Comparative Clinical Trial of Paracetamol alone and Vitamin C and E as an Add on Therapy in Patients Suffering From Primary Knee Osteoarthritis

Among all the specific joint diseases, osteoarthritis is the most frequent cause of rheumatic complaints (1). More than 80% of patients over 55 years of age usually present with x-ray evidence of osteoarthritis. Osteoarthritis commonly involves the knee, hip and hands. Knee osteoarthritis is the leading cause of chronic disability among the elderly in the United States (2). Some of Indian study showed that 92% of orthopaedicians reported the common age of presentation of hip and knee osteoarthritis are above 50 years and that the incidence increases with advancing age (3). Knee osteoarthritis is above 55 years more common in women than men but incidence is same in both sexes under 55 years of age. Various factors implicated are age, sex, obesity, etc. but there is no uniform opinion. Studies have shown that antioxidant have a role in osteoarthritis. Experimental studies showed beneficial effect of extra ascorbic acid added to the drinking water had a slight chondroprotective effect on the development of spontaneous lesion in the experimental osteoarthritis . Abstract A randomized observational blind comparative clinical study was conducted to compare the antioxidant effect of vitamin C and E with paracetamol in patients of primary knee osteoarthritis.Subjects presenting with sign, symptoms of primary knee osteoarthritis were given paracetamol 1 gm (n=50) twice daily for 8 weeks and combinations of paracetamol 1gm bid with vitamin C (500 mg ) and E (200 IU) (n=50) twice daily for 8 weeks. Subjects completed an over all evaluation of symptoms relief on 2nd, 4th and 8th weeks of completed treatment were evaluated by clinical, routine laboratory and radiographic investigations for improvement of disease conditions, also for adverse drug reaction. On completion of 8 weeks of treatment it was observed that both the treatment group patients showed significant efficacy with better results with patients receiving antioxidant therapy in primary knee osteoarthritis patients (p<0.001) and adverse drug reaction were minor and none of patients complain of any severe adverse drug reaction. Present study indicate that antioxidant therapy can be used as an effective add on therapy in primary knee osteoarthritis.