title: Hyaluronate improves pain, physical function and balance in the geriatric osteoarthritic knee: a 6-month follow-up study using clinical tests.
abstract: 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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Veterans General Hospital, Kaohsiung, Taiwan. sfsun.tw@yahoo.com.tw
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Sun
authors.forename: Chien-Wei
authors.initials: CW
authors.lastname: Hsu
authors.forename: Chiao-Wen
authors.initials: CW
authors.lastname: Hwang
authors.forename: Pei-Te
authors.initials: PT
authors.lastname: Hsu
authors.forename: Jue-Long
authors.initials: JL
authors.lastname: Wang
authors.forename: Shin-Lung
authors.initials: SL
authors.lastname: Tsai
authors.forename: Yi-Jiun
authors.initials: YJ
authors.lastname: Chou
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Hsu
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Huang
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Wang
mesh_terms: 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
chemical_list: D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid