Orthvoltage X-ray therapy can provide to long-term improvement in patients with osteoarthritis of the knee joints stage 0-2: results of a randomized trial

Objective. To compare treatment outcomes in Stage 0-2 gonarthrosis after chondroprotective therapy only or in combination with orthovoltage X-ray therapy (oXRT) in an open randomized trial. Materials and methods. We selected patients with clinically and radiologically confirmed cases of 0-2 stage gonarthrosis. All patients were randomly allocated into two groups. Patients of the first group (N=77) received the combined structure-modifying agents (SMA) cartilage glucosamine (500 mg) and chondroitin (400 mg) sulfate during 24 consecutive weeks. In the second arm (N=81) oXRT was administered up to a total dose of 4.5 Gy in combination with a combined SMA in regimen similar to one in the first group. Patients of both groups were allowed to take acetaminophen. Assessment of outcomes was carried out using the visual analogue scale (VAS), WOMAC scales A, B, C, Lequesne index, OMERACT-OARSI before and immediately after treatment, and in 6 to 12 months later on. Results. Immediate pain-relieving effect of treatment was comparable in both groups in terms of VAS level and WOMAC A. At 6 and 12 months after the treatment, a significant advantage of the combination of oXRT-SMA to standard treatment was revealed. Decrease of the pain level by 20% was observed in 80-83% of patients treated with oXRT-SMA comparing to less than 25% of patients in SMA group. At 12 months, freedom of pain and response by OMERACT/OARSI criteria were registered in 15-32% vs 510% (p