Efficacy of Intra Articular Hyaluronic Acid versus Arthroscopic Debridement in Terms of Improvement in Pain Score in Kellgran - Lawrence Grading II & III Osteoarthritis of Knee Joint

Aim: To evaluate and compare the efficacy of the treatment by intra articular hyaluronic acid injections and arthroscopic debridement of knee osteoarthritis in terms of alleviating pain and functional outcome. Study design: A randomized experimental study Place and duration of study: Department of Orthopedics, Ch. Rehmat Ali Memorial Trust Hospital, attached to Continental Medical College Lahore from 1 st January 2012 to 31 st December 2014. Methodology: One hundred and twenty patients above the age of 40 were included in this study. Knee joint radiographs were taken and evaluation of pain score was done. The selected patients were divided in two equal groups (group A and group B) and each group comprised of 60 patients. All the patients included in the study were explained about the procedures and a written consent was also taken. Group A patients were treated by weekly intra articular hyaluronic acid injections for five weeks and group B patients were treated by arthroscopic debridement. Functional outcome was evaluated by pain domain of knee society knee rating system. Results: After one month of the procedures, in group A, 8 patients (13.4%) improved with pain score upto 20, 16(26.7%) improved with pain score upto 30, 14(23.3%) improved with pain score upto 40, and 22 (36.7%) improved with pain score upto 45(p=0.004). In group B, 8 patients (30%) improved pain score upto 20, 20patients (33.3%) improved pain score upto 30 and 22 patients (36.7%) improved pain score up to 40.After three months pain score was 30 in 20patients (33.3%),and pain score 40 in 14 patients (23.3%).after six months of follow up pain score was 30 in 24 patients (40%),and pain score was 40 in 14 patients (23.3%) and it was marked improvement as compared to group B. Conclusion: It was concluded that in patients with osteoarthritis of the knee joint, treatment with Intra articular hyaluronic acid injections is a better option than arthroscopic debridement in terms of pain relief and patient’s mobility.