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. 2006 Apr 19;2006(2):CD005321. doi: 10.1002/14651858.CD005321.pub2

Wu 1997.

Methods Randomised
 Controlled
 Trial
 Double‐blind
 Placebo‐ controlled
 Single centre
 Per protocol analysis: n=111 knees (60 Artz, 51 Placebo)
Participants Country:
 China
 Mean age: 69
 % Female: 28
 Mean disease
 duration: 19 mth
 Duration: 26 wk
 Number randomised: 90
 [116 knees: Artz 62, PL 54]
 Inclusion:
 adults diagnosed as early OA (mild to moderate) by 4 senior orthopedic surgeons
 clinical symptoms with exercise pain, limitation of joint function and radiologic findings of bone spur, JSN, or osteosclerosis
 Exclusion:
 steroid IA injection
 functional disturbance of liver and kidney
 pregnancy
 severe degeneration of knee joints with marked joint narrowing, marked varus or valgus deformity or a large amount synovial effusion
 Baseline values:
 % pt moderate
 walking pain
 Artz: 36, PL:41
 % pt mild rest pain
 Artz:53, PL:54
Interventions Artz 2.5 ml
 5 weekly injections
 Placebo:solvent for Artz (sodium chloride phosphate solution) 2.5 ml
 5 weekly injections
 No local anesthetic drugs.
 Concurrent therapy:
 No antiinflammatory
 agent or physical therapy permitted
Outcomes pain: rest, walking, up/down stairs, flexion and extension, oppressive; swelling, ballote‐
 ment of patella
 (4 grades: no symptoms, mild, moderate,severe symptoms);
 synovial fluid (vol), range of motion (degrees), actvities of daily living (walk 10 min, up/down stairs,squat to pick up some‐
 thing, sitting on floor) impair‐
 ment (1:no problem to do,2=
 fairly possible to
 do alone,3=pos‐
 sible to do but 
 often with incon‐
 venience,4=need
 help,5=complete
 ly impossible)
 radiographic
 change (mild,
 moderate,severe), general
 improvement by pt and MD (1‐7:
 excellent improvement,
 improved, fair
 improvement, unchanged, 
 slightly worsened, wor‐
 sened, markedly
 worsened),
 overall evaluation
 effectiveness (1‐7:excellent improvement, improved, fair improvement, no change, slightly
 worsened, wor‐
 sened, extremely
 worsened), usefulness
 (1‐7: extremely good, good, fairly
 good, uncertain,
 slightly unfavor‐
 able, unfavor‐
 able, extremely unfavorable), and safety (1‐3):no 
 side effect, side
 effect but treat‐
 ment continued,
 stop treatment due to side effect
Notes Jadad's:3/5
 R‐1,B‐1,W‐1
 Pts with large amount synovial effusion excluded
Risk of bias
Bias Authors' judgement Support for judgement
Allocation concealment (selection bias) Unclear risk B ‐ Unclear