title: Six-months pain relief and functional recovery after intra-articular injections with hyaluronic acid (mw 500-730 KDa) in trapeziometacarpal osteoarthritis.
abstract: BACKGROUND
  this retrospective open label study evaluates the efficacy and tolerability of intra-articular injections of Hyaluronic Acid (HA) (MW 500-730 KDa - Hyalgan®) for the treatment of pain and disability of trapeziometacarpal joint osteoarthritis (TMCJ OA).
  
  
  METHODS
  fifty eight patients, 50 females (86%) and 8 male (14%), aged between 40-75 years, suffering from TMCJ OA according to Kellgren-Laurence grades 2-3 on standard plain radiography, were included. Patients with known inflammatory arthritis, previous thumb trauma and intra-articular (i.a.) injections with corticosteroids were excluded. Primary endpoints were: pain (VAS), NSAID intake, radial and palmar ab-/adduction, pinch strength. All patients received an i.a. injection of 0.8 mL of HA (MW 500-730 KDa) once weekly for three weeks. Control examinations were carried out at 1, 3, and 6 months.
  
  
  RESULTS
  intra-articular HA injections have significantly reduced spontaneous and provoked pain and improved hand mobility. At 1,3, and 6 months from baseline, the spontaneous and provoked pain revealed a statistically significant improvement (p<0,0001). NSAID's intake evidenced a statistically significant reduction against baseline (p<0.017). The adverse events (21%) were related to local symptoms such as pain during or following HA administration.
  
  
  CONCLUSIONS
  this study shows that i.a. HA injections for TMCJ OA can induce a significant improvement of function associated to stiffness decrease and pain relief.
authors.affiliation: Department of Physical and Rehabilitation Medicine, University of Padova, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Frizziero
authors.affiliation: Queen Mary University of London Centre for Sports and Exercise Medicine Mile End Hospital Mann Ward, London, UK; Head of Department of Physical and Rehabilitation Medicine, University of Salerno, Azienda Ospedaliera San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.affiliation: Department of Physical and Rehabilitation Medicine, University of Padova, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masiero
authors.affiliation: Department of Rheumatology, Villa Toniolo Hospital, Bologna, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Frizziero
keywords: hyaluronic acid; osteoarthritis; trapeziometacarpal joint