Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trial
OBJECTIVES: This study aimed to evaluate the clinical outcomes of intra-articular infiltration with hyaluronic acid and dexamethasone alone and in combination in the treatment of knee osteoarthritis (OA). METHOD: This prospective randomized trial evaluated 44 patients undergoing treatment for OA. P...
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| Format: | Article |
| Language: | English |
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Elsevier España
2019-11-01
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| Series: | Clinics |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322019000100200&tlng=en |
| _version_ | 1818530923447058432 |
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| author | Phelippe Augusto Valente Maia Victor Rodrigues Amaral Cossich José Inacio Salles-Neto Diego Pinheiro Aguiar Eduardo Branco de Sousa |
| author_facet | Phelippe Augusto Valente Maia Victor Rodrigues Amaral Cossich José Inacio Salles-Neto Diego Pinheiro Aguiar Eduardo Branco de Sousa |
| author_sort | Phelippe Augusto Valente Maia |
| collection | DOAJ |
| description | OBJECTIVES: This study aimed to evaluate the clinical outcomes of intra-articular infiltration with hyaluronic acid and dexamethasone alone and in combination in the treatment of knee osteoarthritis (OA). METHOD: This prospective randomized trial evaluated 44 patients undergoing treatment for OA. Patients were selected through clinical and radiological analysis using the American College of Rheumatology criteria. We included patients aged between 50 and 70 years who presented with K-L stage ≤2 knee OA and normal limb alignment. Patients with a previous history of knee injury (ligamentous, meniscal or traumatic), infection, patellofemoral OA or chondroprotective drug use in the previous year were excluded. Participants were randomized into 3 groups and underwent treatment with viscosupplementation (VS, n=16), viscosupplementation plus dexamethasone (VD, n=16) or dexamethasone (DX, n=12). All patients were evaluated before and 6 weeks, 3 months and 6 months after infiltration. Analysis included a physical examination, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire (total score and domain subscores) and an evaluation of knee extensor and flexor strength and proprioception using an isokinetic dynamometer. RESULTS: VS significantly improved the WOMAC total score and subscores for pain, stiffness and function for up to 6 months after infiltration. It also improved knee extensor and flexor strength during the same period. Proprioception was not affected by any of the treatments. CONCLUSIONS: VS alone improved pain, stiffness and function according to the WOMAC total score and subscores and improved knee extensor and flexor strength, but not proprioception, for up to six months after infiltration. These findings suggest that VS has a positive effect on quadriceps arthrogenic inhibition. |
| first_indexed | 2024-12-11T17:25:50Z |
| format | Article |
| id | doaj.art-efc7318f28a44e8cb89f61fd48e5b8e6 |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-12-11T17:25:50Z |
| publishDate | 2019-11-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-efc7318f28a44e8cb89f61fd48e5b8e62022-12-22T00:56:58ZengElsevier EspañaClinics1980-53222019-11-017410.6061/clinics/2019/e1207Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trialPhelippe Augusto Valente Maiahttps://orcid.org/0000-0003-4915-6244Victor Rodrigues Amaral Cossichhttps://orcid.org/0000-0002-3984-6121José Inacio Salles-Netohttps://orcid.org/0000-0003-4173-0352Diego Pinheiro Aguiarhttps://orcid.org/0000-0002-5341-3779Eduardo Branco de Sousahttps://orcid.org/0000-0001-8577-6403OBJECTIVES: This study aimed to evaluate the clinical outcomes of intra-articular infiltration with hyaluronic acid and dexamethasone alone and in combination in the treatment of knee osteoarthritis (OA). METHOD: This prospective randomized trial evaluated 44 patients undergoing treatment for OA. Patients were selected through clinical and radiological analysis using the American College of Rheumatology criteria. We included patients aged between 50 and 70 years who presented with K-L stage ≤2 knee OA and normal limb alignment. Patients with a previous history of knee injury (ligamentous, meniscal or traumatic), infection, patellofemoral OA or chondroprotective drug use in the previous year were excluded. Participants were randomized into 3 groups and underwent treatment with viscosupplementation (VS, n=16), viscosupplementation plus dexamethasone (VD, n=16) or dexamethasone (DX, n=12). All patients were evaluated before and 6 weeks, 3 months and 6 months after infiltration. Analysis included a physical examination, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire (total score and domain subscores) and an evaluation of knee extensor and flexor strength and proprioception using an isokinetic dynamometer. RESULTS: VS significantly improved the WOMAC total score and subscores for pain, stiffness and function for up to 6 months after infiltration. It also improved knee extensor and flexor strength during the same period. Proprioception was not affected by any of the treatments. CONCLUSIONS: VS alone improved pain, stiffness and function according to the WOMAC total score and subscores and improved knee extensor and flexor strength, but not proprioception, for up to six months after infiltration. These findings suggest that VS has a positive effect on quadriceps arthrogenic inhibition.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322019000100200&tlng=enDexamethasoneHyaluronic AcidOsteoarthritisViscosupplementation |
| spellingShingle | Phelippe Augusto Valente Maia Victor Rodrigues Amaral Cossich José Inacio Salles-Neto Diego Pinheiro Aguiar Eduardo Branco de Sousa Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trial Clinics Dexamethasone Hyaluronic Acid Osteoarthritis Viscosupplementation |
| title | Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trial |
| title_full | Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trial |
| title_fullStr | Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trial |
| title_full_unstemmed | Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trial |
| title_short | Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trial |
| title_sort | viscosupplementation improves pain function and muscle strength but not proprioception in patients with knee osteoarthritis a prospective randomized trial |
| topic | Dexamethasone Hyaluronic Acid Osteoarthritis Viscosupplementation |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322019000100200&tlng=en |
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