Concurrent Imaging and Clinical Study of the Efficacy of Hyaluronic Acid Injection for Knee Osteoarthritis: A Synovial Membrane Investigation with Ultrasound Imaging

Author:

Wang Chien-Chih12,Hu Tsung-Ming34,Chen Chien-Lung56,Hong Chung-Chih7,Chang Yu-Hui8,Kao Chung-Lan291011ORCID

Affiliation:

1. Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital Yuli Branch, Hualien 981002, Taiwan

2. Department of Physical Medicine and Rehabilitation, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan

3. Department of Psychiatry, Taipei Veterans General Hospital Yuli Branch, Hualien 981002, Taiwan

4. Department of Future Studies and LOHAS Industry, Fo Guang University, Yilan 262307, Taiwan

5. Taipei Hospital, Ministry of Health and Welfare, New Taipei City 24213, Taiwan

6. Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan

7. Tri-Service General Hospital Songshan Branch, Taipei 10508, Taiwan

8. Department of Nursing, Taipei Veterans General Hospital, Taipei 11220, Taiwan

9. Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Section 2, Shi-Pai Road, Taipei 11220, Taiwan

10. Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Chiao Tung University, Hsinchu 30010, Taiwan

11. Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan

Abstract

We investigated whether hyaluronic acid (HA) injections can ameliorate ultrasound-detected synovitis in knee osteoarthritis (OA). We recruited 103 patients with symptomatic knee OA and ultrasound-detected synovitis and performed two ultrasound-guided fluid drainage procedures, followed by the administration of a low-molecular-weight HA injection (2.5 mL) in the subpatellar bursa, at a 2-week interval. Knee ultrasound imaging evaluations were performed before injection (baseline) and at 1 and 6 months after the second injection and included the measurements of synovial vascularity by using color Doppler ultrasound, synovial fluid depth over the suprapatellar bursa (SF), and synovial hypertrophy (SH). Initial clinical assessments included a visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). VAS scores decreased significantly at both 1-month and 6-month evaluations (p < 0.001). WOMAC scores also significantly decreased at 1 month (p < 0.001), but not at 6 months (p = 0.23). The ultrasound parameters did not significantly change, except color Doppler grading, which tended to decrease at the 6-month evaluation (p = 0.059). Our findings revealed that two ultrasound-guided HA injections following fluid drainage improved pain and knee function but did not considerably influence imaging-detected synovitis in patients with knee OA.

Funder

Taipei Veterans General Hospital Yuli branch

Publisher

MDPI AG

Subject

Drug Discovery,Pharmaceutical Science,Molecular Medicine

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