Article

OBJECTIVE: To 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.
A prospective cohort
study. SETTING: A research laboratory in an academic medical center.
PARTICIPANTS: Patients with knee OA (N = 53) who were receiving medical care for
OA. INTERVENTIONS: Intra-articular knee injections of HA (3 injections, each
separated by 1 week) and a comparative noninjection group. MAIN OUTCOME MEASUREMENTS: Functional 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). RESULTS: Six 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. CONCLUSIONS: HA 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.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS