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Pes Anserine Bursitis in Symptomatic Osteoarthritis Patients: A Mesotherapy Treatment Study.

Saggini R, Di Stefano A, Dodaj I, Scarcello L, Bellomo RG - J Altern Complement Med (2015)

Bottom Line: The goal is to modulate the pharmacokinetics of the injected substance and prolong the effects at a local level.In both groups pain level decreased significantly after the treatment period.These observations could be of interest for efforts to reduce the adverse effects of oral administration of anti-inflammatory drugs.

View Article: PubMed Central - PubMed

Affiliation: 1 Department of Medical Science Oral and Biotechnology, G. D'Annunzio University , Chieti, Italy .

ABSTRACT

Background: Pes anserine bursitis strongly affects quality of life in patients with osteoarthritis. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and injections of corticosteroid, with highly variable responses; recovery can take 10 days to 36 months. Mesotherapy is a minimally invasive technique consisting of subcutaneous injections of bioactive substances. The goal is to modulate the pharmacokinetics of the injected substance and prolong the effects at a local level.

Objective: To evaluate the effects of mesotherapy with diclofenac for anserine bursitis associated with knee osteoarthritis.

Methods: One hundred and seventeen patients with anserine bursitis associated with grade II Kellgren-Lawrence knee osteoarthritis, assessed by clinical, radiographic, and ultrasonographic examination, were evaluated and treated. They were randomly divided into two groups (A, mesotherapy; B, control). Group A completed nine sessions of mesotherapy with sodium diclofenac (25 mg/1 mL; Akis®, IBSA, Lugano, Switzerland), 1 mL for each session, three times per week. Group B received 21 oral administrations of sodium diclofenac (50 mg; Voltaren®, Novartis, Parsippany, NJ), once a day for 3 weeks. Primary outcome measures were pain intensity assessed by visual analogue scale (VAS), along with ability to perform activities of daily living, ability to participate in sports, level of pain, symptoms, and quality of life, as assessed by the Knee injury and Osteoarthritis Outcome Score. These measures were performed before and after the treatment period and at 30 and 90 days' follow up.

Results: In both groups pain level decreased significantly after the treatment period. Ultrasonography showed a reduction of the hypoechoic area related to anserine bursitis only in group A.

Conclusion: Administration of conventional NSAIDs (diclofenac) by mesotherapy is effective in managing anserine bursitis in knee osteoarthritis in the short term and mid-term. These observations could be of interest for efforts to reduce the adverse effects of oral administration of anti-inflammatory drugs.

No MeSH data available.


Related in: MedlinePlus

Trend of perceived symptoms (KOOS).
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Related In: Results  -  Collection


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f4: Trend of perceived symptoms (KOOS).

Mentions: In group A, the subjective pain levels assessed by VAS were 7±1.05 at T0,2±0.35 at T1, 3.8±0.85 at T2, and 4.0±0.85 at T3 (Fig. 2). The KOOS findings were as follows. Disability during sports activity at T1 decreased significantly (p<0.05): T0 score, 70±10.7; T1 score, 55±7.9; T2 score, 60±8.5; T3 score, 60±8.7 (Fig. 3). Perceived symptoms also were significantly reduced (p<0.05) at T1 and at both follow-up times: T0 score, 71.4±11.9; T1 score, 46.4±9.4; T2 score, 50±9.7; T3, score 53.6±9.0 (Fig. 4). A significant reduction (p<0.05) was seen in the effect of osteoarthritis on quality of life at T1 and at both follow-up times: T0 score, 68.8±13.2; T1 score, 43.8±10.9; T2 score, 50±9.7; T3 score, 50±9.8 (Fig. 5). Disability with regard to ADLs also decreased significantly (p<0.05) at T1 and at both follow-up times: T0 score, 72±14.2; T1 score, 47±8.7; T2 score, 47±8.7; T3 score, 50±9.2 (Fig. 6). Finally, pain perception was significantly reduced (p<0.01) at T1 and at both follow-up times: T0 score, 75±10.3; T1 score, 30.5±5.5; T2 score, 36±5.2; T3 score, 41±5.8 (Fig. 7).


