scholarly journals COMPARATIVE EFFICACY OF INTRAARTICULAR THERAPY OF GONARTHROSIS WITH HYALURONIC ACID OF DIFFERENT MOLECULAR WEIGHT (A DOUBLE-BLIND RANDOMI7ED STUDY)

2014 ◽  
Vol 17 (2) ◽  
pp. 16-21
Author(s):  
N V Vas’kova ◽  
O M Lesnyak
Keyword(s):  
Molecular Weight ◽  
Hyaluronic Acid ◽  
Weight Bearing ◽  
Controlled Study ◽  
Osteoarthritis Of The Knee ◽  
Comparative Efficacy ◽  
Double Blind ◽  
Knee Oa ◽  
Pain At Rest ◽  
Different Molecular Weight

Objectives. To study the comparative efficacy and safety of intra-articular treatment of knee osteoarthritis (OA) with hyaluronic acid (HA) of different molecular weights (MW). Material and methods. Randomized double-blind controlled study included 50 patients with osteoarthritis of the knee stage II-III, weight-bearing pain more 40 mm on VAS and Lequesne index score > 4 and < 12. 25 patients received HA with MW 3500 kDa (Rusvisk group) and 25 patients were treated with HA with MW 1200-1400 kDa (Ostenil group) injected at 3-weekly intervals. During the 22-week observation period we assessed dynamics of pain on VAS (weightbearing pain, pain at rest), index WOMAC, and recorded the overall assessment of the effectiveness of therapy by patient and physician, OMERACT-OARSI criteria and the need for NSAIDs. Results. One week after the last injection, a significant decrease in weight-bearing pain (in the group Rusvisk by 69% in the group Ostenil 55%) and the total index WOMAC (group Rusvisk by 63% in the group Ostenil 60%), continuing until the end of observation. A significant decrease in pain at rest observed in the group Rusvisk at all visits and in the group Ostenil only at 6 and 10 weeks of therapy. The overall evaluation of effectiveness of therapy by patient and physician yielded the benefits observed in high molecular HA group. A high percentage of responses to therapy using OMERACT-OARSI criteria and reduced need for NSAIDs were observed in both groups. Tolerability was satisfactory and did not differ significantly between the groups. Most common adverse reactions were mild pain at the injection site. Conclusion. Intra-articular therapy with HA of different molecular weight Rusvisk and Ostenil resulted in pain reduction and improved joint function in patients with knee OA with satisfactory tolerability.

scholarly journals Oral Administration of Polymer Hyaluronic Acid Alleviates Symptoms of Knee Osteoarthritis: A Double-Blind, Placebo-Controlled Study over a 12-Month Period

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Toshiyuki Tashiro ◽  
Satoshi Seino ◽  
Toshihide Sato ◽  
Ryosuke Matsuoka ◽  
Yasunobu Masuda ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Placebo Group ◽  
Oral Administration ◽  
Knee Osteoarthritis ◽  
Knee Joints ◽  
Controlled Study ◽  
Double Blind ◽  
Knee Oa ◽  
Strengthening Exercise ◽  
The One

This study was conducted to investigate the efficacy of oral hyaluronic acid (HA) administration for osteoarthritis (OA) in knee joints. Sixty osteoarthritic subjects (Kellgren-Lawrence grade 2 or 3) were randomly assigned to the HA or placebo group. The subjects in the HA group were given 200 mg of HA once a day everyday for 12 months, while the subjects in the placebo group were given placebo. The subjects in both groups were requested to conduct quadriceps strengthening exercise everyday as part of the treatment. The subjects’ symptoms were evaluated by the Japanese Knee Osteoarthritis Measure (JKOM) score. The symptoms of the subjects as determined by the JKOM score improved with time in both the HA and placebo groups. This improvement tended to be more obvious with the HA group, and this trend was more obvious with the subjects aged 70 years or less. For these relatively younger subjects, the JKOM score was significantly better than the one for the placebo group at the 2nd and 4th months after the initiation of administration. Oral administration of HA may improve the symptoms of knee OA in patients aged 70 years or younger when combined with the quadriceps strengthening exercise.

