Diz Osteoartritinde İntraartiküler Hyalüronik Asit ve Tenoksikamın Ağrı ve Diz Eklem Fonksiyonları Üzerine Etkilerinin Karşılaştırılması

Year 2018, Volume: 2 Issue: 3, 149 - 158, 13.11.2018

Recai Özkılıç Tolgahan Kuru , Serdar İpek , Ekrem Keskin , Cengiz Işık , Yasin Emre Kaya

https://doi.org/10.30565/medalanya.419286

Cited By: 2

Abstract

Amaç: Bu çalışmada gonartrozlu hastalarda intraartiküler
hyalüronik asit (HA) ve tenoksikam uygulanmasının eklem hareket açıklığı (EHA)
ve ağrı üzerine etkilerinin karşılaştırılması amaçlanmıştır.

Hastalar
ve Yöntem: Bu çalışma prospektif,
randomize olmayan kontrollü ve tek kör olarak planlanmıştır.  ACR (American College of Rheumatology)
kritelerine göre Grade II ve Grade III osteoartrit (OA) tanısı konulmuş 60
hasta çalışmaya ardışık olarak alındı. Hastalar iki gruba ayrılarak  birinci gruba birer hafta arayla 3 doz
intraartiküler HA, diğer gruba ise tek doz intraartiküler tenoksikam
uygulandı.  Grupların tedavi öncesi ve
sonrası VAS ve EHA değerleri karşılaştırıldı.

Bulgular: HA Grubu’nda yer alan hastaların 20’si (%66.6) kadın, 10’u
(%33.3) erkekti ve bu hastaların yaş ortalaması 59.6 (yaş aralığı 45-75) yıl
idi. Tenoksikam Grubu'nda yer alan hastaların 24’ü (%80) kadın, 6’sı (%20)
erkekti ve bu grubun yaş ortalası 61.5 (yaş aralığı 45-75) yıl idi. Tedavi
sonrası her iki grupta da tedavi öncesine göre 1. Gün, 15. Gün, 1. ay, 2. ay ve
3. ay değerlerinde VAS, dizin fleksiyon ve ekstansiyon EHA’sında artış
saptanmıştır (p<0.05). Gruplar arası değişim miktarları
karşılaştırıldığında, erken dönemde Tenoksikam Grubu’ndaki değişiklikler daha
belirgindi fakattedavi sonrası 3. ay değerlerinde iki grup açısından fark
saptanmadı (p>0.05).

Sonuç: Grade 2-3 diz OA’li hastalarda intraartikuler HA ve
tenoksikam uygulamalarının etkin ve güvenilir yöntemler olduğu; fakat
tenoksikamın HA’ya göre erken dönemde ağrıyı azaltma ve EHA’yı arttırmada daha
etkili olduğu görüldü.

Keywords

osteoartrit, tenoksikam, hyalüronik asit

Comparison of the Effects of Intra-articular Hyaluronic Acid and Tenoxicam on Pain and Knee Joint Functions in Knee Osteoarthritis

Abstract

Aim: The objective of this study is comparing the effects of
intra-articular hyaluronic acid (HA) and tenoxicam aplications on joint range
of motion (ROM) and pain in patients with gonarthrosis.

Patients
and Method: This study was designed
as prospective, non-randomized controlled, and single-blinded trial. 60
patients diagnosed with Grade II and Grade III osteoarthritis (OA) according to
the American College of Rheumatology (ACR) criteria were consecutively
enrolled. Patients were divided into two groups whereby the first group
received intra-articular HA three times a week and the other group received a
single dose intra-articular tenoxicam. Pre-treatment and after-treatment VAS
and ROM values of the groups were compared.

Results: In the HA Group, 20 patients (66.6%) were female, 10
patients (33.3%) were male and the mean age of them was 59.6 years (range 45-75
years). In the Tenoxicam Group, 24 patients (80%) were female, 6 (20%) patients
were male, and the average age of this group was 61.5 years (range 45-75
years). VAS scores knee flexion and extension ROM values on the 1st day, the
15th day, the 1st month,the2nd month, and the 3rd month after the treatment,
significantly improved in both groups (p <0.05). When the change levels in
the groups were compared, the changes in the Tenoxicam Group were more
prominent in the early period, but there was no difference between the two
groups in terms of the 3rd-month values after the treatment (p> 0.05).

Conclusion: It was seen that intra-articular HA and tenoxicam administration
seem to be effective and reliable methods in Grade 2-3 knee OA patients; but
tenoxicam was more effective in reducing pain and relieving joint movements
compared to HA injection in the early periods.

Keywords

Osteoarthritis, Tenoxicam, Hyaluronic acid

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