: 45 patients attending were selected and randomized 15 each in each group (A, B and C). The patients treated with hyaluronic acid (A) received one course of three weekly injections. The patients treated with the steroid (B) received one injection at the time of enrollment in the study. In group C, physical therapy in the form of heat and physiotherapy were taught to patients. Western Ontario and McMaster University Osteoarthritis Index and Lequesne were used to assessed the patients.
Results: All the three groups were followed at 2, 4, and 6 months. In group A on first visit WOMAC average score is 70.8 which improves to 68, 61.06 and then to 64 (p- 0.00001). In group B average score before injection is 71.2; the follow up average score 60.4, 66.93, 73.86(p-0.00001). In group C patients WOMAC score in first visit is 72. the follow up average score 68.53, 74.8, 79 (p<0.00001). No significance difference were found with the lequense score. The best effect can be seen around 4 months with steep decrease in WOMAC score in group A. In group B it is seen that at 6 months the effect of corticosteroids has weaned away. In group C the improvement is slow and detoriates with further follow up.
Conclusions: Methylprednisolone has a short term benefit as compare to hyaluronic acid group. In case of patients undergoing conservative therapy no significance improvement. Awareness of this pattern is useful to formulate a therapeutic plan for patients with knee Osteoarthritis.