Using Objective Ultrasonographic Findings and Subjective Self-reported Measures to Evaluate the Effectiveness of a Novel Single Intra-articular Injection of Hyaluronic Acid for the Treatment of Knee Osteoarthritis: A Preliminary Report
Notice bibliographique
Résumé
Purpose: Osteoarthritis (OA) is the most common musculoskeletal disease worldwide. Knee OA is the most common type of OA and is the main cause of disability in elderly people. Intra-articular (IA) injection of hyaluronic acid (HA) has been widely proven to improve pain, physical function, and quality of life among patients with knee OA. However, most of the previous studies have used low-to-moderate molecular weight (MW) HA and have evaluated the clinical benefits by using subjective self-reported measures. In this study, we evaluated the efficacy of a single IA injection of a novel cross-linked HA (HYAJOINT Plus) through objective ultrasonographic assessment of the thickness of quadriceps and femoral intercondylar cartilage (FIC) in addition to subjective self-reported measures. Methods: In this prospective trial with 6-month follow-up, 39 patients with knee OA (Kellgren-Lawrence grades 1 to 3) were recruited from a single medical center. These patients received one IA injection of 3 mL HYAJOINT Plus (20 mg/mL). All patients were assessed at baseline and 1, 3 and 6-months after HA injection. The outcome measures were (1) Visual Analog Scale for pain (VAS Pain); (2) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which generates three subscale scores (pain, stiffness, and physical function) and a total score; (3) Lequesne's Index, (4) thigh circumference at the injected knee site, (5) thickness of quadriceps under ultrasonography, and (6) thickness of FIC under ultrasonography. Results: A total of 37 patients completed the 6-month follow-up. One-way repeated measure analysis of variance revealed that compared with the baseline, VAS Pain, WOMAC, Lequesne's index, thigh circumference, ultrasonographic thickness of quadriceps and FIC improved significantly after HA injection by using one-way repeated measure ANOVA (p ＜ 0.001 for all). Post-hoc analysis revealed the following results. First, compared with the baseline, VAS Pain and WOMAC-pain subscale score improved significantly 1, 3, and 6 months after HA injection (VAS Pain: p ＜0.001, ＜0.001, and ＜0.001 and WOMAC-pain subscale score: p =0.009, ＜0.001, and ＜0.001, respectively). Second, WOMAC-physical function subscale score, WOMAC-total score, and ultrasonographic thickness of quadriceps and FIC improved significantly 3 and 6 months after HA injection (WOMAC-physical function subscale score: p=0.004 and ＜0.001; WOMAC-total score: p=0.001 and ＜0.001; quadriceps thickness: p＜0.001 and ＜0.001; and FIC thickness: p=0.002 and 0.039, respectively). Third, compared with the baseline, WOMAC-stiffness subscale scores, Lequesne's index, and thigh circumference improved significantly 6 months after HA injection (p=0.01, 0.008, and 0.009, respectively). No serious adverse events occurred
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».