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A Search for Factors that Predict the Efficacy of Viscosupplementation in Knee Osteoarthritis

DOI: 10.4236/oalib.1100700, PP. 1-8

Subject Areas: Rheumatology, Clinical Medicine

Keywords: Hyaluronic Acid, Viscosupplementation, Osteoarthritis, Knee Osteoarthritis, Efficacy, Hyaluronate

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Abstract

Objective: Previous research demonstrates inconsistent effects of hyaluronate (HA) viscosupplementation on patients with knee osteoarthritis (OA). The purpose of this study was to evaluate factors that predict clinical response to a single intra-articular injection of Hylan GF-20. Methods: This was an observational study of 55 patients with knee OA, scheduled to receive intra-articular injections of Hylan GF-20. These patients met the institution’s guidelines for use of viscosupplementation, which entails failure/intolerance of medical management of OA. At baseline, patients completed a series of questionnaires, including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Patient Health Questionnaire (PHQ-9) depression score. Questionnaires were repeated at three months post-injection. A clinical responder was someone with a change in KOOS score which exceeded the mean minimal detectable change (MDC) values calculated based on test-retest reliability coefficients reported in four prior studies. Hypothesized predictors of response included PHQ-9 score, baseline visual analog scale (VAS) pain score, age, body mass index (BMI), and Kellgren score. Results: There were 35 responders and 20 non-responders. There were no statistically significant differences between responders and non-responders for any of the primary predictors. There were no differences for secondary predictors, including history of knee injury or smoking, prior HA injection, prior intra-articular corticosteroid injection, or location of OA. There was a moderate negative correlation between age and change in total KOOS score (r = ―0.32, p = 0.01). Conclusions: Our research did not confirm previous predictors of response to hyaluronate injections, and highlighted the need for prospective studies in order to answer this question.

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Koolaee, R. M. , Schumacher, H. R. , Shoemaker, M. , Mooar, S. and Pullman-Mooar, S. (2014). A Search for Factors that Predict the Efficacy of Viscosupplementation in Knee Osteoarthritis. Open Access Library Journal, 1, e700. doi: http://dx.doi.org/10.4236/oalib.1100700.

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