Physical therapy, intra-articular dextrose prolotherapy, botulinum neurotoxin, and hyaluronic acid for knee osteoarthritis: randomized clinical trial
| Autor: | Sharif Najafi, Ehsan Sanati, Fateme Abdorrazaghi, Zahra Rezasoltani, Sirous Azizi, Afsaneh Dadarkhah |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
030506 rehabilitation medicine.medical_specialty Hot Temperature Visual Analog Scale Visual analogue scale Ultrasonic Therapy medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Osteoarthritis Transcutaneous electrical nerve stimulation law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Randomized controlled trial law Hyaluronic acid medicine Humans Outpatient clinic Botulinum Toxins Type A Hyaluronic Acid Aged business.industry Prolotherapy Rehabilitation Middle Aged Osteoarthritis Knee medicine.disease Glucose Knee pain Neuromuscular Agents chemistry Transcutaneous Electric Nerve Stimulation Physical therapy Female medicine.symptom 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | International Journal of Rehabilitation Research. 43:219-227 |
| ISSN: | 0342-5282 |
| DOI: | 10.1097/mrr.0000000000000411 |
| Popis: | This study aimed to compare the efficacy of four treatments in the management of knee osteoarthritis. We carried out a randomized clinical trial with four study arms in an outpatient Department of Physical Medicine and Rehabilitation at a University Hospital. In total, 120 patients with knee osteoarthritis ≥50 years of age were randomly allocated to four groups. The primary outcome was knee pain in visual analog scale and the secondary outcome was the Knee Injury and Osteoarthritis Outcome Score. The exercise was prescribed daily for all participants throughout the study. For physical therapy (group 1), participants received superficial heat, transcutaneous electrical nerve stimulation and pulsed ultrasound. We administered a single intra-articular injection of botulinum neurotoxin type A (group 2) and three injections of hyaluronic acid (group 3) or 20% dextrose (group 4) to patients in the corresponding groups. Mixed analysis of variance showed that there was statistically significant difference between the groups in pain (P < 0.001), and Knee Injury and Osteoarthritis Outcome Score (P < 0.001). Pairwise between- and within-group comparisons showed that botulinum neurotoxin and dextrose prolotherapy were the most, and hyaluronic acid was the least efficient treatments for controlling pain and recovering function in patients. An intra-articular injection of botulinum toxin type A or dextrose prolotherapy is effective first-line treatments. In the next place stands physical therapy particularly if the patient is not willing to continue regular exercise programs. Our study was not very supportive of intra-articular injection of hyaluronic acid as an effective treatment of knee osteoarthritis. |
| Databáze: | OpenAIRE |
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