scholarly journals Efficacy of local injection therapy with hyaluronic acid of different molecular weight in patients with knee osteoarthritis

2019 ◽  
Vol 57 (2) ◽  
pp. 235-242
Author(s):  
V. E. Bialik ◽  
E. I. Bialik ◽  
M. A. Makarov ◽  
S. A. Makarov ◽  
V. A. Nesterenko
Keyword(s):  
Molecular Weight ◽  
Hyaluronic Acid ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Lower Limb ◽  
Varus Deformity ◽  
Neutral Axis ◽  
Stage I ◽  
Knee Oa ◽  
Different Molecular Weight

Intra-articular administration of hyaluronic acid (HA) is one of the methods of conservative treatment of knee osteoarthritis (OA). However, the data of its efficacy in the modern literature are contradictory.Objective: to assess the efficacy of intra-articular administration of HA preparations with different molecular weight in the treatment of patients with knee OA and to study the factors that can influence the effectiveness of such therapy.Subjects and methods. HA preparations were administered to 60 patients with idiopathic and posttraumatic knee OA. The ratio of women to men was 3:1. The average age was 59.5±13.7 years and body mass index – 30.3±5.8 kg/m2. The presence of enthesitis was evaluated prior to treatment by the characteristic clinical picture. The x-ray stage of OA was determined in accordance with the classification of Kellgren–Lawrence. Distribution of of knee joint lesions, relationship of femur and tibia anatomical axes, presence of varus and valgus deformities were also evaluated. The patients were divided into three groups: 18 patients received low-molecular (LM), 19 – medium-molecular (MM) and 23 – high-molecular (HM) HA. To assess the efficacy of the treatment the severity of pain on a visual analog scale (VAS) and the total score of the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire before, 1, 3 and 6 months after treatment were evaluated.Results and discussion. Enthesitis was detected in 17 (28,3%) patients. Stage I of knee OA was diagnosed in 10 (16.6%), II – in 36 (60%) and III – in 14 (23.3%) patients. Varus deformity was detected in 43 (71.7%) patients, neutral axis of the lower limb - in 14 (23.3%), valgus deformity – in 3 (5%). The most significant decrease in the severity of pain was noted in patients with stage I of knee OA: from 54±17.1 to 10.0±10.0 mm. At stage II, the pain decreased from 59.4±12.6 to 45.5±20.3 mm, and at stage III – from 66.4±13.5 to 60.7±23.3 mm. By the 6th month, the severity of pain in patients with enthesitis was higher, and the values of KOOS total score were worse than in patients without it. At stages II and III of knee OA, the ratio of positive to unsatisfactory results for MM, LM and HM HA was as follows: 2:1, 3:1 and 3.6:1. In the group of patients with excellent results, the value of varus deformation averaged 8.5±1.5°, in patients with a good result – 9.8±2.8°, with a satisfactory result – 11.3±4.5°, and with an unsatisfactory – 11.5±3.2°.Conclusion. Intra-articular injection of HA is very effective at stage I of knee OA. The expression and duration of this effect are reducedwith decrease of cartilage thickness and increase of knee joint varus deformation (i.e., at the II and III stages of knee OA). The presence of varus deformation does not affect HA efficacy. Three factors are important: the appearance of varus deformation of the lower limb with initially neutral axis; the increase of varus deformation; the value of varus deformation >10°.

scholarly journals Intra-articular morphine versus bupivacaine for knee motion among patients with osteoarthritis: randomized double-blind clinical trial

2008 ◽  
Vol 126 (6) ◽  
pp. 309-313 ◽  
Author(s):  
Miriam Bellini Gazi ◽  
Rioko Kimiko Sakata ◽  
Adriana Machado Issy
Keyword(s):  
Pain Clinic ◽  
Osteoarthritis Of The Knee ◽  
Double Blind Study ◽  
Double Blind ◽  
Analgesic Effects ◽  
Numerical Scale ◽  
Double Blind Clinical Trial ◽  
Significant Difference ◽  
Pain At Rest ◽  
Flexion And Extension

