Therapeutic efficacy of extracorporeal shock wave therapy combined with sodium hyaluronate injection on knee osteoarthritis

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Objective To investigate the therapeutic efficacy of extracorporeal shock wave therapy combined with sodium hyaluronate injection on knee osteoarthritis(KOA). Methods Prospective study of 240 patients with knee osteoarthritis from June 2015 to June 2017 in Department of Orthopedics, Shandong Provincial Third Hospital. The 240 patients were randomly assigned to group A (n=80), group B (n=80), group C (n=80). Group A was treated with sodium hyaluronate injection, group B was treated with extracorporeal shock wave therapy, while the group C was given extracorporeal shock wave therapy combined with sodium hyaluronate injection on knee osteoarthritis. They were evaluated with visual analog scale (VAS), the Lequesne index score and Western Ontario and McMaster College(WOMAC) osteoarthritis index before the intervention and at the 1st, 3rd, 5th week after the intervention. Results All patient’s VAS, Lequesne Index score and WOMAC Osteoarthritis Index were decrease in turn at the 1st, 3rd and 5th week after treatment, and were all lower than that before treatment by paired t test (all P values <0.05). All observed indexes were compared with the three groups at the same time point, and the differences were statistically significant (all P values <0.05). In group C, the VAS score before treatment was (8.59±0.98)points, the Lequesne index score was (10.55±2.15)points, and the WOMAC osteoarthritis index score was (35.58±10.13)points. The score of VAS was (5.51±0.63)points, (3.39±0.51)points, (1.57±0.12)points at the 1st, 3rd and 5th weeks after the treatment respectively. The score of Lequesne index was (8.13±2.15)points, (7.01±2.03)points, (5.05±2.11)points, while the WOMAC index score of bone and osteoarthritis was (28.45±9.48)points, (20.38±8.64)points, (14.85±5.45)points respectively. Statistically, group C was significantly better than group A and group B (all P values<0.05). Conclusions Synergistic action exits between the extracorporeal shock wave therapy and the sodium hyaluronate injection on KOA. It can further relieve the pain furthermore. This combined therapy is worth popularizing and applying in clinic. Key words: Osteoarthritis, knee; Extracorporeal shock wave; Sodium hyaluronate injection