Comparison of the effect of intraarticular hyaluronic acid and effect of naproxen sodium in patients with osteoarthritis of the knee

Abstract

Purpose: The purpose of this study was to compare the effects of Intraarticular Hyaluronic Acid( IAHA) injection & Naproxen sodium to reduce pain and functional improvement in patient with osteoarthritis of knee. Methods: Randomized clinical trial was conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from November’2015 to October’2016. A number of total 100 patients of OA knee were selected as per inclusion and exclusion criteria. After proper evaluation and clinical examination patients were undergo study procedure and evaluated by selected assessment criteria. All subjects were enrolled after having informed written consent. 100patients were randomly assigned to 2 groups (Group A=50, and Group B=50). Group A: IAHA series of weekly (20mg/2ml each) for 3 weeks, Exercise and ADL instructions and Group B: NSAIDs (Naproxen 500mg) twice daily for four weeks, Exercise and ADL. Respondents of both groups were assessed to at 4th week, 12th week, and 26th week by OA specific translated and validated Bengali instrument- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and VAS pain score. The results were expressed as percentage and mean ± SD and level of significance was set at 0.05 and p<0.05 was considered as the level of significant. Student`s t- test and chi-squared (X2) test were done to test the hypothesis which appropriate. Results: 47 patients in group-A and 50 patients in Group-B have completed the study. The improvement of VAS Pain score was 4.02 in group A and 5.62 in group B at week twenty six (26th), which was significant p<0.001. The improvement of WOMAC Pain score was 271.81 in group A and 315.50in group B at week twenty six (26th), which was significant p<0.05.The improvement of WOMAC stiffness score was 107.98 in group A and128.00in group B at week twenty six (26th), which was significant p<0.05. The improvement of WOMAC physical function scorewas 977.66 in group A and B 1314.50in group B at week twenty six (26th), which wassignificant p<0.05. Conclusions: IAHA injection is more beneficial to Naproxen sodium along with exercise and ADL in OA knee.