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Effects of Botulinum Toxin Landmark‐Guided Intra‐articular Injection in Subjects With Knee Osteoarthritis
Author(s) -
Hsieh LinFen,
Wu ChiaWei,
Chou ChingChieh,
Yang SaiWei,
Wu ShihHui,
Lin YiJia,
Hsu WeiChun
Publication year - 2016
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2016.05.009
Subject(s) - medicine , osteoarthritis , womac , visual analogue scale , randomized controlled trial , rehabilitation , anesthesia , physical therapy , alternative medicine , pathology
Background Increasing evidence has suggested that botulinum toxin A (BoNT/A) can inhibit the release of selected neuropeptide transmitters from primary sensory neurons. Thus, intra‐articular (IA) injection therapies with BoNT/A may reduce pain in patients with knee osteoarthritis (OA). Objective To investigate the effects of landmark‐guided IA injection of BoNT/A on patients with knee OA. Design A prospective randomized controlled trial. Setting A rehabilitation clinic of a private teaching hospital. Patients A total of 46 patients with symptomatic knee OA (mostly Kellgren‐Lawrence grade 2‐3). Methods The patients were randomly assigned to 1 of the following groups: BoNT/A group (BoNT/A injection; n = 21) or control group (education only; n = 20). The patients in the BoNT/A group received an IA injection of 100 units of BoNT/A into the affected knee. Main Outcome Measures The short‐term (1 week posttreatment) and long‐term (6 months posttreatment) effects were evaluated using a pain visual analogue scale (VAS) and questionnaires concerning functional status, including the Lequesne and Western Ontario and McMaster Universities (WOMAC) indexes. Results The between‐group comparison revealed significant differences with regard to the pain VAS score at 1 week ( P < .001) and at 6 months ( P = .001) posttreatment. Similar findings for the between‐group comparison were observed for the WOMAC and Lequesne indexes at 6 months ( P < .05) posttreatment. The pain VAS score in the BoNT/A group significantly decreased from 5.05 ± 1.12 (pretreatment) to 2.89 ± 1.04 at 1 week ( P < .001) and 3.45 ± 1.70 at 6 months posttreatment ( P < .001) but not in the control group ( P = .476). Conclusions The IA injection of BoNT/A provided pain relief and improved functional abilities in patients with knee OA in both the short‐ and long‐term follow‐up. Level of Evidence I