OBJECTIVE: To obtain a effect of intraarticular injection of Sodium Hyaluronate in the patient with degenerative osteoarthritis without restriction of activities of daily living. METHOD: Twenty-five patients were participated in this study. These patients are diagnosed as degenerative osteoarthritis by clinical symtoms and radiographic findings. Sodium hyaluronate, 2.5 ml, 3 mg/ampule, were injected intraarticulary without local anesthesia once a week for 5 times consecutively. For evaluation of the effectiveness of sodium hyaluronate, we assess the parameters for subjective and objective symtoms scored from 0 to 3 on 3 items, and for activities of daily living scored from 0 to 4 on 4 items. And then, we compared these data between pre-injection and at post-injection 2, 4, and 5 weeks. Changes of subjective and objective symtoms, and activities of daily living are assessed using Kellgren's X-ray grading of degenerative osteoarthritis. Improvement of the subjective pain is recorded by visual analogue scale. RESULTS: 1. Subjective and objective symtoms, and activities of daily living with time progression were significantly increased at post-injection 4, 5 weeks compared with pre-injection status (P<0.05). 2. Subjective and objective symtoms, and activities of daily living according to Kellgren's X-ray classification were significantly increased at stage II and III (P<0.05). 3. Visual analogue scale is significantly decreased after injection (P<0.05). CONCLUSION: Intraarticular injection of sodium hyaluronate showed improvement of patient's subjective and objective symtoms, and activities of daily living. The improvement was pronounced in the cases of high grade of degenerative osteoarthritis (stage II, III) according to Kellgren's X-ray classification as well as low grade (Stage I).
Activities of Daily Living ; Anesthesia, Local ; Classification ; Humans ; Hyaluronic Acid* ; Injections, Intra-Articular ; Knee* ; Osteoarthritis* ; Sodium*

PURPOSE: To evaluate the efficacy of catheter-directed thrombolysis in treating symptomatic deep venous thrombosis (DVT) in lower limbs. MATERIALS AND METHODS: Twenty-six consecutive patients (16 male and 10 female; mean age, 55 years) with lower extremity DVT underwent thrombolytic therapy. The duration of symptoms was 1 -90 (mean, 17) days: 20 days or less in 16 cases (acute DVT) and less than 20 days in ten (chronic DVT). Catheter-directed infusions of urokinase were administered via ipsilateral popliteal veins, and angioplasty or stent placement was performed after the thrombolytic procedure. Oral medication of warfarin continued for six months, and for the evaluation of venous patency, follow-up ultrasonography was performed. The total dose of infused urokinase was 1,750,000 -10,000,000 (mean 4, 84,000) IU, and the total procedural time was 25 -115 (mean, 64) hours. RESULTS: Lysis was complete in 16 cases (62%, all acute DVT), partial in five (19%, chronic DVT), and failed in five (19%, chronic DVT). Eight patients with venous stenosis and two with occlusion were treated by means of angioplasty (n=4) or Wallstent placement (n=6). Minor bleeding occurred in six cases and major complications in two (one of pulmonary embolism, and one of multiorgan failure). CONCLUSION: Catheter-directed thrombolysis with urokinase is effective for the treatment of DVT in lower limbs.
Angioplasty ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Lower Extremity* ; Male ; Popliteal Vein ; Pulmonary Embolism ; Stents ; Thrombolytic Therapy ; Ultrasonography ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis* ; Warfarin