Outcome of intra-articular hyaluronic acid in treatment of osteoarthritis of knee at a tertiary care hospital in Kathmandu, Nepal
DOI:
https://doi.org/10.3126/jmcjms.v7i1.30004Keywords:
Intraarticular Hyaluroic Acid, Knee Osteoarthritis, Oxford Knee ScoreAbstract
Background and Objectives: Intra-articular hyaluronic acid is widely used in the treatment of knee osteoarthritis. This study aimed to assess the efficacy of hyaluronic acid in moderate severity knee osteoarthritis.
Material and Methods: Patients of knee osteoarthritis were administered single intra-articular injection of Hyaluronic Acid 25 mg (2.5 ml viscous solution) and were followed up at 4, 12, and 24 weeks. Functional improvement was assessed using Oxford Knee Score (OKS). Comparisons of pre- and post-intervention mean OKS scores were done by paired t test.
Results: Total 50 patients (mean age 58.62±12.62 years) were studied. In the six months follow up, patients showed marked improvement in functional outcome from a mean OKS of 27 before injection to 39 at 4 weeks and remained constant up to 6months of follow up.
Conclusion: Intra-articular hyaluronic acid injectionas a treatment modality for moderate grade knee osteoarthritis provides good functional outcome and pain control for up to six months.
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References
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Churchill Livingstone: Edinburgh; 2006. pp 1065-1144.
2. Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum 1998; 41:778-799.
3. Towheed TE. The impact of musculoskeletal disorders in Canada. Ann Roy Coll Phys Surg Can 1998; 31:229-232.
4. Ma VY, Chan L, Carruthers KJ. Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. Arch Phys Med Rehabil. 2014;95(5):986.e1–995. DOI: 10.1016/j.apmr.2013.10.032
5. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003;81(9):646–656.
6. Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 1998; 41:1343-1355.
7. Hinman RS, Bowles KA, Bennell KL. Laterally wedged insoles in knee osteoarthritis: do biomechanical effects decline after one month of wear? BMC Musculoskelet Disord 2009; 10:146. DOI: 10.1186/1471-2474-10-146.
8. Mahir L, Belhaj K, Zahi S, Azanmasso H, Lmidmani F, El Fatimi A. Impact of knee osteoarthritis on the quality of life. Annals of Physical and Rehabilitation Medicine. 2016;59:e159. DOI:10.1016/j.rehab.2016.07.355.
9. Neogi T. Joint pain epidemiology: fact sheet. International Association for the Study of Pain. 2016;(11).
10. Fibel KH, Hillstrom HJ, Halpern BC. State-of-the-art management of knee osteoarthritis. World J Clin Cases 2015; 3(2):89–101.
11. Abate M, Salini V. Hyaluronic acid in the treatment of osteoarthritis: what is new? In: Chen Q (ed). Osteoarthritis – diagnosis, treatment and surgery. InTech: Rijeka; 2012. pp 102–122.
12. Brown TJ, Laurent UB, Fraser JR. Turnover of hyaluronan in synovial joints: elimination of labelled hyaluronan from the knee joint of the rabbit. Exp Physiol 1991;76(1):125–134.
13. Bagga H, Burkhardt D, Sambrook P, March L. Longterm effects of intraarticular hyaluronan on synovial fluid in osteoarthritis of the knee. J Rheumatol 2006;33(5):946–950.
14. Balazs EA, Denlinger JL. Viscosupplementation: a new concept in the treatment of osteoarthritis. J Rheumatol Suppl 1993;39(Suppl 39):3–9.
15. Pal S, Thuppal S, Reddy KJ, et al. Long-term (1-year) safety and efficacy of a single 6-mL injection of Hylan G-F 20 in Indian patients with symptomatic knee osteoarthritis. Open Rheumatol J 2014;8:54–68.
16. Kohn MD, Sassoon AA, Fernando ND. Classification in brief: Kellgren-Lawrence classification of osteoarthritis. Clin Orthop Relat Res 2016; 474(8):1886-1893. DOI: 10.1007/s11999-016-4732-4
17. Charoencholvanich K, Pongcharoen B. Oxford Knee Score and SF-36: translation and reliability for use with total knee arthroscopy patients in Thailand. J Med Assoc Thai 2005; 88(9):1194-202
18. Luyten F, Dell'accio F, De Bari C. Skeletal tissue engineering: opportunities and challenges. Best Pract Res Clin Rheumatol 2008; 15:7 59-69.
19. Flanigan DC, Harris JD, Trinh TQ, et al. Prevalence of chondral defects in athlete’s knees a systematic review. Med Sci Sports Exerc 2010; 42:795-801.
20. Saturveithan C, Premganesh G, Fakhrizzaki S, et al. Intra-articular hyaluronic acid (HA) and platelet rich plasma (PRP) versus hyaluronic acid (HA) injection alone in patients with grade III and IV knee osteoarthritis (OA): a retrospective study on functional outcome. Malaysian Orthopaedic Journal 2016; 10(2):35-40. DOI: 10.5704/MOJ.1607.007
21. Yan CH, Chan WL, Yuen WH, et al.Efficacy and safety of Hylan G-F 20 injection in treatment of knee osteoarthritis in Chinese patients: results of a prospective, multicentre, longitudinal study. Hong Kong Med J 2015; 21(4):327-332. DOI: 10.12809/hkmj144329
22. du Souich P. Absorption, distribution and mechanism of action of SYSADOAS. Pharmacol Ther 2014;142(3):362–374.
23. Wang Y, Hall S, Hanna F, et al. Effects of Hylan G-F 20 supplementation on cartilage preservation detected by magnetic resonance imaging in osteoarthritis of the knee: a 2-year single-blind clinical trial. BMC Musculoskelet Disord 2011;12:195.
24. Webber TA, Webber AE, Matzkin E. Rate of adverse reactions to more than 1 series of viscosupplementation. Orthopaedics 2012, 35(4):e514-e519. DOI:10.3928/01477447-20120327-26
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Published
2019-12-31
How to Cite
Dutta, D. K. (2019). Outcome of intra-articular hyaluronic acid in treatment of osteoarthritis of knee at a tertiary care hospital in Kathmandu, Nepal. Janaki Medical College Journal of Medical Science, 7(1), 36–40. https://doi.org/10.3126/jmcjms.v7i1.30004
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