Pes Anserine Bursitis in Symptomatic Osteoarthritis Patients: A Mesotherapy Treatment Study.

Saggini R, Di Stefano A, Dodaj I, Scarcello L, Bellomo RG - J Altern Complement Med (2015)

Trend of perceived symptoms (KOOS).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4522948&req=5

f4: Trend of perceived symptoms (KOOS).
Mentions: In group A, the subjective pain levels assessed by VAS were 7±1.05 at T0,2±0.35 at T1, 3.8±0.85 at T2, and 4.0±0.85 at T3 (Fig. 2). The KOOS findings were as follows. Disability during sports activity at T1 decreased significantly (p<0.05): T0 score, 70±10.7; T1 score, 55±7.9; T2 score, 60±8.5; T3 score, 60±8.7 (Fig. 3). Perceived symptoms also were significantly reduced (p<0.05) at T1 and at both follow-up times: T0 score, 71.4±11.9; T1 score, 46.4±9.4; T2 score, 50±9.7; T3, score 53.6±9.0 (Fig. 4). A significant reduction (p<0.05) was seen in the effect of osteoarthritis on quality of life at T1 and at both follow-up times: T0 score, 68.8±13.2; T1 score, 43.8±10.9; T2 score, 50±9.7; T3 score, 50±9.8 (Fig. 5). Disability with regard to ADLs also decreased significantly (p<0.05) at T1 and at both follow-up times: T0 score, 72±14.2; T1 score, 47±8.7; T2 score, 47±8.7; T3 score, 50±9.2 (Fig. 6). Finally, pain perception was significantly reduced (p<0.01) at T1 and at both follow-up times: T0 score, 75±10.3; T1 score, 30.5±5.5; T2 score, 36±5.2; T3 score, 41±5.8 (Fig. 7).

Bottom Line: The goal is to modulate the pharmacokinetics of the injected substance and prolong the effects at a local level.In both groups pain level decreased significantly after the treatment period.These observations could be of interest for efforts to reduce the adverse effects of oral administration of anti-inflammatory drugs.

View Article: PubMed Central - PubMed

Affiliation: 1 Department of Medical Science Oral and Biotechnology, G. D'Annunzio University , Chieti, Italy .

ABSTRACT

Background: Pes anserine bursitis strongly affects quality of life in patients with osteoarthritis. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and injections of corticosteroid, with highly variable responses; recovery can take 10 days to 36 months. Mesotherapy is a minimally invasive technique consisting of subcutaneous injections of bioactive substances. The goal is to modulate the pharmacokinetics of the injected substance and prolong the effects at a local level.

Objective: To evaluate the effects of mesotherapy with diclofenac for anserine bursitis associated with knee osteoarthritis.

Methods: One hundred and seventeen patients with anserine bursitis associated with grade II Kellgren-Lawrence knee osteoarthritis, assessed by clinical, radiographic, and ultrasonographic examination, were evaluated and treated. They were randomly divided into two groups (A, mesotherapy; B, control). Group A completed nine sessions of mesotherapy with sodium diclofenac (25 mg/1 mL; Akis®, IBSA, Lugano, Switzerland), 1 mL for each session, three times per week. Group B received 21 oral administrations of sodium diclofenac (50 mg; Voltaren®, Novartis, Parsippany, NJ), once a day for 3 weeks. Primary outcome measures were pain intensity assessed by visual analogue scale (VAS), along with ability to perform activities of daily living, ability to participate in sports, level of pain, symptoms, and quality of life, as assessed by the Knee injury and Osteoarthritis Outcome Score. These measures were performed before and after the treatment period and at 30 and 90 days' follow up.

Results: In both groups pain level decreased significantly after the treatment period. Ultrasonography showed a reduction of the hypoechoic area related to anserine bursitis only in group A.

Conclusion: Administration of conventional NSAIDs (diclofenac) by mesotherapy is effective in managing anserine bursitis in knee osteoarthritis in the short term and mid-term. These observations could be of interest for efforts to reduce the adverse effects of oral administration of anti-inflammatory drugs.

No MeSH data available.


Related in: MedlinePlus