Journal of Research in Ayurvedic Sciences

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VOLUME 2 , ISSUE 4 ( October-December, 2018 ) > List of Articles

CASE REPORT

Ayurvedic Management of Osteoarthritis Knee with Grade IV Severity and Obesity (Avaranajanya Janu-Sandhigatavata with Sthoulya)

Rajkala P Patil

Keywords : Obesity, Osteoarthritis knee, Sthoulya.,Avarana,Sandhigatavata

Citation Information : Patil RP. Ayurvedic Management of Osteoarthritis Knee with Grade IV Severity and Obesity (Avaranajanya Janu-Sandhigatavata with Sthoulya). J Res Ayurvedic Sci 2018; 2 (4):240-246.

DOI: 10.5005/jp-journals-10064-0064

License: CC BY-NC 4.0

Published Online: 00-00-0000

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

This case illustrates the effective mode of Ayurvedic therapeutic intervention in a chronic osteoarthritis (OA) knee patient with Grade IV severity and obesity, where the regular use of analgesics was reported and surgery was advised. A 60-year old male presented with complaints of severe pain in both the knee joints for the past 11 years, associated with swelling, difficulty to walk, limited movement of knee joints with deformity, loss of sleep due to pain, being unable to perform major activities of daily living with an increased dependency for personal care, and loss of income. The present case was diagnosed as OA knee and the severity was graded as Grade IV. The patient was diagnosed as associated with obesity. On Ayurvedic parlance, the present case was diagnosed as Avaranajanya Janu- Sandhigatavata with Sthoulya based on the etiology and signs and symptoms. The patient was treated with a combination of Ayurvedic oral medications and treatment procedures. After the course of treatment, the patient felt much better with knee joint pain, swelling, and stiffness, and was able to walk without support and without pain for 500 m, able to climb stairs, and do minor household work. Improvement was noted on the Western Ontario and McMaster Universities (WOMAC) OA index score from 78 to 27 (right knee) and 73 to 29 (left knee); the activepain visual analog scale (VAS) score from 10 to 5, body weight from 76 to 65 kg, waist circumference from 112 to 100 cm, and body mass index (BMI) from 28.6 to 24.5 kg/m2. Furthermore, the patient was able to withdraw the use of analgesics and avoid surgery.


