Patient case (clinical description): A 47-year-old woman comes to the office complaining of pain in the calf and knee when she bends down. The pain limits her activity. Her medical history is significant for osteoarthritis, for which she uses nonsteroidal anti-inflammatory drugs (NSAIDs) for the past two years. She is living with her husband and has 3 children. She doesn't smoke but drinks alcohol occasionally. Her vital signs are normal. On physical examination, there is a small effusion in the right knee. The effusion grew a little larger and she developed a tender swelling in the popliteal fossa and calf. Both the pain and swelling worsened as she bent and straightened her knee.

Patient's own account: I'm a 47-year-old woman, married with 3 kids. I don't smoke and I drink occasionally. I went to the doctor because of pain in my calf and knee when I was bending down. This has been limiting my daily activities. I have been diagnosed with osteoarthritis for which I have taken anti-inflammatory drugs for the past 2 years. The doctor saw a small fluid buildup in my right knee. This buildup became a bit bigger and I have a swollen calf. The pain is worse when I bend and straighten my knee.

Clinical trial: Effectiveness and Safety of Celecoxib (Celebrex 200 mg) Combined With Joins in the Treatment of Degenerative Knee Osteoarthritis: a Randomized Controlled Trial

Eligibility criteria:
Inclusion Criteria:

          -  Adults over 50

          -  Patients undergoing outpatient treatment in orthopedic surgery for osteoarthritis of
             the knee joint

          -  Patients diagnosed with Kellgren-Lawrence grade II or III osteoarthritis of the knee
             by imaging examination

          -  Patients with a pain VAS scale of 4 or more out of 10 with a pain in the knee joint
             during daily activities on flat ground

          -  Patients confirmed by the examiner for no abnormal results in blood tests, etc.

          -  Patients who are willing or able to follow doctor's instructions, including joint
             exercises

          -  Patients not participating in other clinical trials

          -  Patients who have received sufficient explanation for this clinical trial and agreed
             to participate

        Exclusion Criteria:

          -  Patients with secondary knee osteoarthritis

          -  Patients with hypersensitivity reactions and serious side effects to Celebrex or Joins

          -  Patients with inflammatory arthritis or crystalline arthritis

          -  Local infection to the lower extremities of the pain area, sepsis, or previous
             neurological abnormalities.

          -  Patients who underwent meniscus surgery on the knee joint in the painful area

          -  Patients who underwent total knee arthroplasty within 180 days of the knee joint
             opposite the pain area

          -  If there is construction or deformation of the knee joint in the pain area

          -  Patients with serious heart-related diseases such as cardiac arrest, a history of
             cerebral infarction, or ischemic heart disease

          -  Hemoglobin A1c level >8% of patients not managed by diabetes

          -  Patients with high blood pressure with poor blood pressure control (Systolic Blood
             Pressure of> 150 mmHg or Diastolic Blood Pressure> 95 mmHg)

          -  Patients taking PPI drugs for recurrent upper gastrointestinal ulcer or inflammatory
             bowel disease (such as Crohn's disease or ulcerative colitis)

          -  Patients with abnormal liver function (ALT)> 2.0 times the upper limit of normal (ULN)
             or blood urea nitrogen (BUN) or serum creatinine> 2.0 times ULN)

          -  Patients who took excessive narcotic analgesics for pain in the affected area before
             the clinical trial

          -  Patients scheduled for surgery during the clinical trial period

          -  Patients who received intraarticular injection treatment into the painful area of the
             knee within 3 months prior to the first visit

          -  Patients who received systemic steroid treatment within 3 months prior to their first
             visit

          -  Pregnant or lactating women
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 50 Years old.


Eligibility (NLI label): Contradiction