The effect of arthroscopic surgery and intraarticular drug injection to the antioxidation system and lipid peroxidation at osteoarthritis of knee

OBJECTIVE: To elucidate the effects of arthroscopy and intraarticular hyaluronan therapies on antioxidant enzyme activity and lipid peroxidation.

METHODS: This study was conducted between January and May 2005, at the Department of Orthopedics and Traumatology, Suleyman Demirel University, Isparta, Turkey. A total of 60 patients with knee pain who were diagnosed as knee osteoarthritis according to the American College of Rheumatology ACR criteria were included in this study and randomly and equally divided into 4 groups. Intraarticular Hylan G-F 20 treatment was given to group 1 for 3 weeks. Intraarticular Hylan G-F 20 treatment plus oral vitamin E were administered to group 2 for 3 weeks. Only arthroscopy treatment was applied to the control group group 3. Intraarticular Na-hyaluronate treatment was given to group 4 for 5 weeks. Blood and synovial fluid samples were taken from all the patients for biochemical analysis, and the following parameters were measured: superoxide dismutase SOD, catalase CAT, glutathione peroxidase GPx, and malondialdehyde MDA.

RESULTS: There was no significant difference in blood SOD, CAT, GPx levels, and synovial SOD and GPx levels in groups treated with hyaluronan, when compared with the controls. However, there was a significant change in MDA levels in synovial fluid samples of group 1, group 2, and group 4, when compared with the controls.

CONCLUSION: In knee osteoarthritis, intraarticular hyaluronan therapy following arthroscopy may diminish lipid peroxidation in synovial fluid.