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  1. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care [see comment] [Review] [45 ref]. Ann Rheum Dis 2001 Feb;60(2):91e7.
  2. “Osteoarthritis.” Gale Encyclopedia of Medicine. 2008. The Gale Group, Inc. Available from: https://medical-dictionary. thefreedictionary.com/osteoarthritis [Last accessed on 2017 Dec. 06]
  3. Lementowski PW, Zelicof SB. Obesity and osteoarthritis. Am J Orthop (Belle Mead NJ) 2008 Mar;37(3):148-151.
  4. Yadavji Trikamji Acharya, editor. Sushruta Samhita of Sushruta, Chikitsa Sthana, Ch. 31, Ver. 1, 9th ed. Varanasi: Choukhamba Orientalia; 2007. p.507.
  5. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum 1986 Aug;29(8):1039-1049.
  6. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis 1957 Dec;16(4):494-502. doi: 10.1136/ard.16.4.494.
  7. Misra A, Chowbey P, Makkar BM, et al. Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management. J Assoc Physicians India 2009 Feb;57:163-170.
  8. Yadavaji Trikamji Acharya, editor. Charaka Samhita of Agnivesha, Chikitsa Sthana, Ch. 28, Ver. 37, 5th ed. Varanasi: Chaukhamba Sanskrit Samsthana; 2001. p.618.
  9. Ibidem. Charaka Samhita, Sutra Sthana, Ch. 21, Ver. 4-9. p.117.
  10. Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988 Dec;15(12):1833-1840.
  11. Ambikadatta Shastri, editor. Rasaratna Samuchchya of Vagbhata, Ch. 20, Ver. 87, 9th ed. Varanasi: Chaukhamba Sanskrit Publisher; 1994. p.400.
  12. Anonymous. The Ayurvedic formulary of India, Part I, 2nd ed. New Delhi: Ministry of Health & Family Welfare, Government of India; 2003. p.67-68.
  13. Shrikanta Murthy KR, (translator). Sharangdhara Samhita of Sharangdharacharya, IInd Section, Ch. 2, Ver. 88-94, 2nd ed. Varanasi: Chaukhambha Orientalia; 1995. p.66-67.
  14. Anonymous. The Ayurvedic formulary of India, Part I, 2nd ed. New Delhi: Ministry of Health & Family Welfare, Government of India; 2003. p.69-70.
  15. Brahma Shankar Mishra, editor. Bhavaprakash of Bhava Mishra, Part 2, Madhyam Khand, Ch. 26, Ver. 50, 5th ed. Varanasi: Choukhambha Sanskrit Sansthan; 1993. p.286.
  16. Yadavji Trikamji Acharya, editor. Sushruta Samhita of Sushruta, Chikitsa Sthana, Ch. 24, Ver. 5, 9th ed. Varanasi: Choukhamba Orientalia; 2007. p.489.
  17. Yadavaji Trikamji Acharya, editor. Charaka Samhita of Agnivesha, Sutra Sthana, Ch. 14, Ver. 35-37, 5th ed. Varanasi: Chaukhamba Sanskrit Samsthana; 2001. p.89.
  18. Nagar Mayur. Pinda Sweda and its possible modification: A critical review. Int J Res Ayurveda Pharm 2017;8(6):31-34 http://dx.doi.org/10.7897/2277-4343.086286
  19. Yadavaji Trikamji Acharya, editor. Charaka Samhita of Agnivesha, Siddhi Sthana, Ch. 4, Ver. 52-54, 5th ed. Varanasi: Chaukhamba Sanskrit Samsthana; 2001. p.701.
  20. Sharma N, Shringi MK. Janubasti, electrotherpy and traction in the management of Janusandhigata vata under the influence of trayodashanga guggulu. J Ayurveda 2010;4:56-69.
  21. Yadavaji Trikamji Acharya, editor. Charaka Samhita of Agnivesha, Nidana Sthana, Ch. 8, Ver. 22, 5th ed. Varanasi: Chaukhamba Sanskrit Samsthana; 2001. p.228.
  22. Ibidem. Charaka Samhita, Sutra Sthana, Ch. 21, Ver. 21. p.117.
  23. Ibidem. Charaka Samhita, Chikitsa Sthana, Ch. 28, Ver. 239-240. p.627.
  24. Yadavji Trikamji Acharya, editor. Sushruta Samhita of Sushruta, Chikitsa Sthana, Ch. 4, Ver. 8, 9th ed. Varanasi: Choukhamba Orientalia; 2007. p.420.
  25. Yadavaji Trikamji Acharya, editor. Charaka Samhita of Agnivesha, Nidana Sthana, Ch. 8, Ver. 22-23, 5th ed. Varanasi: Chaukhamba Sanskrit Samsthana; 2001. p.228.
  26. Ibidem. Charaka Samhita, Sutra Sthana, Ch. 27, Ver. 19. p.154.
  27. Baliga MS, Meera S, Mathai B, et al. Scientific validation of the ethno-medicinal properties of the Ayurvedic drug Triphala: a review. Chin J Integr Med 2012 Dec;18(12):946-954.
  28. Harishastri Paradkar, editor. Ashtanga Hridayaof Vagbhata, Sutra Sthana, Ch. 2, Ver. 15, Reprint ed. Varanasi: Chaukamba Krishnadas Academy; 2006. p.28.
  29. Anonymous. Sahasrayogam, Choorna Prakarana, Ch. 6, Ver. 17, Reprint ed. New Delhi: Central Council for Research in Ayurvedic Sciences; 2001. p.298.
  30. Anonymous. The Ayurvedic formulary of India, Part I, 2nd ed. New Delhi: Ministry of Health & Family Welfare, Government of India; 2003. p.132.
  31. Yadavaji Trikamji Acharya, editor. Charaka Samhita of Agnivesha, Siddhi Sthana, Ch. 1, Ver. 29-31, 5th ed. Varanasi: Chaukhamba Sanskrit Samsthana; 2001. p.682.
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