Qiankun Zhang1, Ting Zhang. 1. From the Department of Rheumatology, Lishui Center Hospital, Lishui, Zhejiang, China (QZ); and Department of Rheumatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China (TZ).
Abstract
OBJECTIVE: 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.
RCT Entities:
OBJECTIVE: 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 patientpain (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.
Authors: Tej B Bhavsar; Wilmer L Sibbitt; Philip A Band; Romy J Cabacungan; Timothy S Moore; Luis C Salayandia; Roderick A Fields; Scarlett K Kettwich; Luis P Roldan; N Suzanne Emil; Monthida Fangtham; Arthur D Bankhurst Journal: Clin Rheumatol Date: 2017-09-14 Impact factor: 2.980