EFFECT OF PIROXICAM ON GAIT IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE

Objective. To determine whether the use of a nonsteroidal antiinflamma tory drug (NSAID) in patients with painful osteoarthritis (OA) of the knee would result in alterations in specific biomechanical parameters of gait. Methods. Eighteen patients with symptomatic knee OA and varus knee deformity underwent initial clinical evaluation for pain and act ivities of daily living, and assessment of parameters of gait utilizin g a well-described computerized system. All patients were then treated with piroxicam at 20 mg once daily, and clinical and gait analyses we re repeated after 4 weeks. Results. Fifteen of the 18 patients studied had a significant increase in the knee adduction moment after treatme nt. In the group as a whole there was a significant increase in knee a dduction moment (mean percent body weight times height [%BWTH] 4.11 pr etreatment versus 4.57 after 4 weeks of treatment; P < 0.01) and maxim um quadriceps moment (mean %BWTH 2.13 pretreatment, 2.62 posttreatment ; P < 0.01), as well as changes in other gait parameters that might be expected to be altered as a result of relief of pain. Sixteen of 18 p atients experienced symptomatic relief, with a significant reduction i n pain in the group as a whole after 4 weeks (P < 0.001). Conclusion. NSAID treatment in patients with knee OA results in a reduction in sym ptomatic pain and an increase in loading of the knee. Whether the incr eased loading is due to the analgesic effects of the treatment is unkn own, but if so, the development of agents capable of relieving pain wh ile reducing loads at the knee may be desirable.