Improvement of self-reported functional scores and thickening of quadriceps and femoral intercondylar cartilage under ultrasonography after single intra-articular injection of a novel cross-linked hyaluronic acid in the treatment of knee osteoarthritis
Affiliations: [a] Department of Rehabilitation Medicine, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan | [b] Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan | [c] Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan | [d] School of Medicine, National Yang-Ming University, Taipei, Taiwan
Correspondence:
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Corresponding author: Shufen Sun, Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung, Taiwan. Tel.: +886 7 3422121 ext 4201; Fax: +886 7 3422288; E-mail: pj73010@hotmail.com.
Abstract: BACKGROUND: Most studies used hyaluronic acid (HA) requiring 3–5 intra-articular injections (IAJ) for knee osteoarthritis (KOA). OBJECTIVE: We evaluated the efficacy of a single IAJ of a novel HA by measuring the thickness of quadriceps and femoral intercondylar cartilage (FIC) under ultrasonography (US) in addition to subjective self-reported measures. METHODS: Forty-nine patients with KOA (Kellgren-Lawrence grades 2–3) received unilateral IAJ of HYAJOINT Plus to the worse knee and were assessed at baseline and 1, 3 and 6-months after IAJ. Outcome measures were the (1) Visual Analog Scale for pain (VAS), (2) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), (3) Lequesne’s Index, (4) single-leg-stance duration (5) thigh circumference, and (6) thickness of quadriceps and FIC under US. RESULTS: Forty-six patients completed the 6-month-follow-up study. All outcome measures improved significantly after HA injection (p< 0.001). Both VAS and WOMAC-pain subscale scores improved significantly at 1, 3, and 6 months (p< 0.01). The US thickness of the quadriceps and FIC improved significantly at both 3 and 6 months (p< 0.05). The Lequesne’s index, single-leg-stance and thigh circumference improved significantly at 6 months (p< 0.01). CONCLUSIONS: HYAJOINT Plus is effective both subjectively and objectively for 6 months and is safe as a treatment for KOA.
