The safety and efficacy of intraarticular hyaluronan with/without corticosteroid in knee osteoarthritis: 1-year, single-blind, randomized study

Abstract

The goal of this study was to assess the safety and efficacy of hyaluronan (HA) with/without corticosteroid in patients with knee osteoarthritis (OA). In a 1-year, randomized, single-blind trial, 24 patients were treated with HA weekly for 3 weeks, then three injections on the 6th month for a total of six injections. Sixteen patients were treated the same but with the addition of 1 ml triamcinolone acetonide prior to the first and fourth HA injection. The treatment was repeated at the sixth month. The patients were evaluated with the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the visual analog pain scale (VAS). After 1 year, progression of OA was evaluated with magnetic resonance imaging (MRI). During the study, pain relief was marked in patients who received combined treatment with respect to WOMAC pain and VAS (p<0.05). At the first year, no progression was observed in either treatment group. Although all patients had improvement for both pain and function, HA together with corticosteroid was superior to HA alone for early pain relief. The MRI findings showed that neither treatment showed a progression on the damage of the cartilage.

Adding Triamcinolone Improves Viscosupplementation: A Randomized Clinical Trial

“…To be able to detect a difference of at least 25% in groups, we established the value of 10 for the difference to be detected, which is a value commonly used for studies using VAS and WOMAC TM . Considering the SDs reported in a previous study [23] and an estimation of 20% of dropouts and exclusions, we calculated 52 patients per group. The investigator (MUR) who gave the questionnaires was blinded (unaware of the patient's group and did not perform any injections).…”

Efficacy and adverse effects of joint medication in the horse – A review of the literature – Part 1: Conventional joint medication and the risks involved with joint injection in the horse

“…In-vitro konnte die negative Wirkung von LPS und IL-1 auf Chondrozyten sowohl durch Zugabe von HA, als auch durch TA und die Kombination der beiden Wirkstoffe gemindert werden (Bolt et al 2008, Schaefer et al 2009). Eine randomisierte klinische Studie aus der Humanmedizin kam zu dem Ergebnis, dass Patienten die die Kombination von TA und HA erhielten weniger unter Gelenkschmerz litten, als Patienten die nur mit HA behandelt wurden (Ozturk et al 2006). Dass eine Zugabe von HA bei MPA-Injektion die knorpelschädigenden Eigenschaften dieses Corticosteroids effektiv mindern kann, wurde durch einen In vitro-Versuch widerlegt (Doyle et al 2005).…”

L’acide hyaluronique avant l’arthrose : à propos de 339 sportifs

“…Concernant l'injection préalable de corticoïdes en intra-articulaire, notre étude n'a pas montré de supériorité de l'association. L'étude d'Ozturk et al, comparant l'efficacité de l'association AH + corticoïdes versus AH seul dans la gonarthrose montre un pic d'efficacité plus précoce et plus long en cas d'association (p < 0,05) ; l'efficacité redevenant comparable à un an [27]. Une perte d'efficacité a été observée en cas de multiplication des protocoles dans le genou.…”