Joint lavage in the treatment of knee osteoarthritis

The treatment of osteoarthritis of the knee presents a series of possibilities that range from taking a simple analgesic to major surgery with total knee replacement. There are different recommendations about similar therapeutic treatments regarding their order and whether or not some of them are applicable. over the last few years, the application of local therapies for the treatment of osteoarthritis is gaining acceptance and the scientific evidence is progressively more abundant, especially regarding the treatment of osteoarthritis of the knee. Within this group, joint lavage holds a leading position in that: it is simple to perform; low cost; demonstrated efficacy and excellent tolerance and so is included in the therapeutic recommendations of expert opinion leaders. The action mechanism by which joint lavage proves to be effective in the treatment of osteoarthritis of the knee is variable and not due to a single action but to the combination of various different ones and includes mechanical and chemical factors that reduce the presence of intra-articular pro-inflammatory substances. The sample presented here consists of 283 joint lavages. The distribution by sex was 225 women and 58 men. The mean age of the total sample was 68.70 years, with a range of 45 to 88 years of age. of the total sample 28 patients were lost to follow-up and of these 16 were due to lack of efficacy and 9 for other reasons including 3 for change of address, 4 for difficulty in travelling and 2 for surgical operations not related to the locomotor apparatus. In three patients the lavage could not be completed as they presented a vagal reaction. The severity of the joint pain was reduced from 64.5 to 29 at six months, and always progressively. The cause of this progressive improvement is not easily attributable to the effect of the lavage after several months have elapsed and so this possibly implies that the beneficial effect of the lavage in the early phases is followed by a functional improvement which favours recovery of muscle strength and joint dynamics that lead to maintenance of its function and a general and progressive improvement of the pain. The favourable response was verified by statistically significant improvements in the clinical variables evaluated (p<0.001). The results of this study confirm that lavage of the knee joint using the technique described, that is infusion of one litre of physiological saline solution under constant flow and pressure using small calibre needles, is an effective and safe method for the treatment of osteoarthritis of the knee.