Clinical Observation Of Intra-articular Injection Of Combined Sodium Hyaluronate And Methylprednisolone Or Etanercept For Knee Osteoarthritis

ObjectiveTo evaluate the efficacy and safety of intra-articular injection of combined Sodium Hyaluronate and Methylprednisolone or tumor necrosis factor anta-gonist(Eanercept)in patients with knee osteoarthritis.MethodsAccording to the standards of Osteoarthritis put forward by Guidelines for diagnosis and treatment of osteoarthritis in China(2007),a total of 218 patients(351 gonitis)with primary knee osteoarthritis from the affiliated hospital of Taishan university during August 2014 to December 2016 were enrolled into our study.The patients were divided into four groups according to the treatment: oral medication group(patients were treated only with oral medication including Glucosamine Hydrochloride + Diacerein +non-steroidal anti-inflammatory drugs,n=56 gonitis),SH group(patients were injected with sodium hyaluronate,n=133 gonitis),Combined Group 1(patients were injected with sodium hyaluronate and methylprednisolone,n=127 gonitis)and Combined Group 2(patients were injected with sodium hyaluronate and etanercept,n=35 gonitis).Subjects in SH group were injected with 20 mg Sodium Hyaluronate into the knee joint,once a week,5 times a course.Subjects in combined group 1 were injected with 40 mg Methylprednisolone and 20 mg Sodium Hyaluronate for the first time,then followed by 4 times injection with 20 mg Sodium Hyaluronate every week.Subjects in combined group 2 were injected with 12.5mg Eanercept and 20 mg Sodium Hyaluronate for the first time,then followed by 4 times injection with 20 mg Sodium Hyaluronate every week.All the observation indexes were collected before treatment and 5 weeks,3 months and 6 months after treatment.Clinical symptoms such as pain,joint swelling,joint activity were compared in each group before and after the treatment,all the clinical symptoms were also compared among different groups respectively.ResultsKnee joint activity of patients in the four were all improved after treatment,tenderness and swelling of joints were all decreased in all the patients after treatment(P<0.05).Compared with control group,improvement of joint activity and alleviation of tenderness and swelling of joints were both significant in the combined group 1 and 2 than in the SH group(P<0.05).The Lequesne scores of symptoms and signs in the combined group 1 and 2 were significantly lower than those in the SH group(P<0.05).Conclusion1.Intra-articular injection of sodium hyaluronate or sodium hyaluronate combined with methylprednisolone/etanercept for treatment of knee osteoarthritis is more effective than oral drugs.2.Intra-articular injection of sodium hyaluronate combined with methylprednisolone or etanercept is more effective than single drug injection of sodium hyaluronate.3.Intra-articular injection of sodium hyaluronate combined with etanercept is more effective than sodium hyaluronate combined with methylprednisolone.4.Intra-articular injection for treatment of knee osteoarthritis is effective and safe.