Efficacy of Rasnadi Ghrita Anuvasana Basti in the Management of Janu Sandhigata Vata W.S.R to Knee Osteoarthritis – A Randomised Controlled Clinical Trial

Osteoarthritis (OA) is the most common type of arthritis and is a major cause of pain and disability in older people[1].  Epidemiological studies have reported that Arthritis uncommon  among adults <40 and highly prevalent of those aged >60[2] and older, and report says that 22% to 39% have been diagnosed with osteoarthritis. Osteoarthritis is prevalent more in females than males, and report says that 45% of women above 65 years have osteoarthritis pain and 70% have been diagnosed with radiological findings[2].

Ageing is associated with multiple condition of medicine due to deteriorating physiological actions and impaired metabolic mechanisms. Epidemiological ageing studies report that non-communicable diseases such as diabetes, arthritis etc., are integral part of ageing[2]. There is higher risk of dependency due to psychological stress.Repetive adverse loading of joints during occupation or competitive sports ,obesity are also important predisposing factor[3].

Osteoarthritis is a chronic condition and the main goals of the treatment  are to alleviate pain and minimalize loss of physical function.[2]

The approach to the management of symptomatic osteoarthritis (OA) in the geriatric population differs from the approach in younger patients because of the substantial toxicity of nonsteroidal anti-inflammatory drugs (NSAIDs) in older patients.[2]

Non-pharmacological interventions should be the first line of treatment[2].

While some patients older than 65 can tolerate NSAID use with concomitant protection from gastrointestinal (GI) bleeding with a proton pump inhibitor (PPI), this regimen exposes patients to two drugs with numerous potential adverse drug effects.[2] Intra-articular corticosteroid injections are effective in the treatment of knee OA and also used for symptomatic relief in treatment of OA at first CMC joint.[3] But repeated steroidal injections leads to more cartilage damage .[4]

Evidence base of anti-neuropathic drugs is also poor. Presently there are no licensed drugs that can prevent, stop or restrain the progression of OA in modern medicine. Even up to 30% of individuals continue to experience pain and disability after total knee joint replacement surgery.[3]

In ayurveda, the vitiated vata combines with dosha ,dushya circulates throughout the body and lodges in a particular site and manifests vatavyadhi.[5]

Anuvasana basti is specifically indicated in the persons who are having dryness in the body,excessive appetite and suffering from kevala vata disorders.In these conditions Anuvasana is the first choice.Anuvasana basti can be given directly without prior administration of niruha basti in the patient suffering from excessive aggravation of vata.[5]

Rasnadi ghrta is selected for Anuvasana Basti chikitsa in Janu sandhivata .It contains Rasna, Dasamoola, Shatavari ,kulatha, Badara, Yava, Ajamamsarasa,and jeevaniya gana drugs which possess madhura, tiktha, guru, snigdha qualities which increases the sleshaka kapha and it helps in preventing the degeneration of the joints .This medicine used in the form of pana ,navana,basti in the diseases caused by vata .