A Comparative Clinical Study to Evaluate the Efficacy of Janu Basti and Janu Dhara With Shudh Bala Tail on Janusandhigata Vata W.S.R.TO Osteoarthritis of Knee Joint

Background: Osteoarthritis of the knee is a highly prevalent degenerative whole-joint disorder that produces pain, stiffness, crepitus, reduced walking capacity and functional limitation. Modern understanding considers knee osteoarthritis as a disease involving articular cartilage, subchondral bone, synovium, ligaments, peri-articular muscles and low-grade inflammatory mediators rather than only a disorder of cartilage wear.1-5 In Ayurveda, the comparable condition is Janusandhigata Vata, a Vata-predominant disorder occurring due to Vata prakopa, dhatu-kshaya and depletion of Shleshaka Kapha, producing sandhi shoola, shotha, stambha, atopa/crepitus and painful movement.10-14 Janu Basti and Janu Dhara are local snehana-swedana based Panchakarma procedures intended to pacify Vata and nourish the knee joint. Aim: To compare the clinical efficacy of Janu Basti and Janu Dhara with Shuddha Bala Taila in the management of Janusandhigata Vata with special reference to osteoarthritis of the knee joint. Materials and Methods: A randomized, double-arm comparative clinical study was conducted on 40 patients fulfilling the diagnostic criteria of Janusandhigata Vata/knee osteoarthritis. Patients were divided equally into two groups. Group A received Janu Basti with Shuddha Bala Taila and Group B received Janu Dhara with Shuddha Bala Taila for 14 days. Assessment was performed using subjective parameters - pain, oedema, crepitus, stiffness and tenderness - and objective parameters - walking distance and knee joint movement. Data were analysed using paired t-test for intra-group comparison and unpaired t-test for inter-group comparison. Results: Janu Basti produced 55.00% relief in pain, 85.71% in oedema, 63.63% in crepitus, 66.67% in stiffness, 94.74% in tenderness, 78.94% in walking distance and 80.00% in knee movement. Janu Dhara produced 62.50% relief in pain, 75.00% in oedema, 67.86% in crepitus, 75.00% in stiffness, 90.00% in tenderness, 80.00% in walking distance and 33.33% in knee movement. Inter-group comparison showed statistically significant superiority of Janu Basti only in stiffness, while most other parameters were comparable. Conclusion: Both Janu Basti and Janu Dhara with Shuddha Bala Taila are effective and safe procedures for symptomatic and functional improvement in Janusandhigata Vata/knee osteoarthritis. Janu Basti appears more useful in stiffness-dominant chronic cases due to longer oil retention and deeper snehana, whereas Janu Dhara may be especially useful in pain and tenderness-dominant presentations due to continuous soothing thermotherapeutic action.