Changes of gait patterns and muscle activity after intraarticular treatment of patients with osteoarthritis of the knee: a prospective, randomised, doubleblind study.
Evaluation of gait performance and muscle activity patterns as well as clinical efficacy and safety after intraarticular injections with hyaluronan (Ostenil) compared with triamcinolone (Volon A10) injections in patients with knee osteoarthritis. This was a prospective, randomised, double-blind clinical trial evaluating the influence of five injections of hyaluronan or triamcinolone on gait pattern and muscle activity. For the clinical evaluation visual analogue scale, Lequesne index, and Knee Society Score were used. Quality of life was estimated with the SF-36. The definitive analysis was performed on the population who received all five injections and were examined in the two follow-up visits. Fifteen patients were treated with triamcinolone and 20 with hyaluronan. Significant improvement could be demonstrated for pain scale and clinical scores in both groups. Gait patterns showed significant differences only for Knee Abduction Moment (p=0.007) in the hyaluronan group and for Maximum Vertical Force 1 and 2 between the both groups in the follow up visit (p=0.018) (p=0.019). In both groups there was no significant difference regarding to muscle activity. Quality of life showed no changes in all visits between the groups. Hyaluronan was not superior to triamcinolone. The results suggest that treatment with hyaluronan can reduce pain and improve knee function. A significant short term improvement in gait and muscle activity patterns, however, was not observed, in either hyaluronan or triamcinolone.
Department of Orthopaedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, D-35043 Marburg, Germany. skwara@med.uni-marburg.de
Adrian
A
Skwara
Christian Dominik
CD
Peterlein
Carsten Oliver
CO
Tibesku
Dieter
D
Rosenbaum
Susanne
S
Fuchs-Winkelmann
D000368:Aged; D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D004311:Double-Blind Method; D004576:Electromyography; D005260:Female; D005684:Gait; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D010147:Pain Measurement; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013647:Task Performance and Analysis; D014221:Triamcinolone / Q000008:administration & dosage*; D055675:Viscosupplements / Q000008:administration & dosage*
D055675:Viscosupplements; D014221:Triamcinolone; D006820:Hyaluronic Acid