Hyaluronate improves pain, physical function and balance in the geriatric osteoarthritic knee: a 6-month follow-up study using clinical tests.
OBJECTIVE
To investigate the effects of intraarticular hyaluronic acid (HA) (Artzal, Seikagaku Corp., Japan) in geriatric participants with unilateral knee osteoarthritis (OA).


METHODS
This was a prospective, observer-blind study with 6 months follow-up done in the setting of an outpatient rehabilitation department in a university-affiliated tertiary care medical center. Sixty-eight patients, aged 65 years or above, with symptoms and radiographic evidence of unilateral knee OA for at least 6 months were recruited. Patients received five weekly intraarticular injections of Artzal into symptomatic knees. Fifty-six participants completed the study. Fifty age-, body mass- and gender-matched healthy individuals were selected as control. Visual analog scale (VAS), Lequesne index and four balance tests including single-leg stance test (SLS), function reach test (FRT), timed "Up-and-Go" test (TUG) and Berg balance scale (BBS) were assessed before injection and at each follow-up visit in the OA group. Four balance tests were obtained on healthy participants for data comparison.


RESULTS
Before Artzal injections, the OA group showed significantly worse VAS, Lequesne index and four balance tests scores than did the control group (P < 0.001). Significant improvement in all outcome measures were noted at 1 week, 1, 3 and 6 months post the fifth injection compared with baseline before injection. Local adverse events were reported in four patients (7.1%).


CONCLUSIONS
Significant improvement in pain, physical function and balance tests was demonstrated after five weekly Artzal injections in geriatric patients with knee OA. The effect had rapid onset at 1 week and may last for 6 months.
Sun
Shu-Fen
SF
Department of Physical Medicine and Rehabilitation, Veterans General Hospital, Kaohsiung, Taiwan. sfsun.tw@yahoo.com.tw
Hsu
Chien-Wei
CW
Hwang
Chiao-Wen
CW
Hsu
Pei-Te
PT
Wang
Jue-Long
JL
Tsai
Shin-Lung
SL
Chou
Yi-Jiun
YJ
Hsu
Ya-Wen
YW
Huang
Chien-Ming
CM
Wang
Yu-Ling
YL
D000203:Activities of Daily Living; D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D008297:Male; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D010146:Pain / Q000517:prevention & control; D004856:Postural Balance; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid