title: Comparative efficacy of intra-articular hyaluronic acid and corticoid injections in osteoarthritis of the first carpometacarpal joint: results of a 6-month single-masked randomized study.
abstract: OBJECTIVE
  The study aim was to compare the efficacy and safety of ultrasound-guided intra-articular injections of hyaluronic acid and betamethasone in the management of patients with osteoarthritis of the thumb.
  
  
  METHODS
  Eighty-eight evaluable patients diagnosed with osteoarthritis of the thumb (Kellgren-Lawrence grade II-III) received ultrasound-guided intra-articular treatment with hyaluronic acid (48) or betamethasone (40). In total, 3 local injections were scheduled at 7-day intervals. Assessments were performed at baseline and at 7, 14, 30, 90, and 180 days.
  
  
  RESULTS
  In both study groups, the pain Visual Analogue Scale and Functional Index for Hand Osteoarthritis scores decreased significantly during follow-up compared to baseline. There were no significant differences between the groups. However, at 90 days, the functional score showed a trend towards greater clinical improvement in the hyaluronic acid group (P 0.071). A subanalysis of patients with Functional Index score≥5 and Visual Analogue Scale score≥3 at baseline showed a significantly higher median functionality score in the hyaluronic acid group (P 0.005 at 90 days and P 0.020 at 180 days). Further limiting analysis to a baseline pain score≥5 showed significantly greater improvement in functionality score (P 0.004 at 180 days), which was already apparent after the second intra-articular injection at 14 days (P 0.028). In this patient subset, the mean pain score also improved significantly at 180 days (P 0.02).
  
  
  CONCLUSIONS
  Both hyaluronic acid and betamethasone were effective and well-tolerated for the management of rhizarthrosis. Hyaluronic acid was more effective over time and more efficiently improved functionality and pain in patients with more severe symptoms.
authors.affiliation: Servei de Reumatologia, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain; Unitat de Recerca en Inflamació i Cartílag, Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain. Electronic address: JMonfort@parcdesalutmar.cat.
authors.forename: Jordi
authors.initials: J
authors.lastname: Monfort
authors.affiliation: Servei de Reumatologia, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain.
authors.forename: Delfin
authors.initials: D
authors.lastname: Rotés-Sala
authors.affiliation: Servei de Reumatologia, Consorci Sanitari del Maresme, Mataró, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Segalés
authors.affiliation: Servei de Reumatologia, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain.
authors.forename: Francisco-Jose
authors.initials: FJ
authors.lastname: Montañes
authors.affiliation: Servei de Reumatologia. Hospital Parc Taulí, Sabadell, Spain.
authors.forename: Cristobal
authors.initials: C
authors.lastname: Orellana
authors.affiliation: Unitat de Recerca en Inflamació i Cartílag, Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
authors.forename: Jone
authors.initials: J
authors.lastname: Llorente-Onaindia
authors.affiliation: Servei d'Assessorament Metodològic en Investigació Biomèdica (AMIB), Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
authors.forename: Sergi
authors.initials: S
authors.lastname: Mojal
authors.affiliation: Servei de Reumatologia, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Padró
authors.affiliation: Servei de Reumatologia, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain; Unitat de Recerca en Inflamació i Cartílag, Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Benito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001623:Betamethasone / Q000008:administration & dosage*; D052737:Carpometacarpal Joints; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy*; D011446:Prospective Studies; D016037:Single-Blind Method; D013933:Thumb; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000893:Anti-Inflammatory Agents; D006820:Hyaluronic Acid; D001623:Betamethasone
keywords: Corticosteroids; Hyaluronic acid; Intra-articular injections; Rhizarthrosis; Ultrasound-guided