sodium-morrhuate and Arthritis

The aim of this study was to assess the efficacy and safety of intra-articular sodium morrhuate injections in the treatment of recurrent knee joint effusions. Ninety-eight knees of 92 patients (f = 59, m = 33) with knee arthritis of heterogeneous etiology were treated with chemical synovectomy (CSO). Of those, 39 patients suffered from rheumatoid arthritis (RA). The mean follow-up was 29.8 months. Clinical outcome was evaluated by analyzing subjective patient satisfaction, activity level, pain severity on the basis of the Visual Analogue Pain Scale (VAS), Lysholm and Gillquist score, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Fifty-seven percent of all patients and 67% of patients diagnosed with RA were satisfied with CSO. No significant effects on patient satisfaction by CSO were noted in patients older than 40 years. Overall, VAS, Lysholm and Gillquist score, and KOOS improved significantly at final review. The intra-articular application of sodium morrhuate is an effective and safe measure in the treatment of recurrent symptomatic knee joint effusions in young patients suffering from recurrent knee joint effusions.

Topics: Adolescent; Adult; Aged; Arthralgia; Arthritis; Arthritis, Rheumatoid; Female; Humans; Injections, Intra-Articular; Knee Joint; Male; Middle Aged; Pain Measurement; Patient Satisfaction; Recovery of Function; Recurrence; Retrospective Studies; Sodium Morrhuate; Surveys and Questionnaires; Synovial Membrane; Synovitis; Time Factors; Treatment Outcome; Young Adult

Prolotherapy is an alternative injection-based therapy for chronic musculoskeletal pain. Three different proliferants, D-glucose (dextrose), phenol-glucose-glycerine (P2G), and sodium morrhuate, used in prolotherapy are hypothesized to strengthen and reorganize chronically injured soft tissue and decrease pain through modulation of the inflammatory process. Our hypothesis is that commonly used prolotherapy solutions will induce inflammation (leukocyte and macrophage infiltration) in medial collateral ligaments (MCLs) compared to needlestick, saline injection, and no-injection controls. MCLs of 84 Sprague- Dawley rats were injected one time at both the tibial and femoral insertions. Immunohistochemistry (IHC) was used to determine the inflammatory response at three locations (tibial and femoral insertions and midsubstance) 6, 24, and 72 h after dextrose injection compared to saline- and no-injection controls and collagenase (positive control) (n = 4). qPCR was used to analyze gene expression 24 h postinjection (n = 4). Sodium morrhuate, P2G, and needlestick control were also investigated after 24 h (n = 4). In general, inflammation (CD43+, ED1+, and ED2+ cells) increased after prolotherapy injection compared to no-injection control but did not increase consistently compared to saline and needlestick control injections. This response varied by both location and proliferant. Inflammation was observed at 6 and 24 h postinjection but was resolved by 72 h compared to no-injection controls (p < 0.05). CD43+ leukocytes and ED2+ macrophages increased compared to needlestick and saline-injection control, respectively, 24 h postinjection (p < 0.05). Prolotherapy injections created an inflammatory response, but this response was variable and overall, not uniformly different from that caused by saline injections or needlestick procedures.

Topics: Animals; Arthritis; Biomarkers; Disease Models, Animal; Gene Expression; Glucose; Glycerol; Leukosialin; Macrophages; Medial Collateral Ligament, Knee; Needlestick Injuries; Neutrophils; Phenol; Polymerase Chain Reaction; Rats; Rats, Sprague-Dawley; Sclerosing Solutions; Sodium Chloride; Sodium Morrhuate

Varicoid was administered to 170 patients with rheumatoid arthritis, to 11 patients with a diagnostically uncertain monarthritis, to 12 patients with exudative gonarthrosis and also to 4 patients with lupus erythematodes visceralis. A total of 262 joints were treated. The short-term results, which were evaluated 4 weeks after the administration of Varicocid, revealed improvement is 95% of the patients. After 12 months, 46% of the patients were found to be free from symptoms within the area of the treated joint, and 33% of the patients showed a considerable improvement. An objectively evident improvement was found in 35 out of 40 patients with rheumatoid arthritis followed up over a period of 3 years. Comparable results after treatment with Varicocid were also obtained in patients suffering from any one of the above-mentioned rheumatic diseases. A new inflammation activity/function index for the evaluation of the local joint therapy has been used. The first investigations both of function and of morphology of the synovial membrane treated with Varicocid are reported. In our opinion, chemical synovectomy with Varicocid fills a gap in the therapy of the rheumatoid arthritis. The essential value of this type of therapy is the absence of toxicity, a temporary increase in local reactions only, and also a continuous improvement, especially in early cases.

Topics: Arthritis; Arthritis, Rheumatoid; Drug Evaluation; Fatty Acids; Humans; Injections, Intra-Articular; Lupus Erythematosus, Systemic; Sodium Morrhuate; Time Factors