Efficacy Evaluation And Time-effectiveness Analysis Of Sodium Hyaluronate In The Treatment Of Knee Osteoarthritis

Objective:To observe and evaluate the clinical efficacy of intra-articular sodium hyaluronate injection in the treatment of knee osteoarthritis,and to analyze the characteristics of the efficacy and its relationship with the treatment time,it provides theoretical basis for clinical treatment decision and curative effect prediction of sodium hyaluronate on knee osteoarthritis.Methods:This is a retrospective study.From January 2016.01 to January2018.01,1,397 patients with knee osteoarthritis received intraarticular injection of sodium hyaluronate from the joint cavity injection registration system of Yueyang Second People’s Hospital.After strict screening,301 patients were enrolled in the study.Vas pain scores and Womac score were recorded before and 1 day,1month,6 months,1 year,2 years and 3 years after injection of sodium hyaluronate,the treatment improvement rate(RIS)was calculated by the difference of Womac score before and after treatment.RIS ≥25% was considered effective,then the effective rate was obtained and the cumulative effective rate was obtained.At the same time pay attention to its adverse reactions.The changes of patients’ score improvement,RIS and effective rate before and after sodium hyaluronate treatment were analyzed.Results:1.The VAS and WOMAC scores on the first day,1 month,6months,1 year,2 years and 3 years after treatment fluctuated,but all scores were lower than those treatment before,and there are significant difference(p < 0.01).2.The RIS of 1 month,6 month,1 year,2 years and 3 years after treatment were more than 50%,except the first day after treatment(0.31±0.02),but still more than 25%.The RIS of other time points were higher than the first day after treatment(p < 0.01),the difference of RIS in different time points was statistically significant,and RIS was the highest at the first month after treatment(0.63±0.02),suggesting that the best effect was achieved at this time point,the difference of effective rate was statistically significant(p < 0.01).3.On the first day after treatment,patients with knee osteoarthritis had 15% and 15% pain and 15% Rigor RIS in the three subcategories of WOMAC,all < 25%,the three subscales of Womac: pain,stiffness,and joint function were all more than 25% in RIS after treatment.Among them,the change of joint function was the largest,followed by pain and joint stiffness.4.During the 3-year treatment with sodium hyaluronate,70.43% of the patients got better treatment(RIS ≥25%),and only 29.57% of the patients failed to achieve RIS ≥25% improvement at any time.65.45%of the patients(197 cases)achieved the improvement of RIS ≥25% in the first month after treatment,and 50.17% of the patients remained effective in the third year after treatment(RIS ≥25%).5.According to the X-ray K-L(Kellgren Florida)grading standard of joint degeneration,the subjects were divided into three groups: K-li,K-LII and K-LⅢ.VAS scores of KLI-Ⅲ group were significantly lower than those of pre-treatment in 3 years after treatment(p < 0.01),and Womac scores of KLI-Ⅲ group were significantly lower than those of pre-treatment in 3 years after treatment,there were significant differences(p < 0.01).6.At 1 day and 1 month after treatment,RIS in K-LⅢ group was less than 25%,RIS in the other two groups were more than 25%.There was no significant difference in RIS between K-LI and K-LII groups(P >0.05),and there was significant difference in RIS between the remaining groups(p < 0.01).Within 6 months to 3 years after treatment,RIS in K-LⅢ group was less than 25%,RIS in the other two groups were more than 25%.There were significant differences in RIS among the three groups(p < 0.01).7.In the course of sodium hyaluronate injection,72 times(4.78%)of mild and moderate swelling pain were observed in the knee joint after injection,the others were swelling of joints(3.65%),fever(0.60%),local skin rash and pruritus(0.27%),and severe knee pain(0.06%).All the above symptoms were gradually relieved within 1 to 3 days after injection,and no special treatment was needed.Conclusions:1.Sodium hyaluronate is highly effective and has few side effects.It is a drug worthy of recommendation.2.The curative effect of sodium hyaluronate on knee osteoarthritis has certain regularity.In the first month after treatment,the best effect was obtained,and still had some effect 3 years after treatment.3.The curative effect of sodium hyaluronate on knee osteoarthritis with different degree of disease is different.The effect of sodium hyaluronate on knee osteoarthritis in the early stage(K-LI,K-LII)is better than that in the middle stage(K-LⅢ).