CONTEXT AND OBJECTIVE: Osteoarthritis causes pain and disability in a high percentage of elderly people. The aim of the present study was to assess the efficacy of intra-articular morphine and bupivacaine on the joint flexion and extension angles of patients with knee osteoarthritis. DESIGN AND SETTING: A randomized double-blind study was performed at a pain clinic of Universidade Federal de São Paulo. METHODS: Thirty-nine patients with pain for more than three months, of intensity greater than three on a numerical scale (zero to 10), were included. G1 patients received 1 mg (1 ml) of morphine diluted in 9 ml of saline, intra-articularly, and G2 patients received 25 mg (10 ml) of 0.25% bupivacaine without epinephrine. Pain was assessed on a numerical scale and knee flexion and extension angles were measured after administration of the drugs at rest and during movement. The total amount of analgesic supplementation using 500 mg doses of paracetamol was also determined. RESULTS: No significant difference in pain intensity was observed between G1 and G2. Significant decreases in pain at rest and during movement and significant increases in mean flexion and extension angles were observed in both groups, with no significant difference between the two groups. The mean total amount of paracetamol used over a seven-day period was 3578 mg in G1 and 5333 mg in G2 (P = 0.2355; Mann-Whitney test). CONCLUSION: The analgesic effects of 1 mg of morphine and 25 mg of 0.25% bupivacaine were similar among patients with osteoarthritis of the knee.

The Biomechanical Impact Of Hyaluronic Acid In Knee Osteoarthrtis Patients: A Randomized, Double-blind, Placebo-controlled Study.

2009 ◽  
Vol 41 ◽  
pp. 24-244
Author(s):  
Joseph E. DeCaria ◽  
Robert J. Petrella ◽  
Manuel Montero-Odasso ◽  
Dalton Wolfe ◽  
Bert Chesworth
Keyword(s):  
Hyaluronic Acid ◽  
Controlled Study ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals A Double-Blind, Active-Controlled Clinical Trial of Sodium Bicarbonate and Calcium Gluconate in the Treatment of Bilateral Osteoarthritis of the Knee

2017 ◽  
Vol 10 ◽  
pp. 117954411668889 ◽  
Author(s):  
María del Carmen Caamaño ◽  
Sandra García-Padilla ◽  
Miguel Ángel Duarte-Vázquez ◽  
Karla Elena González-Romero ◽  
Jorge L Rosado
Keyword(s):  
Clinical Trial ◽  
Sodium Bicarbonate ◽  
Knee Osteoarthritis ◽  
Calcium Gluconate ◽  
Controlled Clinical Trial ◽  
Osteoarthritis Of The Knee ◽  
Short Term ◽  
Double Blind ◽  
Knee Oa ◽  
Double Blind Clinical Trial

Objective: To evaluate the effect of intra-articular injections of sodium bicarbonate with a single (SBCG1) or double dose (SBCG2) of calcium gluconate administered monthly compared with methylprednisolone (MP) for treatment of knee osteoarthritis. Methods: A 3-month, randomized, double-blind clinical trial with patients diagnosed with knee osteoarthritis (OA). The outcome variables were the Western Ontario-McMaster University Osteoarthritis Index (WOMAC) and the Lequesne functional index. Results: After 3 months, all treatments significantly improved in overall WOMAC and Lequesne scores. Mean changes (95% confidence interval) in WOMAC total score and the Lequesne index, respectively, for SBCG1 (−12.5 [−14.3, −10.7]; −9.0 [−11.4, −6.7]) and SBCG2 (−12.3 [−14.3, −10.4]; −8.9 [−10.4, −7.4]) were significantly greater than for MP (−5.0 [−7.2, −2.8]; −3.2 [−4.9, −1.5]) ( P < .001). Conclusions: Intra-articular injections of sodium bicarbonate and calcium gluconate are useful for short-term relief of OA symptoms in patients with bilateral knee osteoarthritis. Both treatments are more effective than MP injections in the reduction of knee OA symptoms. Trial Registration: Clinicaltrials.gov NCT00977444

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