title: Role of hyaluronic Acid in early diagnosis of knee osteoarthritis.
abstract: BACKGROUND
  Osteoarthritis of knee is traditionally diagnosed on the basis of clinical and radiological findings. Usually joint tissue degeneration is already advanced by the time a clinical diagnosis is made, hence the research focus has now shifted to use of biomarkers to diagnose the condition at an early stage of the disease.
  
  
  OBJECTIVE
  The aim of this study was to assess the efficacy of serum HA levels in early detection and grading of the severity of primary knee osteoarthritis and it's co-relation with Western Ontario and McMaster university osteoarthritis index (WOMAC scores) and Kellgren -Lawrence grading (K-L grade).
  
  
  METHODS
  The study included 150 subjects (100 cases and 50 controls) and all were subjected to WOMAC scoring and K-L grading and estimation of serum HA levels.
  
  
  RESULTS
  Age and WOMAC scores have significant correlation with HA levels, but multivariate analysis shows only WOMAC score as an independent variable associated with HA levels. The results show statistically significant high HA levels in cases than in normal population. HA levels are also able to differentiate between various clinical severity grades. ROC Curve analysis suggests cut-off levels of HA between mild, moderate and severe cases.
  
  
  CONCLUSIONS
  HA levels are able to differentiate between normal asymptomatic population and symptomatic cases and also between various severity grades of osteoarthritis.
authors: Professor & Head, Department of Orthopaedics, Era's Lucknow Medical College , Lucknow, India .
authors: Sudhir
authors: S
authors: Singh
authors: Assistant Professor, Department of Orthopaedics, Era's Lucknow Medical College , Lucknow, India .
authors: Dharmendra
authors: D
authors: Kumar
authors: Junior Resident, Department of Orthopaedics, Era's Lucknow Medical College , Lucknow, India .
authors: Nishant Raj
authors: NR
authors: Sharma
keywords: Biomarkers; Hyaluronic acid (HA); Kellgren-lawrence grade (K-L Grade); Knee osteoarthritis (KOA); Western ontario and McMaster university osteoarthritis index (WOMAC Score)
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