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Study aim
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Comparison of Dextrose periarticular Injection versus Hyaluronic Acid Intraarticular Injection in the treatment of pain of knee osteoarthritis
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Design
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In a double-blind randomized clinical trial, 104 patients with knee pain for at least 3 months (who have not responded adequately to conservative treatment) and in accordance with the inclusion and exclusion criteria, are enrolled. Patients are randomly divided to two groups. Before the main injections, lidocaine 2% used as local anesthetic. For the HA group, 2.5 mL of hyaluronic acid is injected intraarticulary. HD group, is received 10 ml of 12.5% hypertonic dextrose through four points around the knee. All injections are done by a 23-G needle subcutaneously under ultrasound guidance. The injections are done, three times within two weeks, at days 0, 7 and 14.All patients are evaluated using the VAS (0-10), WOMAC (0-100) criteria before and 3 months after the last injection. At the first injection time and Three months later, the pain intensity and the WOMAC scores are obtained for all patients and compared intra and between groups.
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Settings and conduct
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In a double-blind randomized clinical trial, 104 patients with knee pain for at least 3 months (who have not responded adequately to conservative treatment) and in accordance with the inclusion and exclusion criteria, are enrolled. Patients are randomly divided to two groups. The injections are done, three times within two weeks, at days 0, 7 and 14.All patients are evaluated using the VAS (0-10), WOMAC (0-100) criteria before and 3 months after the last injection. At the first injection time and Three months later, the pain intensity and the WOMAC scores are obtained for all patients and compared intra and between groups. All analgesics were discontinued 48 hours before the procedure and for up to 2 weeks after the procedure (except acetaminophen). Physician injecting drug and the one evaluating patients in follow-up is different and is blind to patients group.
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Participants/Inclusion and exclusion criteria
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Inclusion criteria: patients with chronic osteoarthritis; grade 2 or higher of OA in radiology; age over 50 years; morning stiffness less than 30 minutes; 3 month unresponsiveness to conservative therapy
Exclusion criteria: severe underlying diseases like diabetes and/or hypothyroidism; immune suppression or deficiency; serious local infectious or inflammatory knee disease; anticoagulant drug history during three last months; history of corticosteroid therapy in past year; history of prolotherapy in past year; history of intraarticular injection in past year; indication for surgical arthroplasty
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Intervention groups
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For the HA group, 2.5 mL of hyaluronic acid is injected intraarticulary via the inferomedial of patella.
The HD group, is received 10 ml of 12.5% hypertonic dextrose through four points injection, two points at suprolateral of patella, one point at medial knee joint line and another remained point is at anterior of fibula head, via fan wise technique, 2.5 cc for each point.
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Main outcome variables
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pain