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"Functional pain," functional outcomes, and quality of life after hyaluronic acid intra-articular injection for knee osteoarthritis.
PM R. 2013 Apr; 5(4):310-8.PM R

Abstract

OBJECTIVE

To compare the effect of hyaluronic acid (HA) intra-articular knee injections on pain and functional outcomes in persons with knee osteoarthritis (OA) over 6 months, and to determine whether or not changes in functional pain are related to improvements in quality of life.

DESIGN

A prospective cohort study.

SETTING

A research laboratory in an academic medical center.

PARTICIPANTS

Patients with knee OA (N = 53) who were receiving medical care for OA.

INTERVENTIONS

Intra-articular knee injections of HA (3 injections, each separated by 1 week) and a comparative noninjection group.

MAIN OUTCOME MEASUREMENTS

Functional pain and outcomes assessments during chair rise, stair climbing, and a 6-minute walking test (by using 0-10 point numerical pain ratings during each test); gait parameters; Medical Outcomes Short Form-36 (SF-36) scores and subscores; the Western Ontario McMaster University Osteoarthritis Index (WOMAC).

RESULTS

Six months after HA, the completion times for the chair rise and stair climb tasks, and the distance covered during the 6-minute walk were not different between the groups. However, functional pain ratings during stair climbing decreased in the HA-treated group (P = .05). Six-month changes in gait velocity, cadence, stride length, step length, and the percentage of the gait cycle spent in single support were all higher after HA injection at month 6 (all P < .05). Significant group-by-time interactions existed for total WOMAC scores. SF-36 Vitality subscores improved by 13%, and Role Physical scores were higher in patients treated with HA injection compared with participants in the noninjection group (P < .05). Regression analyses revealed that changes in the functional pain measures did not correspond with SF-36 scores.

CONCLUSIONS

HA is associated with lower functional pain severity, with minimal impact on functional test scores. We interpreted this finding to represent an increase in the quality of the movement and functional activity. The change in functional pain did not correspond to changes in SF-36 quality-of-life scores.

Authors+Show Affiliations

Interdisciplinary Center for Musculoskeletal Training and Research, Department of Orthopaedics and Rehabilitation, University of Florida, PO Box 112727, Gainesville, FL 32611, USA. vincehk@ortho.ufl.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23416148

Citation

Vincent, Heather K., et al. ""Functional Pain," Functional Outcomes, and Quality of Life After Hyaluronic Acid Intra-articular Injection for Knee Osteoarthritis." PM & R : the Journal of Injury, Function, and Rehabilitation, vol. 5, no. 4, 2013, pp. 310-8.
Vincent HK, Montero C, Conrad BP, et al. "Functional pain," functional outcomes, and quality of life after hyaluronic acid intra-articular injection for knee osteoarthritis. PM R. 2013;5(4):310-8.
Vincent, H. K., Montero, C., Conrad, B. P., Horodyski, M., Connelly, J., Martenson, M., Seay, A. N., & Vincent, K. R. (2013). "Functional pain," functional outcomes, and quality of life after hyaluronic acid intra-articular injection for knee osteoarthritis. PM & R : the Journal of Injury, Function, and Rehabilitation, 5(4), 310-8. https://doi.org/10.1016/j.pmrj.2013.01.004
Vincent HK, et al. "Functional Pain," Functional Outcomes, and Quality of Life After Hyaluronic Acid Intra-articular Injection for Knee Osteoarthritis. PM R. 2013;5(4):310-8. PubMed PMID: 23416148.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - "Functional pain," functional outcomes, and quality of life after hyaluronic acid intra-articular injection for knee osteoarthritis. AU - Vincent,Heather K, AU - Montero,Cindy, AU - Conrad,Bryan P, AU - Horodyski,MaryBeth, AU - Connelly,Jacob, AU - Martenson,Matthew, AU - Seay,Amanda N, AU - Vincent,Kevin R, Y1 - 2013/02/13/ PY - 2012/05/24/received PY - 2012/08/29/revised PY - 2013/01/06/accepted PY - 2013/2/19/entrez PY - 2013/2/19/pubmed PY - 2014/1/8/medline SP - 310 EP - 8 JF - PM & R : the journal of injury, function, and rehabilitation JO - PM R VL - 5 IS - 4 N2 - OBJECTIVE: To compare the effect of hyaluronic acid (HA) intra-articular knee injections on pain and functional outcomes in persons with knee osteoarthritis (OA) over 6 months, and to determine whether or not changes in functional pain are related to improvements in quality of life. DESIGN: A prospective cohort study. SETTING: A research laboratory in an academic medical center. PARTICIPANTS: Patients with knee OA (N = 53) who were receiving medical care for OA. INTERVENTIONS: Intra-articular knee injections of HA (3 injections, each separated by 1 week) and a comparative noninjection group. MAIN OUTCOME MEASUREMENTS: Functional pain and outcomes assessments during chair rise, stair climbing, and a 6-minute walking test (by using 0-10 point numerical pain ratings during each test); gait parameters; Medical Outcomes Short Form-36 (SF-36) scores and subscores; the Western Ontario McMaster University Osteoarthritis Index (WOMAC). RESULTS: Six months after HA, the completion times for the chair rise and stair climb tasks, and the distance covered during the 6-minute walk were not different between the groups. However, functional pain ratings during stair climbing decreased in the HA-treated group (P = .05). Six-month changes in gait velocity, cadence, stride length, step length, and the percentage of the gait cycle spent in single support were all higher after HA injection at month 6 (all P < .05). Significant group-by-time interactions existed for total WOMAC scores. SF-36 Vitality subscores improved by 13%, and Role Physical scores were higher in patients treated with HA injection compared with participants in the noninjection group (P < .05). Regression analyses revealed that changes in the functional pain measures did not correspond with SF-36 scores. CONCLUSIONS: HA is associated with lower functional pain severity, with minimal impact on functional test scores. We interpreted this finding to represent an increase in the quality of the movement and functional activity. The change in functional pain did not correspond to changes in SF-36 quality-of-life scores. SN - 1934-1563 UR - https://www.unboundmedicine.com/medline/citation/23416148/"Functional_pain"_functional_outcomes_and_quality_of_life_after_hyaluronic_acid_intra_articular_injection_for_knee_osteoarthritis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1934-1482(13)00007-5 DB - PRIME DP - Unbound Medicine ER -