JOURNAL ARTICLE

Total knee replacement following repeated cycles of intra-articular sodium hyaluronate (500-730 Kda) in failed conservative treatment of knee osteoarthritis: a 54-month follow-up

Thana Turajane, Tanawat Amphansap, Viroj Labpiboonpong, Samart Maungsiri
Journal of the Medical Association of Thailand 2009, 92: S63-8
20120667

BACKGROUND: Treatment with repeated cycles of Intra-Articular Sodium Hyaluronate (IA-HA), from previous study, can improve symptoms and delay surgical interventions in knee osteoarthritis patients who failed conservative treatment within minimum 2-years follow-up. This is a continued study to follow-up responded patients in the mentioned study whether continuing treatment with IA-HA could prolong time to surgery until the end of follow-up.

OBJECTIVE: To evaluate the incidence of total knee replacement (TKR) in patients receiving repeated cycles of IA-HA during a 54-month follow-up period.

MATERIAL AND METHOD: This was a prospective cohort study with 54-month follow-up period. All patients received at least a single course of 3-weekly injections of IA-HA (500-730 Kilodalton, Hyalgan). Patients who well responded to the treatment were recommended to repeat the administration of a 3-weekly injections every 6-12 months based on their symptoms. The incidence of TKR and time was recorded. Time to event analysis using Kaplan-Meier survival analysis was performed.

RESULTS: 183 patients were recruited during March 2001 and March 2004 and followed-up until October 2008. Patients were classified into three groups according to Ahlback radiological grading system. 46 patients were in group 1 (Ahlback grade I-II), 70 patients were in group 2 (Ahlback grade III-IV) and 67 patients were in group 3 (Ahlback grade V). The incidence of TKR was 28.4% with a mean time to TKR of 15.4 months (0.7-51.7 months). For the rest of patients who had no TKR during study period (80.4%, 64.3% and 73.1% for group 1, 2, and 3 respectively), their mean follow-up time was 45.6 months (19.0-53.1 months). Mean survival time was 42.1 months (95% CI = 39.4-44.9 months).

CONCLUSION: The repeated cycles of intra-articular sodium hyaluronate treatment in delay time to TKR in patients with knee osteoarthritis which failed conservative treatment was found efficacious during a 54-month follow-up period.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
20120667
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"