A prospective comparative study of functional outcome following arthroscopic debridement and hydrocortisone injection vs arthroscopic debridement and hyaluronicacid injection for the treatment of early primary osteoarthritis knee

Abstract

Objective: Early knee osteoarthritis in all cases, lead to degenerative medial meniscus lesions which are visible in MRI as chondral defects. As a result, it is difficult to distinguish between unstable meniscus and early osteoarthritis which leads to symptomatic knee pain. Hence, we decided to study improvement athroscopic meniscectomy and injecting Hyaluronic acid or Hydrocortisone in cases of degenerative ruptures of the medial meniscus with changes of early stage medial compartment knee osteoarthritis. Materials and Methods: 60 consecutive cases of early OA Knee of non traumatic origin were studied. They were given treatment of arthroscopic lavage and randomly administered hydrocortisone or hyaluronic acid. The WOMAC score was obtained and compared from immediate post-op period to upto 6 months. Result: In our study on patient undergoing arthroscopic debridement of osteoarthritis knee with Inj. Hydrocortisone improvement in WOMAC score was from 50.97% to 43.81%, totally an improvement of WOMAC score 7.2% while those undergoing arthroscopic debridement of osteoarthritis knee with Inj. Hyaluronic acid improvement in WOMAC score was from 51.25% to 37.1%, totally an improvement in WOMAC score of around 15%. Conclusion: Joint lavage by arthroscopy in combination with either intra-articular steroid injection or intra-articular hyaluronic acid injection provides significant improvement in osteoarthritis knee patient. Data suggests that, those patient who underwent arthroscopic debridement and injection of hydrocortisone had symptomatic improvement at early follow up more than those of the hyaluronic acid, while arthroscopic debridement of osteoarthritis knee and injection of hyaluronic acid performed better at longer follow up. Keywords: WOMAC score, Hyaluronan, Osteoarthritis.