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Comparison of intra-articular hyaluronic acid injections with transcutaneous electric nerve stimulation for the management of knee osteoarthritis: a randomized controlled trial.
Arch Phys Med Rehabil. 2013 Aug; 94(8):1482-9.AP

Abstract

OBJECTIVE

To compare the effects of intra-articular hyaluronic acid (HA; ARTZ) and transcutaneous electric nerve stimulation (TENS) in the treatment of patients with knee osteoarthritis.

DESIGN

A prospective, randomized controlled trial.

SETTING

Rehabilitation clinic of a teaching hospital.

PARTICIPANTS

Patients with knee osteoarthritis (N=50; aged 51-80y) were randomly assigned to the HA group (n=27) or the TENS group (n=23).

INTERVENTIONS

The HA group received intra-articular HA injection into the affected knee once a week for 5 consecutive weeks, and the TENS group received a 20- minute session of TENS 3 times a week for 4 consecutive weeks.

MAIN OUTCOME MEASURES

The primary outcome measures used were the visual analog scale (VAS) for pain and the Lequesne index. The secondary outcome measures were range of motion of the knee, walking time, pain threshold, patient global assessment, and disability in activities of daily living. All subjects were assessed at baseline, and at 2 weeks, 2 months, and 3 months after the treatments were completed.

RESULTS

The TENS group exhibited a significantly greater improvement in VAS than the HA group at 2 weeks' follow-up (4.17 ± 1.98 vs 5.31 ± 1.78, respectively; P=.03). In addition, the TENS group also exhibited a significantly greater improvement in the Lequesne index than the HA group at 2 weeks' follow-up (7.78 ± 2.08 vs 9.85 ± 3.54, respectively; P=.01) and at 3 months' follow-up (7.07 ± 2.85 vs 9.24 ± 4.04, respectively; P=.03).

CONCLUSIONS

TENS with silver spike point electrodes was observed to be more effective than intra-articular HA injection for patients with knee osteoarthritis in improving the VAS for pain at 2 weeks' follow-up as well as the Lequesne index at 2 weeks' and 3 months' follow-up.

Authors+Show Affiliations

Department of Physical Medicine & Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, ROC.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23628378

Citation

Chen, Wen-Ling, et al. "Comparison of Intra-articular Hyaluronic Acid Injections With Transcutaneous Electric Nerve Stimulation for the Management of Knee Osteoarthritis: a Randomized Controlled Trial." Archives of Physical Medicine and Rehabilitation, vol. 94, no. 8, 2013, pp. 1482-9.
Chen WL, Hsu WC, Lin YJ, et al. Comparison of intra-articular hyaluronic acid injections with transcutaneous electric nerve stimulation for the management of knee osteoarthritis: a randomized controlled trial. Arch Phys Med Rehabil. 2013;94(8):1482-9.
Chen, W. L., Hsu, W. C., Lin, Y. J., & Hsieh, L. F. (2013). Comparison of intra-articular hyaluronic acid injections with transcutaneous electric nerve stimulation for the management of knee osteoarthritis: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 94(8), 1482-9. https://doi.org/10.1016/j.apmr.2013.04.009
Chen WL, et al. Comparison of Intra-articular Hyaluronic Acid Injections With Transcutaneous Electric Nerve Stimulation for the Management of Knee Osteoarthritis: a Randomized Controlled Trial. Arch Phys Med Rehabil. 2013;94(8):1482-9. PubMed PMID: 23628378.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of intra-articular hyaluronic acid injections with transcutaneous electric nerve stimulation for the management of knee osteoarthritis: a randomized controlled trial. AU - Chen,Wen-Ling, AU - Hsu,Wei-Chun, AU - Lin,Yi-Jia, AU - Hsieh,Lin-Fen, Y1 - 2013/04/27/ PY - 2012/12/20/received PY - 2013/03/29/revised PY - 2013/04/02/accepted PY - 2013/5/1/entrez PY - 2013/5/1/pubmed PY - 2013/11/1/medline KW - ACR KW - ADL KW - American College of Rheumatology KW - HA KW - Hyaluronic acid KW - Injections, intra-articular KW - MCII KW - OA KW - Osteoarthritis, knee KW - ROM KW - Rehabilitation KW - SSP KW - TENS KW - Transcutaneous electric nerve stimulation KW - VAS KW - activities of daily living KW - hyaluronic acid KW - minimal clinically important improvement KW - osteoarthritis KW - range of motion KW - silver spike point KW - transcutaneous electric nerve stimulation KW - visual analog scale SP - 1482 EP - 9 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 94 IS - 8 N2 - OBJECTIVE: To compare the effects of intra-articular hyaluronic acid (HA; ARTZ) and transcutaneous electric nerve stimulation (TENS) in the treatment of patients with knee osteoarthritis. DESIGN: A prospective, randomized controlled trial. SETTING: Rehabilitation clinic of a teaching hospital. PARTICIPANTS: Patients with knee osteoarthritis (N=50; aged 51-80y) were randomly assigned to the HA group (n=27) or the TENS group (n=23). INTERVENTIONS: The HA group received intra-articular HA injection into the affected knee once a week for 5 consecutive weeks, and the TENS group received a 20- minute session of TENS 3 times a week for 4 consecutive weeks. MAIN OUTCOME MEASURES: The primary outcome measures used were the visual analog scale (VAS) for pain and the Lequesne index. The secondary outcome measures were range of motion of the knee, walking time, pain threshold, patient global assessment, and disability in activities of daily living. All subjects were assessed at baseline, and at 2 weeks, 2 months, and 3 months after the treatments were completed. RESULTS: The TENS group exhibited a significantly greater improvement in VAS than the HA group at 2 weeks' follow-up (4.17 ± 1.98 vs 5.31 ± 1.78, respectively; P=.03). In addition, the TENS group also exhibited a significantly greater improvement in the Lequesne index than the HA group at 2 weeks' follow-up (7.78 ± 2.08 vs 9.85 ± 3.54, respectively; P=.01) and at 3 months' follow-up (7.07 ± 2.85 vs 9.24 ± 4.04, respectively; P=.03). CONCLUSIONS: TENS with silver spike point electrodes was observed to be more effective than intra-articular HA injection for patients with knee osteoarthritis in improving the VAS for pain at 2 weeks' follow-up as well as the Lequesne index at 2 weeks' and 3 months' follow-up. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/23628378/Comparison_of_intra_articular_hyaluronic_acid_injections_with_transcutaneous_electric_nerve_stimulation_for_the_management_of_knee_osteoarthritis:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(13)00315-8 DB - PRIME DP - Unbound Medicine ER -