Assessing the efficacy of non-arthroscopic joint lavage in patients with osteoarthritis of the knee

• Published in: Reumatología clinica (Barcelona) 2009, Vol.5 (5), p.189-193
• Main Authors: Frías, Gabriel, Font, Pilar, Muñoz-Gomariz, Elisa, Caracuel, Miguel A., Escudero, Alejandro, Castro, Maria C., Collantes-Estévez, Eduardo
• Format: Article
• Language: English
• Subjects: AINE; Joint Lavage; Knee; Lavado articular; NSAIDs; Osteoarthritis; Osteoartrosis; Rodilla
• ISSN: 2173-5743; 2173-5743
• DOI: 10.1016/S2173-5743(09)70120-0

To evaluate the efficacy of joint lavage in patients with osteoarthritis of the knee. We conducted an open prospective study involving 111 patients of whom 77% were females. The patients’ age range was 43–81 years and the average age 64 (8.7) years. All patients had gonarthrosis as diagnosed according to the (ACR) American College of Rheumatology criteria (Kellgren radiographic grades II and III). Patients were randomly distributed between 2 treatment groups: a) joint lavage without nonsteroidal anti-inflammatory drugs (NAJL, n=57), and b) non-steroidal anti-inflammatory drugs alone (NSAIDs, n=54). Evaluations were done at baseline and 1, 3, and 6 months after enrollment. Clinical and demographic variables, and WOMAC index scores, were recorded and patient improvement was determined by following the OARSI guidelines. Statistical analyses included c2, analysis of covariance (baseline WOMAC) with one between-subject factor (treatment). Post-hoc comparisons were made with Sidak's adjustment. The respective improvement rates as measured by the OARSI index for the patients in the JL and NSAIDs groups were 50.9% and 31.5% at 1 month; 55.4% and 38.9% at 3 months; and 63.2% and 64.8% at 6 months. The patients in both groups were seen to improve from the first month (P=.038). At the end of the 6-month follow-up period, the WOMAC score had decreased significantly in both groups (P=.000), with no significant differences between them. Six months after treatment, joint lavage proved as effective as NSAIDs in patients with gonarthrosis, so it constitutes an effective therapeutic choice in those cases where NSAIDs are contraindicated. El objetivo de este trabajo fue evaluar la eficacia del lavado articular (LA) en pacientes con osteoartrosis de rodilla. Se realizó un estudio abierto prospectivo en el que se incluyeron 111 pacientes, de los que el 77% eran mujeres. El rango de edad fue de 43 a 81 años y la media de edad de 64±8,7 años. Todos los pacientes tenían diagnóstico de artrosis según los criterios del American College of Rheumatology (ACR), con grado radiológico II y III de la escala radiológica de Kellgren. Los pacientes se aleatorizaron en 2 grupos de tratamiento: a) LA sin antiinflamatorios no esteroideos (AINE) (LA, n=57) y b) AINE solos (AINE, n=54). Las evaluaciones se realizaron de forma basal, al mes, a los 3 meses y a los 6 meses de haberse realizado el tratamiento. Se recogieron variables clínicas y demográficas, así como el índice de WOMAC (Western Onta