Comparative analysis of the effectiveness of chondroitin sulfate,hyaluronic acid and arthroscopy at the initial stages of hip osteoarthritis
Background. The efficiency of modern drugs that modify the course of the disease is still doubtful, especially, their influence on the long-term effects of hip osteoarthritis. Besides, the following question remains controversial: what is more effective in treatment of osteoarthrosis - arthroscopy or drug therapy? The purpose was to evaluate and to compare the clinical efficiency of preparations of hyaluronic acid, chondroitin sulfate, and also arthroscopy in the treatment of the initial stages of coxarthrosis for 6 months. Materials and methods. In this study, we have study the clinical efficiency of therapy by chondroitin sulfate preparations, hyaluronic acid preparation administered intraarticularly, and arthroscopy in patients with the initial stages of coxarthrosis. The severity of pain syndrome was evaluated on the visual analog scale, the movement function of the hip - on the modified Harris scale, and also a therapeutic effect was assessed, in opinion of patient and doctor. Clinical indexes were determined at baseline, and on months 1, 3 and 6. Results. It was found that the combination of non-steroidal anti-inflammatory drugs with symptom-modifying drugs of delayed action contributes to the reduction of severity of pain in patients with initial stages of coxarthrosis. Intraarticular introduction of hyaluronic acid assists the improvement of movement function of the affected joint and everyday activity of these patients. After arthroscopy, the positive dynamics of pain syndrome and functional ability of the hip joint is marked in 3 months after the surgery, and in 6 months - significantly lower intensity of pain and improvement of functional capability of patients compared to those who received medication. Conclusions. According to the results of the overall assessment of treatment effectiveness by the patient and the physician on the basis of six-month therapy, more pronounced improvement of the functional state of hip joints was detected after arthroscopic treatment than against the background of the pharmacotherapy.