Volume 88, Issue 2 , Pages 135-141, February 2007
Efficacy and Safety of Hyaluronan Treatment in Combination Therapy With Home Exercise for Knee Osteoarthritis Pain
Abstract
Stitik TP, Blacksin MF, Stiskal DM, Kim JH, Foye PM, Schoenherr L, Choi E-S, Chen B, Saunders HJ, Nadler SF. Efficacy and safety of hyaluronan treatment in combination therapy with home exercise for knee osteoarthritis pain.
Objective
To assess the efficacy and safety of intra-articular injections of sodium hyaluronate combined with a home exercise program (HEP) in the management of pain associated with osteoarthritis (OA) of the knee.
Design
Single-blinded, parallel-design, 1-year clinical study with sequential enrollment.
Setting
University-based outpatient physiatric practice.
Participants
Sixty patients (18 men, 42 women; age, ≥50y) with moderate-to-severe pain associated with OA of the knee.
Interventions
(1) Five weekly intra-articular hyaluronate injections (5-HYL); (2) 3 weekly intra-articular hyaluronate injections (3-HYL); or (3) a combination of an HEP with 3 weekly intra-articular hyaluronate injections (3-HYL+HEP).
Main Outcome Measures
The primary outcome measure was a 100-mm visual analog scale for pain after a 50-foot walk (15.24m). Secondary measures included the Western Ontario and McMaster Universities Osteoarthritis Index subscales.
Results
The 3-HYL+HEP group had significantly faster onset of pain relief compared with the 3-HYL (P<.01) and 5-HYL groups (P=.01). All groups showed a mean symptomatic improvement from baseline (reduction in baseline pain at 3mo was 59%, 49%, and 48% for the 3-HYL+HEP, 3-HYL, and 5-HYL groups, respectively) that was clinically and statistically significant. There were no between-group differences in the incidence or nature of adverse events.
Conclusions
The combined use of hyaluronate injections with HEP should be considered for management of moderate-to-severe pain in patients with knee OA.
Key Words: Exercise, Hyaluronic acid, Injections, intraarticular, Osteoarthritis, Rehabilitation
Supported by an investigator-initiated grant from Sanofi-Aventis Inc.No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
PII: S0003-9993(06)01486-9
doi:10.1016/j.apmr.2006.11.006
© 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Volume 88, Issue 2 , Pages 135-141, February 2007
