gms | German Medical Science

Objectives: To evaluate the efficacy of a specific protocol of conservative treatment for knee osteoarthritis applied to old patients who want to avoid surgery.

Methods: In a prospective study, 64 (48 females and 16 males, age : 83±2.6 ys) old patients suffering from knee osteoarthritis pain, who did not want to have surgery, were assigned to receive conservative treatment including: intrarticular ropivacaine and cortisone injection (1 shot), intrarticular ropivacaine and hyalouronic acid injection (3 shots), infiltration of around knee trigger points (4 shots), diacerein 30mg administrated orally twice daily for 45 days, alendronate 35mg once a week per os for 6 months (with calcium and Vitamin D). Clinical outcomes were measured with VAS pain scale and Womac score at baseline, 6 months and 1 year after the end of the conservative treatment. Statistical analysis was performed by statistical packet STATA 8.0 and significance was set at p-value <0.05.

Results and Conclusion: The VAS pain score decreased significantly from 8.2±1.8/10 to 5.8±1.1/10 (p<0.05) during gait and at 1 year of follow up. Also the VAS pain score decreased significantly from 6.2±1.3 to 3.8±1.5 (p<0.05) at rest and at 1 year of follow up. Womac score decreased also significantly from average 82±5.7 to 61±1,8 (p<0.05). No patient wanted to have knee surgery, except two, 1 year after the end of the conservative treatment.

Conservative treatment of knee osteoarthritis could be efficient in treating old patients with low functional demands.