Article

Increasing evidence has suggested that botulinum toxin A (BoNT/A) can
inhibit the release of selected neuropeptide transmitters from primary sensory
neurons. Thus, intra-articular (IA) injection therapies with BoNT/A may reduce
pain in patients with knee osteoarthritis (OA).
OBJECTIVE: To investigate the
effects of landmark-guided IA injection of BoNT/A on patients with knee OA.
DESIGN: A prospective randomized controlled trial. SETTING: A rehabilitation
clinic of a private teaching hospital. PATIENTS:
A total of 46 patients with
symptomatic knee OA (mostly Kellgren-Lawrence grade 2-3). METHODS: The patients
were randomly assigned to 1 of the following groups: BoNT/A group (BoNT/A
injection; n = 21) or control group (education only; n = 20). The patients in the
BoNT/A group received an IA injection of 100 units of BoNT/A into the affected
knee. MAIN OUTCOME MEASURES: The short-term
(1 week posttreatment) and long-term
(6 months posttreatment) effects were evaluated using a pain visual analogue
scale (VAS) and questionnaires concerning functional status, including the
Lequesne and Western Ontario and McMaster Universities (WOMAC) indexes. RESULTS:
The between-group comparison revealed significant differences with regard to the
pain VAS score at 1 week (P < .001) and at 6 months (P = .001) posttreatment.
Similar findings for the between-group comparison were observed for the WOMAC and
Lequesne indexes at 6 months (P < .05) posttreatment. The pain VAS score in the
BoNT/A group significantly decreased from 5.05 +/- 1.12 (pretreatment) to 2.89
+/- 1.04 at 1 week (P < .001) and 3.45 +/- 1.70 at 6 months posttreatment (P <
.001) but not in the control group (P = .476). CONCLUSIONS:
The IA injection of
BoNT/A provided pain relief and improved functional abilities in patients with
knee OA in both the short- and long-term follow-up.
LEVEL OF EVIDENCE: I.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS