Comparison of intraarticular hyaluronic acid injections and mudpack therapy in the treatment of knee osteoarthritis
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Bibliographic record
Abstract
Abstract Objectives: Conservative treatment should be tried prior to surgical treatment in knee osteoarthritis. This study was designed to evaluate the short-term effects of mud-pack therapy on pain relief and functional improvement in knee osteoarthritis in comparison with intra-articular hyaluronic acid injections. \r\nMethods: The study included 23 patients who were diagnosed as having knee osteoarthritis according to the ACR (American College of Rheumatology) criteria, and had complaints lasting for more than three months. All the patients had stage 2 or 3 osteoarthritis radiographically according to the Kellgren-Lawrence criteria. Twelve patients (3 males, 9 females; mean age 54±6 years; range 46 to 67 years) received mud therapy bilaterally. Mud packs were heated to 45 °C and applied on both knees for 30 minutes daily for a total of 12 weekdays. Eleven patients (2 males, 9 females; mean age 53±9 years; range 40 to 66 years) received a total of three bilateral intra-articular hyaluronic acid injections, each interspersed by weekly intervals. The patients were evaluated before and after treatment in terms of pain and functionality using the pain subscale of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index, Hospital for Special Surgery (HSS) score, and Knee Society clinical rating system (knee and function scores). The patients were followed-up for a mean of 5.9±6.3 months (range 4 to 8 months) after mud-pack therapy, and 5.8±0.8 months (range 5 to 7 months) after intra-articular hyaluronic acid injections.\r\nResults: No significant differences were found between the two groups with respect to pre-and posttreatment WOMAC, HSS, and knee and function scores (p>0.05). The scores of all instruments showed significant improvements following treatment in both groups (p<0.001). Posttreatment changes in relation to baseline scores did not differ significantly between the two groups (p>0.05).\r\nConclusion: Treatment of knee osteoarthritis with intra-articular hyaluronic acid injections or mud-pack therapy yielded similar results in the short-term in terms of functional improvement and pain relief. Mud-pack therapy is a noninvasive, complication-free, and cost-effective alternative modality for the conservative treatment of knee osteoarthritis. Özet Amaç: Diz osteoartritinde cerrahi tedaviden önce zaman kazandırıcı konservatif yöntemler denenmelidir. Çalışmamızda, diz osteoartritinde tıbbi çamur tedavisinin kısa dönemde ağrı ve fonksiyonlar üzerine etkisi değerlendirildi ve eklemiçi hiyalüronik asit uygulamasıyla karşılaştırıldı. \r\nÇalışma planı: Çalışmaya, Amerikan Romatoloji Derneği ölçütlerine göre diz osteoartriti tanısı konan ve yakınmaları üç aydan uzun süren 23 hasta alındı. Kellgren-Lawrence sistemine göre radyografik olarak bütün hastalarda evre 2 veya 3 diz osteoartriti vardı. On iki hastanın (3 erkek, 9 kadın; ort. yaş 54±6.; dağılım 46-67) her iki dizine, günde bir kez, 12 gün süreyle, 45 °C sıcaklıkta ve 30 dakika süreyle, diz üzerine paket tarzında çamur tedavisi uygulandı. On bir hastanın (2 erkek, 9 kadın; ort. yaş 53±9; dağılım 40-66) her iki dizine de, birer hafta arayla üç kez hiyalüronik asit enjeksiyonu uygulandı. Hastalar tedavi öncesi ve tedavi sonrası son kontrollerinde WOMAC osteoartrit ölçeğinin (Western Ontario and McMaster Universities) ağrı altbölümü, HSS skoru (Hospital for Special Surgery) ve Diz Derneği (Knee Society) fonksiyon skoru ve diz skoru ile ağrı ve fonksiyon açısından değerlendirildi. Çamur tedavisi grubunda ortalama takip süresi 5.9±6.3 ay (dağılım 4-8 ay), hiyalüronik asit grubunda 5.8±0.8 ay (dağılım 5-7 ay) idi.\r\nSonuçlar: Hem tedavi öncesi hem de tedavi sonrası WOMAC, HSS, diz ve fonksiyon skorları iki grup arasında anlamlı farklılık göstermedi (p>0.05). Her iki grup içinde de, işlem öncesine göre işlem sonrasında tüm skorlarda anlamlı iyileşme görüldü (p<0.001). İki grup arasında işlem öncesine göre işlem sonrasındaki değişim yönünden anlamlı farklılık bulunmadı (p>0.05).\r\nÇıkarımlar: Diz osteoartritinde eklemiçi hiyalüronik asit ve tıbbi çamur uygulamaları hastaların fonksiyonlarında iyileşme ve ağrının azaltılmasında kısa dönemde benzer sonuçlar göstermektedir. Girişim gerektirmemesi, komplikasyonsuz ve düşük maliyetli bir seçenek olması nedeniyle, tıbbi çamur diz osteoartritinde kullanılabilecek önemli bir konservatif tedavi seçeneğidir.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it