%0 Journal Article %T A Search for Factors that Predict the Efficacy of Viscosupplementation in Knee Osteoarthritis %A R. Michelle Koolaee %A H. Ralph Schumacher %A Michael Shoemaker %A Sarah Mooar %A Sally Pullman-Mooar %J Open Access Library Journal %V 1 %N 5 %P 1-8 %@ 2333-9721 %D 2014 %I Open Access Library %R 10.4236/oalib.1100700 %X
Objective:
Previous research demonstrates inconsistent effects of hyaluronate (HA)
viscosupplementation on patients with knee osteoarthritis (OA). The purpose of
this study was to evaluate factors that predict clinical response to a single
intra-articular injection of Hylan GF-20. Methods: This was an observational
study of 55 patients with knee OA, scheduled to receive intra-articular
injections of Hylan GF-20. These patients met the institution¡¯s guidelines for
use of viscosupplementation, which entails failure/intolerance of medical
management of OA. At baseline, patients completed a series of questionnaires,
including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Patient
Health Questionnaire (PHQ-9) depression score. Questionnaires were repeated at
three months post-injection. A clinical responder was someone with a change in
KOOS score which exceeded the mean minimal detectable change (MDC) values
calculated based on test-retest reliability coefficients reported in four prior
studies. Hypothesized predictors of response included PHQ-9 score, baseline
visual analog scale (VAS) pain score, age, body mass index (BMI), and Kellgren
score. Results: There were 35 responders and 20 non-responders. There were no
statistically significant differences between responders and non-responders for
any of the primary predictors. There were no differences for secondary
predictors, including history of knee injury or smoking, prior HA injection,
prior intra-articular corticosteroid injection, or location of OA. There was a
moderate negative correlation between age and change in total KOOS score (r = ¨D0.32,
p = 0.01). Conclusions: Our research did not confirm previous predictors of
response to hyaluronate injections, and highlighted the need for prospective
studies in order to answer this question.