MedPath

Injection Site Diversity Influences HA Distribution and Clinical Results in CP and KOA

Phase 4
Completed
Conditions
Hyaluronan
Osteoarthritis, Knee
Registration Number
NCT03600571
Lead Sponsor
Nanfang Hospital, Southern Medical University
Brief Summary

In order to investigate the difference of intra-articular hyaluronate's distribution and compare the clinical outcomes of viscosupplementation for mild-to-moderate knee osteoarthritis (mKOA) between the anteromedial (AM) and medial midpatellar (MMP) approach groups. This study included two parts, cadaver study (n=64) and random controlled trial (n=100). Hyaluronic acid (HA) traced by methylene blue was injected into the knee, and the intra-articular distribution of HA was assessed using a five-point scale in the cadaver study. The clinical outcomes of 5-weekly injections of HA were evaluated by WOMAC and Lequesne index and the follow-up times were at weeks 1, 2, 3, 4, 5, 14, and 24 after the injections in the random controlled trial.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
164
Inclusion Criteria
  • Symptomatic unilateral mild-to-moderate knee osteoarthritis (mKOA) that were defined by the American College of Rheumatology criteria
  • Kellgren-Lawrence grade 2 or 3
  • Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index (Likert version 3.1) pain subscale reached 10 or greater
Exclusion Criteria
  • Pregnancy, acute fracture, rheumatoid arthritis, gouty arthritis, traumatic arthritis, inflammatory arthritis
  • Oral Celebrex within 2 weeks, HA and lidocaine allergy, intra-articular injection of HA or corticosteroid to the target knee within the past 6 months
  • Surgery in the target knee within the past 6 months, OA of the target knee with K-L grade 4
  • Active liver and renal disease, cardiovascular and cerebrovascular disease.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
WOMAC (Likert version 3.1)24 weeks after the first injection

WOMAC included three subscales: pain, stiffness and function, and each subscale was graded using a 5-point Likert scale (0=none, 1=mild, 2=moderate, 3=severe, 4=extreme). Pain index score ranges from 0 to 20, whereas the stiffness score ranges from 0 to 8 and the function score ranges from 0 to 68. The reliability of the three subscales of the WOMAC was 0.82, 0.68 and 0.74, respectively.

Lequesne index24 weeks after the first injection

The Lequesne index questionnaire included 10 questions about pain, stiffness and function. The score ranges from 0 (no pain, no disability) to 24 (maximum pain, stiffness and disability), and its reliability was 0.95.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Nanfang Hospital

🇨🇳

Guangzhou, Guangdong, China

Nanfang Hospital
🇨🇳Guangzhou, Guangdong, China

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