Mud-bath therapy and oral glucosamine sulfate in patients with knee osteoarthritis: a randomised, controlled, crossover study

Objective To evaluate the efficacy and safety of combined treatment of mud-bath therapy and glucosamine crystalline sulfate (GIcN-S) in patients with knee osteoarthritis (OA). Methods This study was a randomised, controlled, crossover investigation. Patients were randomly assigned ( I :1) by the investigators to two groups, named group 1 and 2. Group 1 included twenty-three patients receiving oral GlcN-S treatment from the beginning of the study (TO) to the end of the 3rd month of treatment (T3) and a combined treatment of both mud-bath therapy and GIcN-S from T3 to the end of the study at six months (T6). Group 2 included twenty-two patients receiving a combined treatment of both mud-bath therapy and GIcN-S from TO to T3 and that discontinued mud-bath therapy, receiving GIcN-S treatment alone, from T3 to T6. Primary endpoints of the study consisted of evaluating OA severity and activity at baseline and at follow-up visits. Results All 45 patients, eligible for the study, completed the period of the crossover. In group I, no significant difference was shown in the comparison from TO to T3, while from T3 to T6 most variables were significantly improved. In group 2, instead, the comparison between TO and T3 showed a significant difference in different parameters. When comparing T3 and T6, despite an improvement of all the variables, no significant difference was shown. Conclusion The association of GlcN-S and mud-bath therapy has a positive and safe role in improving pain, function and quality of life in knee OA patients.