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  Background & Objectives: This study was conducted to compare the clinical efficacy of two-drug regimen of glucosamine and prednisolone with one-drug regimen of glucosamine in treatment of knee osteoarthritis.

  Methods: In this randomized clinical trial, 30 patients received glucosamine and prednisolone (case group) and 25 cases underwent treatment by only glucosamine (control group) for 12 weeks. For considering pain and disability, WOMAC ( Western Ontario and McMaster Universities) was used.

  Results: Mean value of WOMAC index in the case group was 2.81 at the beginning, 1.53 in week 6, and 1.49 in week 12. In the control group, this value was 3.15 at the beginning, 2.39 in week 6, and 2.35 in week 12. In week 6 and 12, mean value of WOMAC index was significantly lower in the case group compared to the control group (P < 0.05). In patients younger than 65 years old, females, and body mass index of equal or less than 30 a significant difference was seen in both week 6 and 12 between the case and control groups (P < 0.05).

  Conclusion: Two-drug regimen of glucosamine and prednisolone in a 12-week period had a better clinical efficacy than one-drug regimen of glucosamine in lowering the pain and improving joint function of patients with knee osteoarthritis, especially females with body mass index less than 30 and younger than 65 years of age.

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Background & objectives: Osteoarthritis as a result of the destruction of articular cartilage, leads to joint pain and stiffness. The purpose of this study was to investigate the effect of endurance and ozone therapy on the expression levels of FLS and VEGF genes in the knee tissue of rats with knee osteoarthritis.
Methods: Subjects were male Wistar rats that were randomly divided into 5 groups after two weeks of adaptation, including: control-healthy, control-patient, patient-ozone, patient-exercise and patient-sport. For adapting the rats to exercise and treadmill, walking program was performed before exercise program. The training program consisted of 30 minutes of running on a treadmill with no slope at a speed of 16 m/min for the first week and one m/min added weekly until it reached 22 m/min in the eighth week. Ozone was injected into the knee through the tibiofemoral articular line at a concentration of 20 μg/ml once a week for 3 weeks at 9 o'clock in the morning. Expression levels of FLS and VEGF genes were measured by Real Time PCR. One way ANOVA and Tukey's method were used to determine the difference between groups.
Results: The results showed that the expression levels of FLS and VEGF genes were significantly increased in rats with osteoarthritis. It was also shown that physical training and ozone therapy led to a decrease in FLS and VEGF gene expression levels in osteoarthritic rats. VEGF and its receptors are expressed in OA cartilage and indicating the possibility that VEGF is involved in the elimination of OA articular cartilage by increasing MMP production.
Conclusion: The results of this study are promising for the role of VEGF as a diagnostic marker. VEGF can participate in early OA changes and a treatment modality by modulating VEGF production, which can be considered in future.

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Background & objectives: Knee osteoarthritis is an important cause of pain and disability in the community. The present study investigated the risk factors for primary osteoarthritis of the knee in patients with knee pain and their relationship with knee osteoarthritis.
Methods: 87 patients were included in the study and were matched in terms of age. Cases consisted of female patients less than 50 years of age with knee pain and the control group was selected from patients under 50 years of age with knee pain and no radiographic findings of osteoarthritis.
Results: This study showed that the rate of osteoarthritis of the knee was significantly related to body mass index (p=0.001). The relationship between knee osteoarthritis and ESR was not significant, but an increase in CRP with a p-value of 0.01 was associated with a risk of approximately a 3.5-fold increase in knee osteoarthritis. With increasing education, the rate of knee osteoarthritis decreased (p=0.022). The Increased circadian outpatient activity was significantly associated with increased knee osteoarthritis (p=0.032). In performed assessments on osteoarthritis of the knee, there was no statistically significant relationship between the type of bathroom used, the use of stairs, and residential houses.
Conclusion: Knee osteoarthritis has a relationship with body mass index, Education level, CRP index, and circadian activity level. it is recommended to lose weight in people with abnormal body mass index, exercise, and improve their lifestyle to reduce the incidence of knee osteoarthritis and disability.

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Background & objectives: Designing knee osteoarthritis (KOA) prevention programs requires recognizing modifiable risk factors. This study aimed  to determine the frequency of osteoarthritis in patients with knee pain referred to Imam Khomeini Hospital in Ardabil city.
Methods: In this cross-sectional descriptive study, 850 patients with knee pain who were referred to the clinic of rheumatology in Imam Khomeini Hospital in Ardabil city were studied. Demographic and personal characteristics and medical history of OA were collected from the participants by a checklist. Osteoarthritis was diagnosed based on clinical and radiographic evidence by a rheumatologist.
Results: Of all patients, 310 (36.5%) were diagnosed with knee osteoarthritis. The most of patients (33.5%) were in the  age group of 50-59 years old, women (80.6%) and housewives (29%). 39.9% of all patiens had obesity and most of them (43.2%) have  not exercised at any time. A family history of knee osteoarthritis was reported in 45.2% of patients, while a family history of joint replacement was reported in 6.1%. 15.8% of patients reported a history of previous knee trauma. The type of used toilet was traditional in 90.3%.
Conclusion: The frequency of knee OA in our study similar to other studies was at a moderate level and due to regional risk factors, it is suggested to reduce the incidence of KOA by presenting necessary training programs and changing the nutritional patterns of society people.