Topical Pistacia vera L. Seed Oil Preparation and Its Effects on Knee Osteoarthritis Through a Randomized Double-blind Controlled Clinical Trial

Background: Osteoarthritis (OA) is a degenerative joint disease that globally affects the elderly, leading to pain and disability. Herbal medications and alternative therapies have demonstrated positive effects on arthritis management. Pistacia vera has traditionally been used for inflammatory conditions and has also shown antinociceptive effects. Objectives: Given the limited available scientific evidence, our randomized controlled trial aimed to assess the potential protective role of topical P. vera seed oil preparation in patients with knee OA. Methods: A total of 89 patients with knee OA (n = 89) were randomly allocated into three groups: Placebo, piroxicam, and P. vera. The topical formulations were administered twice daily over a period of three months. Pain level, patient health status, and performance were evaluated using the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Statistical analysis was performed using SPSS software. Results: The application of P. vera ointment demonstrated pain reduction in patients, as indicated by VAS and WOMAC assessments. Additionally, WOMAC scores showed that P. vera ointment alleviated motion stiffness and improved activity difficulties in patients (P < 0.001). In certain parameters, the topical application of P. vera showed greater effectiveness in treating knee OA than piroxicam (P < 0.05). Conclusions: Pistacia vera ointment shows promise as a potential therapeutic option for osteoarthritis, effectively addressing the detrimental effects of the disease. Further experimental and clinical studies are warranted to elucidate its efficacy and safety profile.