ORTHVOLTAGE X-RAY THERAPY FOR THE TREATMENT OF 0-2 GONARTHRITIS STAGES: LONGTERM RESULTS OF A RANDOMIZED TRIAL. THE DYNAMICS OF A PAIN SYNDROME

The aim of the study was the comparative analysis of treatment for gonarthritis of 0–2 stages by symptomatic therapy (Symptomatic slow acting drugs for osteoarthritis — SYSADOA) and in combination with orthovoltage x-ray therapy (OVRT) within an open randomized study.

Material and methods. The study included patients with clinically confirmed gonarthritis. Patients were randomly divided into 2 groups, each of them was administered a combined SYSADOA glucosamine (500 mg) and chondroitin (400 mg) sulfate, OVRT was prescribed to patients of second group. OVRT was performed on X-ray machine Xstrahl-200, a single dose was 0,45 Gy, in 10 sessions to a total dose of 4,5 Gy. The pain syndrome was evaluated by VAS, WOMAC scales, efficiency of the treatment by OARSI/OMERACT (reduction of VAS and WOMAC by more than 20% of the baseline). Disability and the number of endoprosthesis replacement were also analyzed. Evaluation was performed before, after treatment, 6, 12 and 36 months.

Results. There were selected 300 patients, 150 in each group, eight people were lost. By the end of the treatment there were no statistically significant differences in the reduction of pain syndrome evaluating by VAS and WOMAC A. After 6–36 months degree of pain reduction was significantly higher in the OVRT group. After three years in the OVRT group, WOMAC A levels, VAS, VAS 20%, WOMAC A 20% were 21,9, 21,2, 69%, 78%, in the SYSADOA group 53,5, 54,9, 25%, 32%, p<0,0001. In the SYSADOA group, by the end of follow-up, 48 (32,9%) patients had a disability group, 42 (28,8%) underwent endoprosthesis replacement, in the combined treatment group — four and four cases (2,7%), respectively, p<0,0001.

Conclusion: there was stable reduction of pain syndrome level among patients underwent OVRT, and improvement of the functional state of the joint, which allows to reduce the frequency of disability and knee endoprosthesis replacement.

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