“Functional Pain,” Functional Outcomes, and Quality of Life After Hyaluronic Acid Intra‐articular Injection for Knee Osteoarthritis

Wiley - Tập 5 Số 4 - Trang 310-318 - 2013
Heather K. Heather K., Cindy Cindy, Bryan P. Bryan P., MaryBeth MaryBeth, Jacob Jacob, Matthew Matthew, Amanda N. Amanda N., Kevin R. Kevin R.

Tóm tắt

ObjectiveTo compare the effect of hyaluronic acid (HA) intra‐articular knee injections on pain and functional outcomes in persons with knee osteoarthritis (OA) over 6 months, and to determine whether or not changes in functional pain are related to improvements in quality of life.DesignA prospective cohort study.SettingA research laboratory in an academic medical center.ParticipantsPatients with knee OA (N = 53) who were receiving medical care for OA.InterventionsIntra‐articular knee injections of HA (3 injections, each separated by 1 week) and a comparative noninjection group.Main Outcome MeasurementsFunctional pain and outcomes assessments during chair rise, stair climbing, and a 6‐minute walking test (by using 0‐10 point numerical pain ratings during each test); gait parameters; Medical Outcomes Short Form‐36 (SF‐36) scores and subscores; the Western Ontario McMaster University Osteoarthritis Index (WOMAC).ResultsSix months after HA, the completion times for the chair rise and stair climb tasks, and the distance covered during the 6‐minute walk were not different between the groups. However, functional pain ratings during stair climbing decreased in the HA‐treated group (P = .05). Six‐month changes in gait velocity, cadence, stride length, step length, and the percentage of the gait cycle spent in single support were all higher after HA injection at month 6 (all P < .05). Significant group‐by‐time interactions existed for total WOMAC scores. SF‐36 Vitality subscores improved by 13%, and Role Physical scores were higher in patients treated with HA injection compared with participants in the noninjection group (P < .05). Regression analyses revealed that changes in the functional pain measures did not correspond with SF‐36 scores.ConclusionsHA is associated with lower functional pain severity, with minimal impact on functional test scores. We interpreted this finding to represent an increase in the quality of the movement and functional activity. The change in functional pain did not correspond to changes in SF‐36 quality‐of‐life scores.

Tài liệu tham khảo

10.1016/j.cger.2010.03.001 10.1016/j.jbspin.2004.08.009 10.1186/1471-2474-9-95 10.1007/s12160-012-9353-x Peter W.F., 2011, Physiotherapy in hip and knee osteoarthritis: Development of a practice guideline concerning initial assessment, treatment and evaluation, Acta Reumatol Port, 36, 261 10.3810/psm.2009.10.1728 10.1111/j.1532-5415.2011.03375.x Turajane T., 2007, Outcomes of intra‐articular injection of sodium hyaluronate for the treatment of osteoarthritis of the knee, J Med Assoc Thailand, 90, 1845 Kul‐Panza E., 2010, Is hyaluronate sodium effective in the management of knee osteoarthritis?. A placebo‐controlled double‐blind study, Minerva Med, 101, 63 10.1007/s00296-005-0611-0 10.1053/mr.2000.4432 10.1111/j.1532-5415.2008.02126.x 10.1186/ar623 10.1007/s10067-006-0504-y 10.1080/02841850510016027 10.1007/s00167-009-0760-x 10.1016/j.knee.2009.03.003 10.1016/j.archger.2011.11.007 10.1016/j.arth.2009.09.001 10.1016/j.joca.2006.01.010 10.1001/archinte.162.3.292 10.1016/j.jpain.2007.09.005 10.1097/00007632-200012150-00009 Bellamy N., 1988, Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee, J Rheumatol, 15, 1833 10.1046/j.1532-5415.2002.50267.x 10.1177/0269215506070698 10.1038/oby.2007.221 10.1093/gerona/60.3.324 10.1093/gerona/gln031 10.1111/j.1532-5415.2005.53501.x 10.1046/j.1532-5415.2001.49005.x 10.3138/physio/60/1/10 10.1002/msc.22 10.1093/rheumatology/38.9.870 Ware J.E., 2001, How to Score and Interpret Single‐Item Health Status Measures: A Manual for Users of the SF‐8 Health Survey (with a supplement on the SF‐6 health survey) Kiebzak G.M., 2002, The SF‐36 general health status survey documents the burden of osteoarthritis and the benefits of total joint arthroplasty: But why should we use it?, Am J Manage Care, 8, 463 10.1136/annrheumdis-2011-200972 10.1016/j.semarthrit.2009.04.001 Petrella R.J., 2006, A prospective, randomized, double‐blind, placebo controlled study to evaluate the efficacy of intraarticular hyaluronic acid for osteoarthritis of the knee, J Rheumatol, 33, 951
Thông tin
Thông tin xuất bản

Wiley

Tập 5 Số 4

310-318

Thông tin tác giả