The Lawson Health Research Institute, Aging Rehabilitation & Geriatric Care, Parkwood Hospital, Room B3002, 801 Commissioners Road East, London, Ontario, Canada, N6C 5J1.
Arch Gerontol Geriatr. 2012 Sep-Oct;55(2):310-5. doi: 10.1016/j.archger.2011.11.007. Epub 2011 Dec 9.
To determine the effect of intra-articular hyaluronic acid (HA) on gait velocity, pain, and function, in older knee osteoarthritis (OA) patients.
Thirty knee OA patients (Kellgren-Lawrence II-III) [72.44 (± 6.11) years old] were randomized, using the 'RANDBETWEEN' function in Microsoft Excel, to receive three weekly injections of HA (2 ml of 20 mg/ml HA), or placebo (P) (1.2 ml of 0.001 mg/ml HA), with fifteen participants per group. Patients and assessors were blind to treatment. Self-selected and fast gait velocities were measured with the GAITRite system. Knee pain, stiffness, and physical function were measured with the Western Ontario McMaster Osteoarthritis OA index (WOMAC OA index). Data from 1 week, 3 and 6 months post-treatment were analyzed using repeated measures ANOVA.
The HA group significantly improved self-selected and fast gait velocity, while the P group only significantly improved self-selected gait velocity. Mean improvements in self-selected gait velocity [Mean (SD); 95% CI] [1.25 (52.4)cm/s; -18.38; 20.88] and fast gait velocity [7.16 (71.75)cm/s; -19.72; 34.04] were not significantly different between groups. Improvements in WOMAC pain scores were significantly greater in the HA group than the P group [-2.47 (6.39); -4.86; -0.08], while improvements in stiffness [-0.87 (2.42); -1.77; 0.04] and physical function [-7.23 (19.77); -14.63; 0.16] scores were not.
The overall effect of HA on gait velocity in older knee OA patients was not significant compared to placebo. The preliminary results of improved fast gait velocity following HA treatment should be investigated further, along with the incidence of falls, in a larger sample of older knee OA patients.ClinicalTrials.gov ID: NCT00778076.
评估关节内透明质酸（HA）对老年膝关节骨关节炎（OA）患者步态速度、疼痛和功能的影响。
30 例膝关节 OA 患者（Kellgren-Lawrence II-III）[72.44（±6.11）岁]采用 Microsoft Excel 中的“RANDBETWEEN”函数随机分为两组，分别接受每周三次关节内注射 HA（2 ml 20 mg/ml HA）或安慰剂（P）（1.2 ml 0.001 mg/ml HA），每组 15 例患者。患者和评估者对治疗均不知情。使用 GAITRite 系统测量患者自主选择的和快速行走速度。采用 Western Ontario McMaster Osteoarthritis OA 指数（WOMAC OA 指数）评估膝关节疼痛、僵硬和身体功能。采用重复测量方差分析对治疗后 1 周、3 个月和 6 个月的数据进行分析。
HA 组患者自主选择的和快速行走速度显著提高，而 P 组仅自主选择的行走速度显著提高。自主选择行走速度的平均改善值[均值（标准差）；95%置信区间] [1.25（52.4）cm/s；-18.38；20.88]和快速行走速度[7.16（71.75）cm/s；-19.72；34.04]在两组间无显著差异。HA 组患者 WOMAC 疼痛评分的改善明显大于 P 组[-2.47（6.39）；-4.86；-0.08]，而僵硬评分[-0.87（2.42）；-1.77；0.04]和身体功能评分[-7.23（19.77）；-14.63；0.16]的改善无显著差异。
与安慰剂相比，HA 对老年膝关节 OA 患者步态速度的总体影响无统计学意义。HA 治疗后快速行走速度的改善初步结果应进一步调查，同时还应在更大的老年膝关节 OA 患者样本中调查跌倒发生率。
ClinicalTrials.gov 注册号：NCT00778076。
