Role of arthroscopic knee lavage supplemented with intra-articular methy l prednisolone in osteoarthritis of knees

Abstract

Pain, swelling, and stiffness in the knee joint due to degenerative knee disease (osteoarthritis in the knee, which affects the joint lining and menisci) are among the most prevalent causes of difficulty walking. Damage to the cartilage in the knee joint leads to increased friction and, in extreme situations, the development of new bone. It is widely prevalent in our country due to predominance of kneeling and other cultural habits. We hypothesized that if we could remove the debris of the cartilage and other degenerative tissue through knee lavage it would relieve the joint pain and stiffness. We further decided to augment this treatment with intra articular methyl prednisolone 80 mg to decrease the inflammation of the synovium and provide a prolonged relief. All patients will undergo arthroscopic knee lavage with 3000 milliliters of ringer lactate solution under sterile conditions in the operating room.As a local anesthetic, 10 milliliter of lignocaine 2% was used. Eighty milligrams of methyl prednisolone were injected through the arthroscopic cannula at the conclusion of the procedure. The patient was sent home with stringent activity restrictions for only 24 hours. For seven days following surgery, patients were prescribed a moderate analgesic and an antibiotic. After a week, the bandage was removed and a band-aid was affixed for the remaining five days. At 1 month, 3 months, and 6 months, patients were contacted for evaluation and the pre operative and post operative pain scales were compared. Patients with Kellgren and Lawrence grade 3 osteoarthritis reported a statistically significant improvement in pain relief from pre- to post-operative VAS scores (p 0.05) after three months, and 67 percent reported good or excellent results after six months. Knee lavage with methyl prednisolone 80mg under local anesthesia is an effective treatment option for patients with grades 1, 2, and 3 osteoarthritis who are unable to undergo surgery for economic or medical reasons or who have a substantial NSAIDS requirement.