Application of methylprednisolone suspension by iontophoresis in patients with arthrosis of the knee

The knee arthrosis is very frequent rheumatic degenerative disease. It primarily represents a damaged joint cartilage, which causes pain and reduction in mobility, inability to walk and associated symptoms. In this clinical syndrome we found synovitis as attendant symptom of „activated knee arthrosis“. Therapeutic regiment is based on applications of non-specific inhibitors of inflammation, non-steroidal inflammatory drugs, and application of physical therapy. Later on, preparations of hyaluronic acid have been given. Application of corticosteroid by iontophoresis is not so common in clinical practice, instead of intraarticular injection of cortisone preparations (e.g. poorly soluble suspensions of methylprednisolone and betamethasone). In this work we have shown the importance of application of corticosteroids with iontophoresis in patients with arthrosis of the knee joint. The optimal iontophoretic application of methylprednisolone acetate in the cases with knee joint arthrosis was performed by the following protocol: application of the drug with negative electrode, the current of 120 mA*min/cm 2 , with the average time of application (depending on to patient individual sensitivity) of 20 minutes. The improvement of the signs and symptoms and the subjective discomfort in the knee joints were measured by Hubertus test and VAS scale. Our results showed that clinical and subjective improvement was larger and more sustained in the group which was treated with iontophoretic application of methylprednisolone, than in the group treated with placebo (distilled water). Abbreviations: VAS - visual analogue scale, NSAID - nonsteroidal anti-inflammatory drugs, TENS - transcutaneous electrical nerve stimulation