Comparison Between Extracorporeal Shock Wave Therapy and Intra-articular Hyaluronic Acid Injections in the Treatment of First Carpometacarpal Joint Osteoarthritis

Abstract

ObjectiveTo compare extracorporeal shockwave therapy (ESWT) with hyaluronic acid (HA) intra-articular injections in terms of pain relief, improvement in hand function, and strength in subjects with first carpometacarpal (CMC) joint osteoarthritis.MethodsFifty-eight patients received either focused ESWT or HA injection once a week for 3 consecutive weeks. In the ESWT group, 2,400 consecutive pulses were performed during each treatment session using a frequency of 4 Hz and an energy flux density of 0.09 mJ/mm2. The HA group underwent one cycle of three injections of 0.5 cm3 HA. The main outcome measures were pain and hand function as measured by the visual analogue scale (VAS) and Duruoz Hand Index (DHI), respectively. The secondary outcomes were grip and pinch strength. Each assessment was performed at baseline, at the end of treatment, and at 3- and 6-month follow-up visits.ResultsAccording to VAS and DHI scores, a significant change in test performance was observed over time in both groups (p<0.001), with a greater average improvement in painful symptomatology at the 6-month follow-up in the ESWT group. A significant improvement in strength was observed in both groups, but the ESWT group showed better results on the pinch test starting immediately at the end of treatment.ConclusionThe use of ESWT in patients with first CMC joint osteoarthritis leads to a reduction in pain, an improvement in pinch test performance that persists for at least 6 months, and a decrease in hand disability up to the 6-month follow-up visit.

A Randomized Controlled Single-Blind Study Demonstrating Superiority of Amniotic Suspension Allograft Injection Over Hyaluronic Acid and Saline Control for Modification of Knee Osteoarthritis Symptoms

“…Due to the study design, patients' results were carried forward using a single imputation model for missing data. Last observation carried forward (LOCF) has been used in several clinical studies 14,15 and was deemed appropriate here due to the nonrandomness of missing data; most missing data were because of dropout due to an inadequate response to the assigned study injection. Inclusive of all previously mentioned PRO subsets, 17 variables were identified and analysis of each was completed by calculating the change from baseline at follow-up time points (3 or 6 months) for all groups.…”

Extracorporeal Shock Wave Therapy for the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis

“…The sample size ranged from 18 to 160. All experimental groups received ESWT, while control groups received different treatments including placebo [22,23,25,26,28,30,34,48,49,51,52], medication [31,32,43,44,50], intra-articular injections [21,26,27,29,35,36,39,40], traditional Chinese medicine [38,41,42,45,2 BioMed Research International 46], ultrasound [22,24,47], surgery [33], and kinesiotherapy (KIN) [37].…”

“…Only temporary pain, minor bruising, or transient soft tissue swelling was observed in nine studies [25,30,34,42,44,47,[50][51][52]. No adverse events were observed during the treatment in other six studies [27,29,[36][37][38]46], and the remaining studies did not mention it.…”

The effect of extracorporeal shock wave therapy on the treatment of moderate to severe knee osteoarthritis and cartilage lesion

“…But all of they suggested that shock wave can serve as one of the treatments on KOA. [7–10] Notarnicola et al [11] had verified through in vitro cell experiment that, ESWT could upregulate the expression of IL-10, while down-regulating that of N-cadherin and β-catenin. Yilmaz et al [12] had treated the KOA rats through ESWT and confirmed that, ESWT could promote the proliferation and regeneration of cartilage tissues in rats.…”