A Comparative Clinical Study to evaluate the efficacy of Mahasneha with Mahanarayana Taila as Matra Basti and Janu Basti in Janu Sandhigata Vata Vis-a-Vis Osteoarthritis of knee joint

Sandhigatavata is one among Shoola and Shotha Pradhana Vata Vyadhi. It is mentioned in the context of Gatavata in the classical texts. The clinical features are swelling in the joints, and pain which increases on extension and flexion and there will be damage to the joint leading to functional impairment The clinical features of Sandhigatavata are similar to osteoarthritis. Osteoarthritis is an abnormality of the synovial joints, characterized by softening, splitting and fragmentation of articular cartilage not attributable to direct contact with inflammatory tissue**.** This is usually accompanied by subchondral sclerosis and bony cysts, joint space narrowing and bony overgrowths at tissue joint margins.Osteoarthritis is the most common type of arthritis ,commonly affected joints include knee, hip, first metatarsal phalangeal joint  and joints of cervical and lumbar spine. The overall prevalence of OA in India is 28.7-39 percentage  with female prevalence of 31.6 percentage .Symptomatic management in modern medicine is through NSAIDs, opioid analgesics and glucocorticoids. Long term usage of above medicines causes gastrointestinal, hepatic toxicity, renal impairment. And surgery is recommended only if patient have severe symptoms and it causes economic burden to the patients. Hence an alternative ,natural ,effective , safer management needs to be explored for this disorder. Management protocol for  Sandhigata Vata includes therapeutic methods like *Snehana , Upanaha, Agnikarma , Bandhana and  Mardana.*Astimajjagatavata samprapti is also seen in Janusandhigata vata and Sandhi shoola is one of the symptom of Astimajjagatavata. hence the treatment protocol of Astimajjagatavata can be adopted in *Sandhigatavata.*Bahyabhyantara Sneha prayoga are proposed for Asthimajjagatavata.Sneha Basti is one of the route of Abhyantara Sneha Prayoga and Basti is the best chikithsa for Vatavyadhi . Matrabasti is a type of Sneha Basti which is effective in Kevala Vata condition because of its Snehana, Brumhana properties.Matra basti is given in very smaller dosage and it can be administered at anytime,for longer duration without any complications. Parihara kala has not been addressed in relation to *Matrabasti.*Hence it is more feasible to the patients and can be given in OPD level. Bahya sneha is given in the form of Janubasti which is one of the effective Sthanika chikithsa for *Janusandhigata vata.*Mahasneha is a variety of Sneha Kalpana prepared by all four varieties of *Sneha .*indicated in Astimajjagata vata,due to its Shreshta Vatahara properties.Mahanarayana taila is Vatahara Brumhana. Trayodashanga guggulu is indicated in Asti,Sandhi,Majja and *Snayugata vata.*Keeping above rationality into consideration Mahasneha and Mahanarayana taila are selected for Bahyabhyantara Snehana  as Matra basti and Janubasti.