Methotrexate in the Treatment of Advanced Knee Osteoarthritis With Effusion-synovitis

Ki vehet részt

• Meet the America College of Rheumatology (ACR) criteria for clinical knee OA assessed by a rheumatologist
• Knee pain, visual analogue scale (VAS) pain at least 40mm
• Kellgren-Lawrence(K-L) grade of 2-4
• Physical examination showed signs of inflammation (at least 2 of the following 4 clinical signs of inflammation: warmth around the joint; tenderness around joint margin; articular cavity effusion; swelling of soft tissue around the knee joint)
• MRI evaluated effusion synovitis grade of ≥ 2
• Capable of understanding the study requirements and willing to cooperate with study instructions, and voluntarily sign informed consent

Ki nem vehet részt

• Knee surgery or arthroscopic examinations were performed or planned within one year, Severe valgus knee deformity (angle of genu valgum > 30°) or previous traumatic history
• Infectious history such as HIV infection
• Hypersensitivity to methotrexate
• Clinical significant conditions, such as (but not limited to) active malignant tumor, abnormal renal function (assessed by GFR), hepatic abnormalities [active hepatitis B, hepatitis C, abnormal liver function (ALT is more than twice the upper limit)], respiratory diseases (lung infection, pulmonary fibrosis), hematological changes (e.g white blood cell (WBC) count < 4 x 10\^9 /L, platelet < 100 x 10\^9 /L or hemoglobin < 100 g/L), serious diseases of gastrointestinal, endocrine, heart, nerve or brain assessed by clinical physicians
• Inflammatory arthritis (such as gout, reactive arthritis, rheumatoid arthritis, psoriatic arthritis, seronegative spondyloarthropathy), systemic lupus erythematosus
• MRI contraindications
• Intra-articular injection, intramuscular injection or oral glucocorticoid were used within the last 4 weeks
• Other anti-synovitis agents (such as hydroxychloroquine and sulfasalazine) were applied in the past 3 months
• Pregnant and Lactating women