Morphological reflection of highly purified chondroitin sulfate action in patients with decompensated form of knee osteoarthritis

Abstract

Objective: to study the morphological reflection of the parenteral form of highly purified chondroitin sulfate (CS) action in patients with osteoarthritis (OA) of the knee joints (KJ) during total knee arthroplasty (TA).Patients and methods. An open, prospective, controlled, randomized study included 67 patients (24 men and 43 women aged 41—73 years) with stage III knee OA and grade 2 functional insufficiency. The 1st (control) group included 35 patients, the 2nd (main) group included 32 patients. At baseline of the study, all patients were taking non-steroidal anti-inflammatory drugs (NSAIDs) at a standard daily dose. Patients of the 2nd group 2 months before the TA of KJ, additionally received a parenteral form of CS (Honrogard®), intramuscularly every other day: the first 3 injections at a dose of 100 mg/day; and if tolerability was good starting from the 4th injection, at a dose of200 mg / day (course — 25 injections). The intensity of pain was assessed according to the visual analog scale, WOMAC index, functional status according to the KOOS (Knee and Osteoarthritis Outcome Score) scale and the Lequesne index, standard radiography and magnetic resonance imaging of the knee joint were performed with an assessment of the T2 relaxation time. TA KJ was carried out according to C. Ranawat method.Results and discussion. In contrast to patients who took only NSAIDs, in patients who received CS during 50 days within 2 months before surgery, there were signs of adaptive restructuring in all layers of the preserved volume of hyaline cartilage and a decrease in the synovial membrane inflammation at the time of TA of KJ.Conclusion. The obtained results allow us to recommend the use of the parenteral form of CS (Honrogard®) according to the described scheme within 2 months before the TA of KJ in order to improve the morphological characteristics of cartilage and synovial tissue in the joints of the contralateral lower limb, taking into account the increase in the load on it in the postoperative period.