Efficacy, Tolerability and Adverse Events of Single-Shot Intra-Articular Hyaluronic Acid Injection in Knee Osteoarthritis
Journal Title: Journal of Medical Sciences - Year 2015, Vol 18, Issue 2
Abstract
Objective: The clinical experience with single intra-articular hyaluronic acid injection in knee OA is limited. The aim was to assess the therapeutic efficacy, tolerability and adverse events of single-shot intra-articular hyaluronic acid injection in knee OA. Method: Between February 2008 and December 2010, forty-eight (48) patients (Males=21, Females=27) with OA knees were enrolled in this prospective study. These patients had failed to respond adequately to conservative treatment including analgesics and rehabilitative modalities. The inclusion criteria were (1) Resting visual analog scale pain of >50 mm and (2) Radiographic evidence for osteoarthritis and at least one of the following three characteristics; Age ≥50yrs, Morning stiffness ≤ 30 min in duration and coarse crepitus on motion (as per American College of Rheumatology guidelines 1986). Functional scoring as per WOMAC and VAS for pain at rest and during walking was documented. Patient satisfaction was documented as per Linkert scale. Patients received a single injection of Synvisc-One (consisting of 6 ml hylan G-F 20). The patients were reviewed at 1 month, 3 months and 6 months post- injection with final analysis at 1 year. Use of only paracetamol, when required was allowed for concomitant analgesia. Results: The mean age of the patients was 65 ± 5 years; mean duration of symptoms 5.4 ± 1.5 years and mean body mass index (BMI) 29.1 2 kg/m . Bilateral knees were involved in 69% of patients. Knee swelling and effusion was present in 70% and 31.5 % patients, respectively. All the patients were available at final follow-up. The resting and walking VAS pain significantly improved from baseline after the injection (45 from 70 and 50 from 82, respectively). There was a significant improvement in pain and disability based on the WOMAC scores. Adverse events were recorded and included local pain and swelling, mild redness, and/or effusion in the knee. Based on “Knee Society Score” the overall efficacy was judged as excellent in 55%, satisfactory in 43%, and poor in 2 %. The beneficial effects stayed till 6 months but returned to baseline at last follow up at 1 year. Conclusions: This study confirmed the therapeutic efficacy and safety of single-shot intra-articular injection of hyaluronic acid for the treatment of osteoarthritis of the knee. The pain relief and functional improvement last for up to 6 months. The procedure is tolerated well and associated with very few local adverse events. The need for concomitant analgesia is reduced.
Authors and Affiliations
Shahid Hussain, Abdul Hamid Rather, Asif Qayoom
Keywords
Related Articles
- EP ID EP432563
- DOI -
- Views 58
- Downloads 0
Abdominal Hydatidosis: Surgical Perspectives
Hydatid disease or Echinococcosis is a zoonotic disease (Krabbe and Finsen 1862) caused by the larva of Echinococcus species and is one of the oldest known parasitic diseases to man. The disease has a worldwide distribut...
Massive Pulmonary Embolism In A Postpartum Case of Caesarean Section A Case Report
Introduction: The overall incidence of acute pulmonary embolism is 0.004% per year1; among post-partum women, the incidence of venous thromboembolism is approximately 3 to 7 every 10,000 deliveries, which is 15 to 35 tim...
Undulant Fever, Melitococemia, and focalizations, Brucellosis to be rediscovered
Since, the advent of the 20th Century, Brucellosis has been making a smoldering impact on health care system in developed as well as developing countries. The places dependent on livestock, intertied rural customs, socia...
Pneumococcal Vaccination in Patients with Chronic Kidney Disease and Kidney Transplant Recipients
Chronic kidney disease (CKD) denotes structural and/or functional impairment of kidneys that persists for more than three months (1). CKD is arbitrarily divided into stages 1 to 5 based on the level of glomerular filtrat...
Prevalence of Vitamin D Deficiency in Northern India
Background and Objective: In India, widely consumed food items are rarely supplemented with vitamin D3. Indians do not make use of unlimited sunshine which can synthesize vitamin D in their body. Deficiency of vitamin D...