Injection Site Diversity Influences HA Distribution and Clinical Results in CP and KOA

NCT ID: NCT03600571

Last Updated: 2018-07-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

164 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-08-30

Study Completion Date

2018-05-01

Brief Summary

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In order to investigate the difference of intra-articular hyaluronate's distribution and compare the clinical outcomes of viscosupplementation for mild-to-moderate knee osteoarthritis (mKOA) between the anteromedial (AM) and medial midpatellar (MMP) approach groups. This study included two parts, cadaver study (n=64) and random controlled trial (n=100). Hyaluronic acid (HA) traced by methylene blue was injected into the knee, and the intra-articular distribution of HA was assessed using a five-point scale in the cadaver study. The clinical outcomes of 5-weekly injections of HA were evaluated by WOMAC and Lequesne index and the follow-up times were at weeks 1, 2, 3, 4, 5, 14, and 24 after the injections in the random controlled trial.

Detailed Description

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Conditions

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Osteoarthritis, Knee Hyaluronan

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

64 osteoarthritic knees of cadavers were randomly assigned to two groups: the anteromedial (AM) group (n=32) and the medial midpatellar (MMP) group (n=32).

100 patients with unilateral mKOA were enrolled and randomly divided into two groups according to the injection portal of HA: the AM group (n=50) and the MMP group (n=50).
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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AM groups in cadavers study

32 osteoarthritic knees of cadavers were randomly assigned to the AM group (injection medial from patella tendon towards intercondylar notch was performed with the target knee 90° flexion). Hyaluronic acid (HA) traced by methylene blue was injected into the knee, and the intra-articular distribution of HA was assessed using a five-point scale.

Group Type EXPERIMENTAL

anteromedial (AM) portal

Intervention Type PROCEDURE

injection medial from patella tendon towards intercondylar notch was performed with the target knee 90° flexion

MMP groups in cadavers study

32 osteoarthritic knees of cadavers were randomly assigned to the MMP group (injection medial under horizontal patella midline was administrated with the lower limb extension). Hyaluronic acid (HA) traced by methylene blue was injected into the knee, and the intra-articular distribution of HA was assessed using a five-point scale.

Group Type EXPERIMENTAL

medial midpatellar (MMP) portal

Intervention Type PROCEDURE

injection medial under horizontal patella midline was administrated with the lower limb extension

AM groups in random controlled trial

50 patients with unilateral mKOA were enrolled and randomly into the AM group (injection medial from patella tendon towards intercondylar notch was performed with the target knee 90° flexion).The clinical outcomes of 5-weekly injections of HA were evaluated by WOMAC and Lequesne index. The follow-up times were at weeks 1, 2, 3, 4, 5, 14, and 24 after the injections.

Group Type EXPERIMENTAL

anteromedial (AM) portal

Intervention Type PROCEDURE

injection medial from patella tendon towards intercondylar notch was performed with the target knee 90° flexion

MMP groups in random controlled trial

50 patients with unilateral mKOA were enrolled and randomly into the MMP group (injection medial under horizontal patella midline was administrated with the lower limb extension).The clinical outcomes of 5-weekly injections of HA were evaluated by WOMAC and Lequesne index. The follow-up times were at weeks 1, 2, 3, 4, 5, 14, and 24 after the injections.

Group Type EXPERIMENTAL

medial midpatellar (MMP) portal

Intervention Type PROCEDURE

injection medial under horizontal patella midline was administrated with the lower limb extension

Interventions

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medial midpatellar (MMP) portal

injection medial under horizontal patella midline was administrated with the lower limb extension

Intervention Type PROCEDURE

anteromedial (AM) portal

injection medial from patella tendon towards intercondylar notch was performed with the target knee 90° flexion

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Symptomatic unilateral mild-to-moderate knee osteoarthritis (mKOA) that were defined by the American College of Rheumatology criteria
* Kellgren-Lawrence grade 2 or 3
* Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index (Likert version 3.1) pain subscale reached 10 or greater

Exclusion Criteria

* Pregnancy, acute fracture, rheumatoid arthritis, gouty arthritis, traumatic arthritis, inflammatory arthritis
* Oral Celebrex within 2 weeks, HA and lidocaine allergy, intra-articular injection of HA or corticosteroid to the target knee within the past 6 months
* Surgery in the target knee within the past 6 months, OA of the target knee with K-L grade 4
* Active liver and renal disease, cardiovascular and cerebrovascular disease.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nanfang Hospital, Southern Medical University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Nanfang Hospital

Guangzhou, Guangdong, China

Site Status

Countries

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China

Other Identifiers

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NFEC-2014-074

Identifier Type: -

Identifier Source: org_study_id

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