[Comparing results of subchondral percutaneous drilling with conventional medical treatment for decreasing pain in patients with degenerative disease of knee]

ABSTRACT

Osteoarthritis is one of the most important etiologies of pain in weight bearing joints. Our objective was to investigate the efficacy of Subchondral percutaneous drilling for degenerative disease of the knee [DJD] and compare it with conservative treatment. 44 patients with knee DJD were studied from Oct 2005 to Dec 2006. 21 knees [17 patients] underwent surgery, and 29 knees [27 patients] were treated conservatively. Pain, patient satisfaction, pain free active range of motion [ROM], and quality of life were assessed at the time of first visit, 2, 6 and 12 weeks and at the end of one year after treatment. Patients were followed at least for 1 year. Mean age of surgically treated patients and controls was 47.3 and 58.3 years, respectively. Best results for the surgical group were achieved at second week after surgery and many of pain free patients deteriorated at 6 and 12 weeks and at one year. Patient satisfaction and pain free ROM of patients were better in control group in comparison with first group [P<0.05]. Subchondral percutaneous drilling doesn't have the ability of decreasing pressure. Subchondral site is not the source of pain in most patients with DJD. The origin of pain should be investigated in the joint cartilage or other sites. Both these theories need further studies