|Beitragstitel||A single-shot of Viscosupplement increases gait speed in patients with OA knee|
The new generation of viscosupplements contain polyols that are expected to be more effective in reducing joint inflammation and undesired side effects in patients with knee-osteoarthritis (OA). Single bolus injections with new generation biological hyaluronic acids (HA) have never been tested in conjunction with gait analysis.
This study aimed to investigate which gait parameters are more sensitive to change following new generation HA injection.
Study Design & Methods
This 3-arm randomised double-blind pilot study was conducted in a tertiary hospital setting. Outcome measures used were gait analysis through a portable data logger Physilog® with five inertial sensors (BioAGM, La-Tour-de-Peilz, Switzerland), EuroQol five-dimensions questionnaire (EQ-5D), a visual analogue scale (VAS) pain and stiffness scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Knee Society score (KSS). Twenty-two patients with Ahlbäck stage 1-3 knee-OA were randomly allocated into three groups: one group received a sorbitol-containing viscosupplement (n=5), one group a mannitol-containing viscosupplement (n=9) and a placebo group (n=8). Patients were assessed by blinded observers prior to the injection and at 4 weeks (4W).
The differences between 4W and baseline were statistically significant for the mannitol containing viscosupplement with a median increase of 0.076m/s on gait speed (p=0.039), 0.055m on stride length (P=0.027) and 15 points on the KSS (P=0.047).
In the literature seven trials used gait analysis following HA knee injection. There is a wide heterogeneity throughout the design of the studies, the outcome measures chosen, methods of data collection and the substances delivered. Some trials failed to show the effectiveness of viscosupplementation using gait analysis. However, this is likely due to the parameters chosen and/or patient selection. The mean increase in gait speed in the present study is thought to be clinically important. This represents approximately 13% more than the mean difference between healthy and OA knee subjects. However, it is unknown whether increasing walking speed will result in accelerated degeneration or delayed time for a total knee arthroplasty.