title: Correlation of changes in pain intensity with synovial fluid adenosine triphosphate levels after treatment of patients with osteoarthritis of the knee with high-molecular-weight hyaluronic acid.
abstract: We sought to determine whether a clinical association exists between osteoarthritis (OA)-associated knee pain and adenosine triphosphate (ATP) levels in synovial fluid (SF). A total of 28 patients with 28 primary OA knees were included. They routinely received intra-articular injection of high-molecular-weight hyaluronic acid (HA) once weekly for 5 weeks (treated group). Eight patients without knee pain who had undergone an operation for anterior or posterior cruciate ligament reconstruction 2 years ago were also examined (control group). SF and blood ATP concentrations, total amount of ATP, total SF volume, and Visual Analogue Scale (VAS) scores in all patients were measured and we compared pre-treatment values with those 1 week after the final treatment. We evaluated the correlation of change in total ATP (ΔATP) and change in VAS score (ΔVAS), ΔVAS and change in SF volume (ΔSF), and ATP concentration in SF and blood. In the treated group, SF ATP concentration, total amount of ATP, SF volume, and VAS score were all significantly lower post-treatment than pre-treatment (p = 0.0005, 0.0003, 0.0022, and < 0.0001, respectively). In treated group, ΔVAS was significantly associated with ΔATP (r = 0.56, p = 0.0032), ΔSF was significantly associated with ΔVAS (r = 0.78, p < 0.0001), and total amount of SF ATP and SF volume at pre-treatment were significantly higher than the control group (p < 0.0001, p < 0.0001) We demonstrated an association between SF ATP level changes and OA knee pain, which should facilitate a further understanding of OA pain mechanisms.
authors.affiliation: Department of Orthopaedics, Ohda Municipal Hospital, 1428-3 Yoshinaga Ohda-shi, Shimane 694-0063, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kumahashi
authors.forename: Kohei
authors.initials: K
authors.lastname: Naitou
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nishi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Oae
authors.forename: Yohei
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Suguru
authors.initials: S
authors.lastname: Kuwata
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ochi
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Ikeda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Uchio
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism*; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D010147:Pain Measurement; D012720:Severity of Illness Index; D013582:Synovial Fluid / Q000378:metabolism*; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage*
chemical_list: D015415:Biomarkers; D055675:Viscosupplements; D000255:Adenosine Triphosphate; D006820:Hyaluronic Acid