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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article presents results from a double-blind, randomized clinical trial demonstrating that injections of hyaluronic acid were no more effective than placebo in treating patients with knee osteoarthritis.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EBone Density \u0026amp; Structure Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EArthritis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EArthritis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics \u0026amp; Sports Medicine\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EWalter van der Weegen, MSc, St. Anna Hospital, Geldrop, The Netherlands, presented results from a double-blind, randomized clinical trial demonstrating that injections of hyaluronic acid (HA) were no more effective than placebo in treating patients with knee osteoarthritis (KOA).\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EWhether the use of synthetic HA injections are helpful for KOA has been the subject of debate for decades. Numerous published reviews on the effectiveness of HA treatment in this patient population have been inconclusive [Rutjes AW et al. \u003Cem\u003EAnn Intern Med\u003C\/em\u003E 2012; Arrich J et al. \u003Cem\u003ECMAJ\u003C\/em\u003E 2005; Reichenbach S et al. \u003Cem\u003EArthritis Rheum\u003C\/em\u003E 2007; Divine JG et al. \u003Cem\u003EClin Orthop Relat Res\u003C\/em\u003E 2007; Bellamy N et al. \u003Cem\u003ECochrane Database Syst Rev\u003C\/em\u003E 2006].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EHowever, data from patients at St. Anna Hospital have demonstrated potential efficacy of HA treatment in KOA. With this in mind, Prof. van der Weegen and colleagues conducted a randomized, double-blind, placebo-controlled trial to collect more information on the effectiveness and safety of HA injections in this patient population. The study aimed to determine whether HA injections would be more effective than placebo for knee pain and function in KOA.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EInclusion criteria included patients with a radiographic score of 1 to 3 based on the Kellgren and Lawrence grading scheme. Patients previously treated with HA were excluded.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EPatients (n=200) at two hospitals with mild to moderate KOA received either three intra-articular injections of HA (2 mL injections, 30 mg HA with a molecular weight of 2.2 M Dalton) or placebo at weekly intervals, with follow-up at 1, 3, and 6 months to assess visual analog scale (VAS) scores for pain, Western Ontario and McMaster Universities Arthritis (WOMAC) scores, knee range of motion, treatment satisfaction, and adverse events. Baseline details, including age, KOA severity, and pain scores were similar in both groups.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EAlthough patients\u0027 pain scores improved significantly from baseline, there was no significant difference between the two groups (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). Additionally, there was no significant difference between groups at any of the follow-up time intervals in all other outcome measurements (VAS scores for pain, WOMAC scores, knee range of motion, and treatment satisfaction). No serious adverse events were reported in either of the treatment groups.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/2\/14.2\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Visual Analog Scale Scores for Pain\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-279408072\u0022 data-figure-caption=\u0022Visual Analog Scale Scores for Pain\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/2\/14.2\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/2\/14.2\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/2\/14.2\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15650\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003EVisual Analog Scale Scores for Pain\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EFermathron plus is the hyaluronic acid compound used in the study.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from WA. van der Weegen, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-9\u0022\u003ESimilarly, although subgroup analyses on pretreatment duration of symptoms, pain severity, and radiological KOA severity were also performed, there were no significant differences between subgroups.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EAlthough an earlier study using the same HA as used in this trial demonstrated clinical improvement from baseline [McDonald C et al. \u003Cem\u003EJ Clin Res\u003C\/em\u003E 2000], the results of this current study showed that three injections of HA were no more effective than placebo. Prof. Van der Weegen therefore concluded that HA treatment can not be recommended for patients with mild to moderate knee OA.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/2\/14.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzpcne\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzpcne\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}