الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Chronic knee osteoarthritis (OA) is one of the most common diseases of advanced age. As osteoarthritis can’t be reversed, the aim of current treatments is to reduce pain and help the patient to move better. This prospective blinded randomized study was conducted at Mansoura University Hospitals in the period between January 2018 and December 2018 aiming to compare the efficacy and safety of intra articular sodium bicarbonate calcium gluconate (SBCG) injection versus intraarticular steroids in patients with knee osteoarthritis. The study was approved by the local ethical committee. Fifty cases with knee OA were included in the study. They were divided into two groups; CS group (group I) that included 25 cases who underwent intra- articular injection of CS, and SBCG group (group II) that included the remaining 25 cases who underwent intra articular injection of SBCG monthly for 3 months. All cases were subjected to complete history taking, thorough physical examination, as well as routine investigations (knee X ray and/or MRI). Efficacy of treatment was assessed using Western Ontario and Mcmaster Universities (WOMAC) Index of Osteoarthritis, Lequesne functional index (LFI), and joint space width. Patient satisifaction was assessed using patient global impression scale of improvement (PGI-I). Patient safety was assessed by recording any adverse event that may occur during follow up. The demographics and BMI did not differ significantly between the two study groups (p > 0.05). Compared to CS group, patients in SBCG group showed significant improvement of pain, stiffness and physical function subscales of WOMAC scores, global WOMAC scale, and global LFI starting from 2 month (except pain from 1-month) till the end of follow up. Compared to baseline values, significant improvement of pain, stiffness and physical function subscales of WOMAC score, global WOMAC, and global LFI were seen from 1-month till 2- month follow up and disappeared by 3-month in CS group and from 1-month and thereafter reaching maximum at the end of intervention (3-month) and maintained till 6 month in SBCG group. Compared to CS group, patients in SBCGI group experienced greater improvement in PGI-I starting from 2-month and continued throughout the follow up reaching maximum at 6-month. Conclusion: Intra-articular injections of a mixture of sodium bicarbonate and calcium gluconate monthly into the knee joint significantly reduce pain and stiffness and improve function and patients’ satisfaction after the first intervention. After one month this treatment is significantly more effective than MP and thereafter. The beneficial effect of SBCG is maximized at the end of intervention and maintained for at least 3 months after the administration. It is a safe effective alternative for treatment of knee OA. SBCG does not eliminate further narrowing of joint space.