title: Kinetics features changes before and after intra-articular hyaluronic acid injections in patients with knee osteoarthritis.
abstract: OBJECTIVE
  To examine the kinetic features in patients with knee osteoarthritis (OA) after intra-articular hyaluronic acid (IAHA) injections in different time periods.
  
  
  METHODS
  A single group repeated measures study.
  
  
  METHODS
  Gait laboratory in a tertiary hospital.
  
  
  METHODS
  Twenty-five subjects with bilateral symptomatic knee OA and 15 healthy control subjects.
  
  
  METHODS
  Gait analyses were performed in both control and OA groups before (baseline), and after the completion of IAHA injections (1 week, 3 months, and 6 months).
  
  
  METHODS
  Knee pain and functional indices were assessed using a visual analogue scale (VAS) and the Lequesne function Index (LI). Joint kinetic changes were analyzed in the frontal and sagittal planes with 6-camera motion analysis system and two AMTI force plates.
  
  
  RESULTS
  VAS and LI scores were both improved in OA group after IAHA injections (p<0.001). In the frontal plane, increased knee adduction moment (p<0.001) after IAHA treatment was observed and would last up to a period of 6 months. In the sagittal plane, lower knee extension moments at early stance, and larger knee flexion moments at terminal stance were demonstrated after the completion of IAHA injections (p<0.05).
  
  
  CONCLUSIONS
  This study revealed that IAHA injections can provide significant pain relief and improvement in activity of daily living function for patients with knee OA. However, the reduction in pain and the increase in knee adduction moment may last up to 6 months. This may cause excessive loading on the knee joints, which may further accelerate the rate of knee degeneration. As a result, longer study time is needed to determine whether the observed kinetic findings in this study are associated with detrimental outcomes on the knee joints.
authors: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.
authors: Alice Chu-Wen
authors: AC
authors: Tang
authors: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taiwan.
authors: Simon Fuk-Tan
authors: SF
authors: Tang
authors: School of Sports Medicine, China Medical University, Taichung, Taiwan. Electronic address: whhong@mail.cmu.edu.tw.
authors: Wei-Hsien
authors: WH
authors: Hong
authors: Department of Industrial Engineering and Management, Taipei University of Technology, Taipei, Taiwan.
authors: Hsieh-Ching
authors: HC
authors: Chen
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000502:physiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology*; D016896:Treatment Outcome; D055675:Viscosupplements / Q000627:therapeutic use*
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: Gait; Hyaluronic acid; Intra-articular injection; Kinetic; Knee osteoarthritis