LAUSR

LEVEL OF EVIDENCE: 4 SUMMARY Objective. We aimed to document the effectiveness of an Ayurvedic treatment protocol in patients with knee ligament injuries. Methods. We observed 20 patients with knee ligament injuries ranging from partial to complex meniscal/ligamentous pathological states who underwent an Ayurvedic treatment protocol. Knee Outcome survey (KOOS) and International Knee Documentation Committee (IKDC) scores were assessed as baseline figures along with supportive radiological reports if available such as an MRI and the same scores were used to assess the effectiveness of the Ayurvedic treatment protocol. Person centered stage wise administration of Ayurvedic medicaments and external therapies were carried out for the concerned patients. The outcome measures of change in KOOS and IKDC scores were analyzed pre-treatment [a1], post-treatment [a2] and after a follow-up [a3] of 3 months. Data analysis was carried out using Statistical Package for Social Sciences (SPSS). The ordinal data was subjected to Friedman’s test. Post Hoc comparisons were carried out using Wilcoxon test (with Bonferroni correction). Results with p-value < 0.01 were considered significant. Results. There were statistically significant differences in KOOS and IKDC scores between a1 and a2; & a1 & a3. When analyzed between a2 & a3 in the prescribed parameters, results were statistically insignificant. KOOS-Overall scores with Friedman’s test between a1, a2 and a3 were χ2(2) = 28.737, p = 0.000 < 0.01. Post hoc analysis with Wilcoxon signed-rank tests (at Bonferroni-adjusted significance level) between a1 & a2 gave results Z = -3.921, p = 0.000 < 0.017 and between a1 &a3 it was Z = -3.771, p = 0.000 < 0.017. Between a2 & a3 the result was Z = 0.000, p = 1.000 > 0.017. IKDC score withFriedman’s test between a1, a2 & a3 were χ2(2) = 32.430, p = 0.000 < 0.01. Post hoc analysis with Wilcoxon signedrank tests, between a1 & a2 was Z = -3.920, p = 0.000 < 0.017 and between a1 & a3 was Z = -3.922, p = 0.000 < 0.017). The analysis between a2 & a3 gave result Z = -2.234, p = 0.025 > 0.017). A variable in knee joint rehabilitation viz. the body mass index (BMI) of the patients did not seem to influence the results. The treatment was found to be comparatively more effective in females and in patients who engaged in moderate labour as well as who led a sedentary lifestyle. Elderly population though of less number in the study, experienced improved joint stability and relief in symptoms statistically as well as clinically. Conclusions. The preliminary analysis of this observatory report indicates that suggested Ayurvedic treatment protocol is effective in knee ligament injuries, wherein it improves joint stability, reduces the symptoms of pain, swelling, stiffness and rehabilitates the individual towards his daily activities of strenuous/non strenuous origin. The effectiveness observed after the treatment phase sustained across the follow up period of 3 months as well. To substantiate the effectiveness of the prescribed Ayurvedic treatment protocol in decelerating the osteoarthritis onset in a traumatic knee injury requires long term followups. Yet we have documented some positive leads from this report wherein Ayurvedic treatments may be adopted for effective and non-invasive rehabilitation of knee ligament injuries ranging from partial to complex origin and also in decelerating the risk of developing early osteoarthritis.