scholarly journals Comparison between the effect of platelet rich plasma (PRP) and hyaluronic acid local injection in treatment of thumb carpometacarpal joint osteoarthritis

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R Abdelfattah ◽  
H Abdelsabour ◽  
D Alzifzaf ◽  
H Saad
Keyword(s):  
Hyaluronic Acid ◽  
Platelet Rich Plasma ◽  
Hand Function ◽  
Pinch Strength ◽  
Function Score ◽  
Thumb Carpometacarpal Joint ◽  
Hyaluronic Acid Injection ◽  
Acid Injection ◽  
Thumb Carpometacarpal

Abstract Base of the thumb OA represents one of challenges to clinicians due to limited efficacy of treatment options. Resulting in OA pain, in addition it can cause deformity, stiffness with decreased range of motion and strength. The conservative therapeutic approach is the main line in management. Local injection treatment could be a good choice because of low systemic side effects and rapid improvement. Objectives to compare the effectiveness of PRP versus hyaluronic acid injection in osteoarthritis of thumb carpometacarpal joint based on clinical and functional outcome measures. Patients and Methods Prospective interventional study conducted on thirty patients with thumb CMC OA. Patient was assessed by joint Palpation for tenderness with grading from I-IV, Provocative tests (Grind test and Lever test), VAS for pain, AUSCAN score, grip and pinch strength. The patients were randomly divided into two equal groups, Group 1: received single Platelet-Rich Plasma (PRP) intra-articular injection. Group 2 received single hyaluronic acid injection. Re-evaluation at 4 and 12 weeks was done for tenderness, VAS, AUSCAN index, Grip and pinch strength. Results This study was conducted on thirty patients with ages ranged from 40 to 70 years (mean: 52.77 ± 8.59). Our results revealed that both groups showed a highly significant improvement after 4 weeks regarding pain relief assessed by VAS, tenderness grading, AUSCAN hand function score, grip and pinch strength after injection in comparison to before injection (P = 0.000). However, these improvement couldn’t be sustained for the PRP group after 12 weeks, there was a highly statistically significant increase (deterioration) in hand functional score from 4 to 12 weeks follow up (P = 0.000) and total score (P = 0.004) , highly statistically increase in VAS(P = 0.000) and decrease in grip & pinch strength (P = 0.000) , while HA group showed a highly statistically significant improvement regarding pain, hand function score , grip and pinch strength after 12 weeks of injection. Conclusion We observed clinical improvement in both groups of CMC OA treated either with single dose of HA or PRP at 4 and 12 weeks follow up. However, HA provide a superior improvement with respect to PRP at 12 weeks follow up regarding VAS for pain, joint tenderness, AUSCAN hand function score, grip and pinch strength. So we support the use of a single hyaluronic acid injection as therapy for thumb CMC OA in preference to PRP injection.

scholarly journals First Use of Thermal Stabilized Hyaluronic Acid Injection in One-Year Follow-Up Patients with Genitourinary Syndrome

2020 ◽  
Vol Volume 13 ◽  
pp. 399-410
Author(s):  
Elisabetta Garavaglia ◽  
Cinzia Sala ◽  
Manuela Busato ◽  
Gilberto Bellia ◽  
Nadia Tamburlin ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Hyaluronic Acid Injection ◽  
Acid Injection ◽  
One Year ◽  
Genitourinary Syndrome

ARTHROSCOPIC EVALUATION AND TREATMENT BY TENDON INTERPOSITIONAL ARTHROPLASTY OF FIRST CARPOMETACARPAL JOINT ARTHRITIS

Hand Surgery ◽  
2007 ◽  
Vol 12 (01) ◽  
pp. 35-39 ◽  
Author(s):  
L. Pegoli ◽  
C. Parolo ◽  
T. Ogawa ◽  
S. Toh ◽  
G. Pajardi
Keyword(s):  
Pinch Strength ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Mayo Score ◽  
Basal Joint ◽  
Palmaris Longus Tendon ◽  
Thumb Carpometacarpal ◽  
Tendon Interposition ◽  
Joint Arthritis

Basal joint arthritis of the thumb is usually seen in females beginning from the fourth and fifth decades. In the last two decades, arthroscopic techniques have brought new chances of diagnosis and treatment for this condition. In this paper, the authors describe the indications and their experience concerning arthroscopic hemitrapezectomy and tendon interposition using the palmaris longus tendon. A series of 16 patients with a maximum follow-up of 12 months is analysed. All of the 16 patients were followed and assessed with grasp strength, pinch strength, DASH and MAYO evaluation score both pre- and post-operatively at 12 months follow-up. According to the MAYO score, there were six excellent results, six good, three fair and one poor. No complications occurred. According to our preliminary results, this procedure with the proper indications gives a valid option for the treatment of thumb carpometacarpal joint arthritis in stages I and II according to Eaton's classification.

scholarly journals Efficacy, Tolerability and Adverse Events of Single-Shot Intra-Articular Hyaluronic Acid Injection in Knee Osteoarthritis

JMS SKIMS ◽  
2015 ◽  
Vol 18 (2) ◽  
pp. 128-133
Author(s):  
Shahid Hussain ◽  
Hamid Rather ◽  
Asif Qayoom
Keyword(s):  
Hyaluronic Acid ◽  
Adverse Events ◽  
Therapeutic Efficacy ◽  
Functional Improvement ◽  
Osteoarthritis Of The Knee ◽  
Single Shot ◽  
Duration Of Symptoms ◽  
Hyaluronic Acid Injection ◽  
Acid Injection

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 significant improvement of 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 lasts 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. JMS 2015; 18(2):128-133

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