The effect of viscosupplementation on neuromuscular control of the knee in patients with osteoarthritis

Dıraçoğlu, Demirhan; Vural, Meltem; Başkent, Akın; Dikici, Fatih; Aksoy, Cihan

doi:10.3233/bmr-2009-0207

Cited by 47 publications

(34 citation statements)

References 25 publications

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“…The 14 studies left were reviewed in chronological order (Fig 1). 4,12,[17][18][19][20][21][22][23][24][25][26][27][28] study 1…”

Section: Resultsmentioning

confidence: 99%

“…Three studies suggested a statistically significant superiority of HA over placebo but for only a short period of time not exceeding 18 weeks. 24,26,27 Finally, two studies showed a modest effect in favour of HA over placebo for pain that was noticeable at six months but not for function. 23,28 Of the two studies that compared HA with steroid injections, one showed no statistically significant difference between the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…27 There was a statistically significant difference for proprioception as well as pain and function. The authors concluded that intra-articular HA injections can lead to short-term improvement in pain and function in patients with knee OA.…”

Section: Study 13mentioning

confidence: 91%

“…27 This was a prospective, double blind study. Sixty patients were enrolled for the study after assessment for eligibility against clearly defined criteria.…”

Section: Study 13mentioning

confidence: 99%

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The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain

Trigkilidas

Anand

2013

annals

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INTRODUCTION Knee osteoarthritis (OA) is a common and progressive joint disease. Treatment options for knee OA vary from simple analgesia in mild cases to knee replacement for advanced disease. Knee pain due to moderate OA can be targeted with intra-articular injections. Steroid injections have been used widely in managing acute flare-ups of the disease. In recent years, viscosupplementation has been used as a therapeutic modality for the management of knee OA. The principle of viscosupplementation is based on the physiological properties of the hyaluronic acid (HA) in the synovial joint. Despite a sound principle and promising in vitro studies, clinical studies have been less conclusive on the effectiveness of HA in managing osteoarthritic knee pain. The aim of this systematic review was to assess the effectiveness of HA intra-articular injections in the management of osteoarthritic knee pain. METHODS A systematic review of the literature was performed using MEDLINE ® , Embase™ and CINAHL ® (Cumulative Index to Nursing and Allied Health Literature). The databases were searched for randomised controlled trials available on the effectiveness of HA intra-articular injections in managing osteoarthritic knee pain. RESULTS The search yielded 188 studies. Of these, 14 met the eligibility criteria and were reviewed in chronological order. CONCLUSIONS HA intra-articular injections have a modest effect on early to moderate knee OA. The effect peaks at around 6-8 weeks following administration, with a doubtful effect at 6 months.

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“…The 14 studies left were reviewed in chronological order (Fig 1). 4,12,[17][18][19][20][21][22][23][24][25][26][27][28] study 1…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study 13mentioning

confidence: 91%

“…27 This was a prospective, double blind study. Sixty patients were enrolled for the study after assessment for eligibility against clearly defined criteria.…”

Section: Study 13mentioning

confidence: 99%

See 2 more Smart Citations

The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain

Trigkilidas

Anand

2013

annals

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“…[67] In the patients who had been treated with IHA, short-term improvement in proprioception and isokinetic muscle strength along with significant improvement in function were also reported (LOE Ib). [68] In brief, the trials concernig the effects of IHA are heterogenous. Their application may provide a beneficial effect by selecting appropriate patients.…”

Section: Nonselective and Selective Nonsteroidal Antiinflammatory Drumentioning

confidence: 99%

Evidence-Based Recommendations for the Management of Knee Osteoarthritis: A Consensus Report of the Turkish League Against Rheumatism

et al. 2012

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Amaç: Diz osteoartriti (OA) sık görülen ve neden olduğu ağrı ve sakatlık sonucunda sosyoekonomik yük bindiren bir hastalıktır. Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) OA tedavisi ile uğraşan hekimlere günlük klinik uygulamalarında yardımcı olmak amacıyla, uzman görüşleri ile desteklenmiş, ulusal "diz osteoartrit tedavisinde kanıta dayalı önerileri" hazırlamak için bir proje başlatmıştır. Objectives: Knee osteoarthritis (OA) is a common disease which causes pain, disability and great socioeconomic burden as a result. Turkish League Against Rheumatism (TLAR) initiated a project to prepare national, "evidence-based recommendations for the management of knee osteoarthritis" supported by expertopinion in order to assist the physicians who are interested in knee OA in their daily clinical practice. Gereç ve yöntemler: Materials and methods:The expert committee was composed of 25 academicians, 23 of whom were physical medicine and rehabilitation (PM&R) specialists (three also had rheumatology subspeciality) and two were orthopedic surgeons. At the first meeting, the previous guidelines were discussed, and 2008 Osteoarthritis Research Society International (OARSI) recommendations were decided to be taken as the fundamental template for national recommendations. Databases of the Pubmed, Embase, Cochrane, and Turkish Medical Index were used to search the literature, and this was carried out for the period between 2009-2010 for international publications since studies up to 2009 were present in the 2010 OARSI update. No limit was applied for searching of national publications. The selected relevant publications were graded according to evidence level and quality, and were sent to the members who were then asked to suggest propositions according to their experiences, knowledge, and review of the literature. After amalgamation and editing of new proposals, Delphi rounds were started. After five Delphi rounds, the propositions on which the members were in consensus, were discussed with regard to evidence and the "strength of recommendation" was determined by measuring on visual analog scale (VAS) for each proposal at the final meeting.Results: Nineteen propositions (one for general principles, nine for nonpharmacologic treatments, seven for pharmacologic treatments, and two for surgical treatments) were accepted as the "TLAR Evidence-Based Recommendations for the Management of Knee OA" in consensus as a result of Delphi rounds. Conclusion:Evidence-based recommendations for the management of knee OA were developed by TLAR for the first time in our country. The recommendations should be updated regularly according to new evidence and insights. It is expected that physicians who are interested in knee OA will benefit greatly from this report in their daily clinical practice.

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The anatomy of osteoarthritic joint pain

Witt

Vilensky

2012

Clinical Anatomy

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The anatomical understanding of the pain generators in osteoarthritis (OA) is incomplete and the teaching about these pain generators in medical school anatomy/histology courses is minimal. This review covers the nociceptive innervation of synovial joints for the purposes of teaching. Studies that discuss the presence of neuropeptides involved in pain, such as Substance P (SP) and calcitonin-gene-related peptide, are the focus of this review. Nociceptive free-nerve endings and SP staining nerves are found in the accessory ligaments, synovium, subchondral bone, menisci, and periosteum. The vasculature may also play a role in pain generation through vasospasm or ischemia, but this has yet to be proven. Joint denervation may relieve joint pain showing that it is indeed articular nerves that are carrying pain impulses but denervation does not identify the precise source of the pain. It remains unclear which of the anatomical loci of pain generation are primary in OA and if sources of pain vary in different patients and in different joints.

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The effect of viscosupplementation on neuromuscular control of the knee in patients with osteoarthritis

Abstract: In this study, it was demonstrated that intraarticular injection of hyaluronan in patients with knee OA led to a short-term increase in proprioception and isokinetic muscle force, and also significant improvements in the functional conditions of patients. Long-term studies are needed.

Cited by 47 publications

References 25 publications

The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain

The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain

Evidence-Based Recommendations for the Management of Knee Osteoarthritis: A Consensus Report of the Turkish League Against Rheumatism

The anatomy of osteoarthritic joint pain

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