Pereira L.C.1, Schweizer C.1, Moufarrij S.1, Krähenbühl S.M.1, Julien F.1, Gremion G.1, Applegate L.A.1, Jolles B.M.1
1University Hospital of Lausanne, Lausanne, Switzerland
Background: The new generation viscosupplements containing a polyol are expected to be more effective in reducing joint inflammation 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.
Purpose: The purpose of thios study was to investigate which gait parameters are more sensitive to change following new generation HA injection.
Methods: This 3-arm randomised double-blind pilot study was conducted in an University 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 II-III 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).
Results: 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).
Conclusion(s): 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. Gait analysis is proposed as a complementary outcome measure to the standard scores in order to test the effectiveness of HA injection.
Implications: Gait analysis will be performed in future trials investigating the effectiveness of OA knee therapeutic interventions. Particularly in the study of HA viscosupplements, parameters such as gait speed and stride lenght should be accounted for. These results should encourage further clinical research investigating the effectiveness of one-shot new-generation viscosupplements in larger patient samples.
Funding acknowledgements: There was no funding or commercial association that might pose a conflict of interest in connection with the submitted article.
Topic: Musculoskeletal: lower limb
Ethics approval: Ethical approval was obtained from the local Research Ethics Board
All authors, affiliations and abstracts have been published as submitted.
