Features of therapy for gonarthrosis in patients with decreased bone mineral density
Keywords:knee osteoarthritis, osteoporosis, bone mineral density, chondroitin-4, 6-sulfate, nimesulide, diclofenac
AbstractObjective: to determine features of therapy of gonarthrosis in patients with decreased bone mineral density (BMD). Methods: we examined 120 patients with radiological grades II–III of knee osteoarthritis according to Kellgren-Lawrence. 54.2 % of them have had decreased BMD. Depending on therapy performed these patients were divided into four groups: 1 — patients received chondroitine-4, 6-sulfate (C-4, 6-S) 1 g daily for 6 months and nimesulide 200 mg per day up to 15 days; 2 — C-4, 6-S, 1 g daily for 6 months and diclofenac 150 mg daily up to 15 days; 3 — nimesulide 200 mg per day up to 15 days; 4th — diclofenac 150 mg per day up to 15 days. Results: correlations between BMD and clinical and laboratory data were determined. We found such distinctive peculiarities of gonarthrosis in patients with decreased BMD as more pronounced pain and limitation of functional activity as well as increased level of C-reactive protein. After 6 and 12 months of therapy we found significantly less decline in BMD (T-and Z-indices in standard deviations) in patients who has received C-4, 6-S which allows to conclude its positive impact on BMD. In case of nimesulide monotherapy after 6 months we observed significantly less negative dynamics of BMD indicators (Z-index standard deviation) than in cases of diclofenac monotherapy indicating a positive effect of nimesulide on BMD.
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