Strontium Ranelate and KOA
Condition: Knee Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      The present study was carried out on thirty patients with primary knee osteoarthritis.
      Patients were recruited from Rheumatology and Rehabilitation

      Outpatient Clinic at Mansoura University Hospi Patients were divided into two groups:

      Group 1: included 15 patients who received oral strontium ranelate and physiotherapy program.
      The age of the patients ranged from 50 to 62 years, they were 11 females and 4 males. Group
      2: included 15 patients who received physiotherapy program. The age of the patients ranged
      from 50 to 62 years, they were 12 females and 3 males. Written consent was obtained from each
      participant sharing in the study. This study was approved by the institution research board
      of faculty of medicine, Mansoura University, code: MS/15.10.08. Inclusion
    

Detailed description: 
      The present study was carried out on thirty patients with primary knee osteoarthritis.
      Patients were recruited from Rheumatology and Rehabilitation

      Outpatient Clinic at Mansoura University Hospi Patients were divided into two groups:

      Group 1: included 15 patients who received oral strontium ranelate and physiotherapy program.
      The age of the patients ranged from 50 to 62 years, they were 11 females and 4 males. Group
      2: included 15 patients who received physiotherapy program. The age of the patients ranged
      from 50 to 62 years, they were 12 females and 3 males. Written consent was obtained from each
      participant sharing in the study. This study was approved by the institution research board
      of faculty of medicine, Mansoura University, code: MS/15.10.08.

      InclusionAll patients were subjected to the following:

      I. History Taking :

        1. Personal History

             -  Name, age, sex, residence, marital status.

             -  Occupational status.

             -  Special habits e.g. smoking status (current/previous).

        2. Complaint:

           Taken in the patient's own words with special stress on disease duration.

        3. Present history:

           Onset, course and duration of disease. Analysis of complaint Pain: type of pain, site of
           pain, factors participating/alleviating pain. Swelling. Crepitus. Limitation of
           movement. Morning and inactivity stiffness, its duration and location. Other joints
           affected and its pattern of distribution.

           History of other systems affections:

           Neurological symptoms (muscle power and sensation of the lower limbs). Eye symptoms
           (redness, ulcers and blurred vision). Gastrointestinal tract (GIT) symptoms (diarrhea,
           heart burn and mucus in the stool). Urinary tract (UT) symptoms (dysuria and frequency).
           Skin affection (ulcers, erythema, papules and nodules).

        4. Past history:

      History of surgical operation of knee.

      HistoryAssessment of range of motion of the affected knee joint:

      For any limitation in the range of motion of the knee joint.

      D) Special tests to assess ligaments and menisci:

      Varus stress test for lateral collateral ligament. Valgus stress test for medial collateral
      ligament. Anterior drawer test for anterior cruciate ligament. Posterior drawer test for
      posterior cruciate ligament.

      McMurry's test for menisci.Radiological investigations:
    

Intervention name(s): Strontium Ranelate; physiotherapy
Intervention type(s): Drug; Other
Intervention description(s): Patients received strontium ranelate 2gm (one sachet daily with 50 ml water at bedtime at least 2 h after food), as the compliance of patient assessed by counting number of sachet that patient returns at every visit and safety is assessed by recording adverse effects as blood pressure and heart rate every visit and patients received physiotherapy program in the form of (US therapeutic acoustic radiation and exercise program) 3 times per week for 6 months.
Ultra sound (US):
Pulsed ultrasonic waves were delivered at a 1 MHz frequency and at an intensity of 1 watt/ cm2 via a transducer with a diameter of 5 cm and effective radiating area of 3.5 to 5cm² for 9.5 min (; Ultra sound (US):
Pulsed ultrasonic waves were delivered at a 1 MHz frequency and at an intensity of 1 watt/ cm2 via a transducer with a diameter of 5 cm and effective radiating area of 3.5 to 5cm² for 9.5 min (Medserve, England) (Huang et al., 2001). Patients were positioned in a supine position with the affected knee flexed at 90° and the sound head was held stationary over the tibiofemoral joint medial to the patellar tendon to enhance energy penetration into the joint space (White et al., 2007).
Exercise program:
The subjects were treated with a group-exercise program composed of a range of motion of all lower limb and 45 min strengthening exercises with 5 min stretching exercises of lower limb muscles 3 times per week under the supervision of the same physiatrist (Fitzgerald and Oatis
Intervention MeSH terms: Strontium ranelate
Allocation: Randomized
Intervention model: Sequential Assignment
Masking: None (Open Label)
Primary purpose: Treatment