title: Pes Anserine Bursitis in Symptomatic Osteoarthritis Patients: A Mesotherapy Treatment Study.
abstract: BACKGROUND
  Pes anserine bursitis strongly affects quality of life in patients with osteoarthritis. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and injections of corticosteroid, with highly variable responses; recovery can take 10 days to 36 months. Mesotherapy is a minimally invasive technique consisting of subcutaneous injections of bioactive substances. The goal is to modulate the pharmacokinetics of the injected substance and prolong the effects at a local level.
  
  
  OBJECTIVE
  To evaluate the effects of mesotherapy with diclofenac for anserine bursitis associated with knee osteoarthritis.
  
  
  METHODS
  One hundred and seventeen patients with anserine bursitis associated with grade II Kellgren-Lawrence knee osteoarthritis, assessed by clinical, radiographic, and ultrasonographic examination, were evaluated and treated. They were randomly divided into two groups (A, mesotherapy; B, control). Group A completed nine sessions of mesotherapy with sodium diclofenac (25 mg/1 mL; Akis®, IBSA, Lugano, Switzerland), 1 mL for each session, three times per week. Group B received 21 oral administrations of sodium diclofenac (50 mg; Voltaren®, Novartis, Parsippany, NJ), once a day for 3 weeks. Primary outcome measures were pain intensity assessed by visual analogue scale (VAS), along with ability to perform activities of daily living, ability to participate in sports, level of pain, symptoms, and quality of life, as assessed by the Knee injury and Osteoarthritis Outcome Score. These measures were performed before and after the treatment period and at 30 and 90 days' follow up.
  
  
  RESULTS
  In both groups pain level decreased significantly after the treatment period. Ultrasonography showed a reduction of the hypoechoic area related to anserine bursitis only in group A.
  
  
  CONCLUSIONS
  Administration of conventional NSAIDs (diclofenac) by mesotherapy is effective in managing anserine bursitis in knee osteoarthritis in the short term and mid-term. These observations could be of interest for efforts to reduce the adverse effects of oral administration of anti-inflammatory drugs.
authors.affiliation: 1 Department of Medical Science Oral and Biotechnology, G. D'Annunzio University , Chieti, Italy .
authors.forename: Raoul
authors.initials: R
authors.lastname: Saggini
authors.affiliation: 2 School of Specialties in Physical Medicine and Rehabilitation, G. D'Annunzio University , Chieti, Italy .
authors.forename: Alexandra
authors.initials: A
authors.lastname: Di Stefano
authors.affiliation: 2 School of Specialties in Physical Medicine and Rehabilitation, G. D'Annunzio University , Chieti, Italy .
authors.forename: Ira
authors.initials: I
authors.lastname: Dodaj
authors.affiliation: 2 School of Specialties in Physical Medicine and Rehabilitation, G. D'Annunzio University , Chieti, Italy .
authors.forename: Laura
authors.initials: L
authors.lastname: Scarcello
authors.affiliation: 3 Department of Medicine and Science of Aging, G. D'Annunzio University , Chieti, Italy .
authors.forename: Rosa Grazia
authors.initials: RG
authors.lastname: Bellomo
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000627:therapeutic use*; D002062:Bursitis / Q000209:etiology* / Q000628:therapy*; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D057748:Mesotherapy; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications*; D010147:Pain Measurement; D011788:Quality of Life; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac