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
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".