Efficacy and safety of viscosupplementation by ultrasound-guided intra-articular injection in osteoarthritis of the hip

Migliore, Alberto; Martin, Luis Severino Martin; Alimonti, Andrea; Valente, C; Tormenta, Sandro

doi:10.1016/s1063-4584(03)00008-6

Cited by 82 publications

(74 citation statements)

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“…6. Interpretation of results is made difficult by the different degree of severity of OA, genetic and biological characteristics of patients enrolled in the studies and by concurrent therapies with other drugs and rehabilitation treatments (16,29,44,49,50).…”

Section: Discussionmentioning

confidence: 99%

“…From the papers retrieved in the search the following data were extracted: sample size, inclusion / exclusion criteria, treatment procedures, evaluation methods, clinical results and follow-up duration. The case series, published by Migliore et al (16)(17)(18)(19)(20)(21) and Van den Bekerom et al (22,23), at different times, were considered cumulative. Methodological quality of included studies was assessed by assigning Levels of Evidence as previously defined by the Centre for Evidence Based Medicine (CEBM) (24).…”

Section: Methods Of Literature Analysismentioning

confidence: 99%

“…Also a lateral approach is possible, injecting the preparation near the great trochanter's tuberosity (45). Most of Authors perform the procedure "free hand" (43,45,46), but others (18), using the biopsy guide, claim that the positioning of the needle is simpler, quicker and more accurate (16). Moreover, utilising a real-time biopsy guidance software, the progression of the needle into the capsular recess may be monitored, so optimizing the procedure.…”

Section: Ultrasound-guided Injectionmentioning

confidence: 99%

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Viscosupplementation with Hyaluronic Acid in Hip Osteoarthritis (a review)

Abate¹,

Pelotti²,

Amicis³

et al. 2008

Upsala Journal of Medical Sciences

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Background: Viscosupplementation (VS) with hyaluronic acid (HA) is largely used for knee osteoarthritis therapy, but the evidences for its usefulness in hip osteoarthritis (OA) are limited. Methods: In this review, an extensive search of published trials on VS in hip OA was performed. From the selected papers the following data were extracted: sample size, inclusion / exclusion criteria, treatment procedures, evaluation methods, follow-up duration and clinical outcomes. Results: The level of evidence was low in quite all the trials (no placebo controlled groups). A reduction of pain and an improvement of function after 3 months, persistent in the long term (12 -18 months), was observed. Patients with mild morphological alterations responded better to therapy. Side effects were negligible, and were limited to pain and a sensation of heaviness in the injection site. No clear differences among Low (LMW) and High Molecular Weight (HMW) HA preparations were found in the clinical outcomes. However, for HMW-HA preparations, a lower number of injections was, in general, necessary in order to reach the therapeutic effect. Conclusions: Despite the initial promising results, some questions still remain open : 1) the characteristics of responders must be more precisely defined; 2) the treatment schedules, at present mainly based on the individual clinical experience, need a proper and accepted standardization. Finally, larger and placebo controlled trials are necessary to confirm the efficacy of VS in hip OA.

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Section: Discussionmentioning

confidence: 99%

Section: Methods Of Literature Analysismentioning

confidence: 99%

Section: Ultrasound-guided Injectionmentioning

confidence: 99%

See 1 more Smart Citation

Viscosupplementation with Hyaluronic Acid in Hip Osteoarthritis (a review)

Abate¹,

Pelotti²,

Amicis³

et al. 2008

Upsala Journal of Medical Sciences

View full text Add to dashboard Cite

show abstract

“…Some authors prefer to use high molecular weight hyaluronic acid because these preparations have a longer half -life time, so that the number of the injections needed to obtain the therapeutic effect may be reduced. Interpretation of result is made difficult by the different degree of severity of osteoarthritis, genetic and biological characteristics of patients enrolled in the studies and by concurrent therapies with other drugs and rehabilitation treatments (Brocq et al, 2002;Conrozier et al, 2003;Migliore et al, 2003;Tikiz et al, 2005;Vad et al, 2003). Finally, it must be remembered that there is a strong placebo effect from joint injection, which may cause a nearly 30 % reduction in pain relief during the first 2 weeks (Brocq et al, 2002;Egsmose et al, 1984;Kirwan, 2001;Ravaud et al, 1999;Tikiz et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Hyaluronic Acid in the Treatment of Osteoarthritis: What is New

Abate¹,

Salini²

2012

Osteoarthritis - Diagnosis, Treatment and Surgery

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“…In other analyses HA products seem to have more prolonged effects than lA corticosteroids. Little datum exists in literature on the viscosupplementation of hip OA in spite of it being common site of the disease after the knee (9)(10)(11)(12)(13)(14)(15). One of the limiting factors for this practice is related to the need of guidance for the injection procedure.…”

mentioning

confidence: 99%

Efficacy and Safety Profile of Intra-Articular Administration of Jointex® in Patients Suffering from Symptomatic Hip Osteoarthritis: An Open, Prospective Study with a 12-Month Follow-up

et al. 2011

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Hip osteoarthritis represents a statistically relevant problem in clinical practice; previous reports showed different efficacy and safety profiles for intra-articular use of hyaluronic acid in hip osteoarthritis-affected patients, and in this sense, to add evidence to this topic, data regarding safety and efficacy of ultrasound-guided viscosupplementation are reported in order to establish whether such a therapeutic tool may represent a valid option. This study investigates the safety and efficacy profiles of ultrasound-guided intra-articular injections of Jointex® in hip osteoarthritis affected patients. This is a prospective multicentric study carried out in public hospitals. Adult outpatients suffering from symptomatic hip OA (Kellgren and Lawrence Grade 2, 3 or 4) were injected with one syringe of 4 ml (2 vials) of Jolntex" under ultrasound guidance, repeated after six months; when clinically necessary an adjunctive injection was performed. Patients' characteristics, such as gender, age, weight, height and BMI, smoking habit, unilateral or bilateral hip OA, radiological grade for hip OA following KellgrenLawrence grading and duration of disease, were evaluated. Patients were assessed at baseline and at every control visit and injection time for Lequesne index as primary endpoint, pain (evaluated by VAS) and NSAID consumption (number of days patients assumed NSAID in the last month) both as secondary endpoint. A total of 180 patients entered the study, all of whom received at least one IA US-guided injection of .lointex" into the hip joint. A total of 36 drop outs were registered, and both distribution and causes of drop out were recorded. A total of 389 injections were carried out, as 18 patients were affected by bilateral hip OA and 7 patients affected by monolateral hip OA required one more injection for symptomatic relief in respect to other patients. Scores obtained for primary as well as secondary study endpoints reached statistical significance when compared with scores obtained at baseline visit. Lequesne index mean scores obtained at each control visit, when compared with baseline mean value, were significantly different (p

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Efficacy and safety of viscosupplementation by ultrasound-guided intra-articular injection in osteoarthritis of the hip

Cited by 82 publications

References 1 publication

Viscosupplementation with Hyaluronic Acid in Hip Osteoarthritis (a review)

Viscosupplementation with Hyaluronic Acid in Hip Osteoarthritis (a review)

Hyaluronic Acid in the Treatment of Osteoarthritis: What is New

Efficacy and Safety Profile of Intra-Articular Administration of Jointex® in Patients Suffering from Symptomatic Hip Osteoarthritis: An Open, Prospective Study with a 12-Month Follow-up

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