DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20212243

Efficacy and safety of single dose of Non-animal stabilized hyaluronic acid intraarticular injection for knee Primary osteoarthritis: a pilot study at Midnapore Medical college in West Bengal

Kripasindhu Gantait, Kalimujjaman Molla, Akshaya Elango

Abstract


Background: Hyaluronic acid is a commonly prescribed intra-articular (IA) therapy for knee primary osteoarthritis (OA). In India majority of population lives in rural areas having limited resources and socio-cultural biodiversity. Their personal, socio-cultural and occupational habits vary and need to be addressed. The primary outcome measure was pain of knee joint reduction after therapy and follow up visit. Secondary outcomes were therapy related adverse events (AEs).

Methods: Population (n=20) are selected from rural areas of age range 40 to 60 years having poor economic background and daily labour by profession. Participants with diabetes and cardic illness and BMI ≥30 were excluded. All participants were having grade- 2 B/L knee OA with mild effusion and fulfill the ACR classification criteria. Each participant was assessed on Visual analog scale (VAS) pain and Composite indian functional knee assessment scale (CIFKAS) at the end of three months of therapy and statistical analysis was done.

Results: Among the 20 participants 11 were female, 9 were male. The mean (mean±S.D.) of BMI and duration of disease was 23.6±2.73 and 4±2.08 respectively. Pearson correlation coefficient calculated for pain during physical activity/ pain during functional ADL activity, ability to perform physical activity/ ability to perform ADL activity and social function and emotional function score were 0.634/0.701, 0.731/0.687 and 0.566/0.607 respectively which indicates that they are highly correlated.

Conclusions: A single dose of IA NASHA is effective and safe in reducing pain and functional disability in patients with primary OA of knee.

 


Keywords


Knee osteoarthritis, Functional disability, CIFKAS, NASHA

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References


Millward-Sadler SJ, Wright MO, Lee H. Integrin-regulated secretion of interleukin 4: A novel pathway of Mechano-transduction in human articular Chondrocyte. J Cell Biol. 1999;145(1):183-9.

Hurley MV. The role of muscle weakness in the pathogenesis of osteoarthritis. Rheum Dis Clin North Am. 1999;25(2):283-98.

Hurley MV. Muscle dysfunction and effective rehabilitation of knee osteoarthritis: what we know and what we need to find out. Arthritis Rheum. 2003;49(3):444-52.

Sharma L. Proprioceptive impairment in knee osteoarthritis. Rheum Dis Clin North Am. 1999;25(2):299-314.

Dixon J, Howe TE. Quadriceps force generation in patients with osteoarthritis of the knee and asymptomatic participants during patellar tendon reflex reactions: an exploratory cross-sectional study. BMC Musculoskeletal Disorders. 2005;6:46.

Chaiamnuay P, Darmawan J, Muirden KD. Epidemiology of rheumatic disease in rural Thailand: a WHO-ILAR COPCORD study. Community Oriented Programme for Control of Rheumatic Disease. J Rheumatol. 1998;25(7):1382-7.

Manek NJ, Lane NE. Osteoarthritis: current concepts in diagnosis and management. Am Fam Physician. 2000;61(6):1795-804.

Wen DY. Intra-articular hyaluronic acid injections for knee osteoarthritis. Am Fam Physician. 2000;62(3):565-70.

Boettger MK, Kümmel D, Harrison A, Schaible HG. Evaluation Of Long-Term Antinociceptive Properties Of Stabilized Hyaluronic Acid Preparation (NASHA) In An Animal Model Of Repetitive Joint Pain. Arthritis Research and Therapy. 2011;13(4):R110.

Goldring MB, Goldring SR. Articular cartilage and subchondral bone in the pathogenesis of osteoarthritis. Ann N Y Acad Sci. 2010;1192:230-7.

Al-Johani AH, Kachanathu SJ, Ramadan Hafez A, Al-Ahaideb A, Algarni AD, Alroumi MA et al. Comparative study of hamstring and quadriceps strengthening treatmentsin the management of knee osteoarthritis. J Phys Ther Sci. 2014;26(6):817-20.

Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494-502.

R Altman, G Alarcon, D Appelrouth. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheumatism. 1991;34(5):505-14.

Veerapen K, Asokan RN, Rathakrishnan V. Clinical and radiological profile of symptomatic knee osteoarthritis in Malaysia. APLAR J Rheumatol. 2004;7(2):97-107.

Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2010;18(1):24-33.

Huskisson EC, Donnelly S. Hyaluronic acid in the treatmentof osteoarthritis of the knee. Rheumatology (Oxford). 1999;38(7):602-7.

Leopold SS, Redd BB, Warme WJ, Wehrle PA, Pettis PD, Shott S. Corticosteroid compared with hyaluronic acid injections for the treatment of osteoarthritis of the knee a prospective, randomized trial. J Bone Joint Surg Am. 2003;85-A(7):1197-203.