Osteoarthritis (OA) is a leading cause of musculoskeletal disability in elderly patients. It is a slow evolving disorder causing degeneration of articular cartilage associated with symptoms of joint tenderness, stiffness and limitation of movement. These symptoms get more worsened with weight bearing and movement. Non-steroidal anti-inflammatory (NSAIDS) drugs and often Opioid analgesics offers a symptomatic relief in the management of osteoarthritis. So, the present study is conducted to compare the efficacy and tolerability of Tramadol and Aceclofenac in patients of osteoarthritis. MATERIALS AND METHODS The present study is a randomized, single centered, prospective clinical study and was conducted on 140 patients. INCLUSION CRITERIA Patients of sex, aged 40-60 years, suffering with symptoms of OA of knee who are radiologically diagnosed. EXCLUSION CRITERIA Patients <40 and >60 years of age. Patients with a history of peptic ulcers and hypersensitivity to NSAIDs/Opioids. Patients with history of bleeding tendencies, cirrhosis and oesophageal varices. Patients who have previously received Tramadol or Aceclofenac for treatment of osteoarthritis. After initial clinical assessment and baseline investigations, Aceclofenac tablet was given to 70 patients and Tramadol tablet was given orally to another 70 patients for 8 weeks. At the follow up, the results were analysed and compared statistically by paired t-test, unpaired t-test, Fischer's exact test. RESULTS Aceclofenac has shown significant change than Tramadol in efficacy parameters like Western Ontario Mac Master (WOMAC) scores (p<0.0001), joint tenderness (p<0.0001), investigator assessment for disease status (p=0.01) and response to therapy (p=0.038). Incidence of adverse effects is significant with Tramadol (p=0.02). DISCUSSION Aceclofenac was found superior than Tramadol in improving the patient's clinical condition. Aceclofenac was found to be well tolerated than Tramadol in terms of nausea, dyspepsia, epigastric distress, drowsiness. CONCLUSION Aceclofenac is efficacious and safer drug than Tramadol in treatment of osteoarthritis of knee.
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