| Methods |
Randomised
Controlled
Trial
Parallel group
Blinded physical therapist
Single centre |
| Participants |
Country:
Turkey
Mean age: 56.6
% Female: 86
Mean disease duration: NR
Duration: 18 mth
Number randomised: 105
(200 knees)
(HA 52, PE 53)
Inclusion:
primary OA of the knee as defined by ACR criteria,
Kellgren Law‐
rence grade III with joint space narrowing and sclerosis of the subchondral bone
Exclusion:
radiographic appearance of pseudocysts as defined by Kellgren Law‐
rence Grade IV,
unable to discontinue NSAID for duration of study,
previous fracture around the knee,
inflammatory arthritis, previous intraarticular injections or any other invasive procedure in the knee,
significant comorbidity (renal, hepatic or heart disease),
chicken or egg allergy
Baseline values:
pain during activity
HA: 4.0, PE: 4.5
pain at rest
HA: 7.8, PE: 9.1
pain during climbing stairs
HA: 2.5, PE: 2.5
pain during transfer activity
HA: 2.9, PE: 3.1
walking distance
HA: 8.1, PE: 7.9
range of motion
HA: 113.2,
PE: 114.4
total HSS score
HA: 62.6,
PE: 65.4 |
| Interventions |
Hylan G‐F 20
(Synvisc) 3 weekly injections at baseline, Week 1 and Week 3,
Exercise programme included a series of progressive, simple range of motion and resistance exercises for 6 wk. Home‐based regimen but patients came to hospital at baseline and weeks 1, 2, 3 and 6 to learn the exercises. |
| Outcomes |
Knee function evaluated by the Hospital for Special Surgery knee score criteria that is based on a total of 100 points with the score divided into 7 categories: pain, function, range of motion, muscle, strength, flexion deformity, instability, and subtractions. scores 85‐100 excellent, 84‐70 good, 60‐69 fair and less than 60 poor‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
pain during activity, pain at rest,
pain during climbing stairs, pain during transfer activity, walking distance and range of motion all but walking distance and ROM are graded by HSS score (i.e. pain) |
| Notes |
Jadad's: 3/5
R‐2, B‐0, W‐1
95 patients had bilateral OA; 48 in the HA group and 47 in the PE group. 10 patients had unilateral OA: 4 HA and 6 PE |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Allocation concealment (selection bias) |
Unclear risk |
B ‐ Unclear |
