Article

The main objective of this study was to observe whether synovial fluid
aspiration of the knee joint compared to no aspiration, before and after 5 weekly
injections of intra-articular hyaluronan, provides an improvement in knee pain
and physical function. DESIGN: Patients were randomized to an arthrocentesis
group (n = 92) or a nonarthrocentesis group (n = 88). In the arthrocentesis
group, knee joints were maximally aspirated before each hyaluronan
administration. In the nonarthrocentesis group, synovial fluid was not removed.
Hyaluronan was injected into the knee joints once a week for 5 weeks. Patients
were followed up for 25 weeks. Outcome measures included patient pain (using the
100-mm visual analog scale [VAS] during a 50-foot walking test), Western Ontario
McMaster University Osteoarthritis Index (WOMAC) function scores, and overall
effectiveness evaluated by patients and investigators on a scale of 1 to 6.
RESULTS: The arthrocentesis group showed significantly greater improvement from
baseline to week 25 in VAS pain (P < 0.001) and WOMAC function scores (P < 0.001)
than the nonarthrocentesis group. However, the differences of patient and
investigator assessment of effectiveness did not achieve significance.
CONCLUSIONS: Synovial fluid drainage before injection of intra-articular
hyaluronan significantly improved VAS pain and WOMAC function scores in patients
with knee osteoarthritis, however, the differences of patient and investigator
assessment did not achieve significance.

Langue : ANGLAIS