The study shows single 5 ml dose regime comparing well with conventional three doses of 2.5 ml of intra-articular GO-ON HA injected at weekly intervals and confirms good efficacy, tolerability and safety of single larger dose of GO-ON knee intra-articular injection.
Purpose: A recent 3-month randomized, open-label controlled trial found that the intra-articular hyaluronic acid injection (GO-ON®) given as a single dose of 5 mL is as effective and safe as three repeated doses of 2.5 mL in patients with knee osteoarthritis. However, the information on the long-term efficacy and economic implications of the single-dose regimen is still limited. Hence, this follow-up study was designed to compare the effectiveness and costs of the two regimens 12 months following the treatment. Methods: All the 127 patients, who received either three repeated doses ( n = 64) or a single dose ( n = 63) of GO-ON in the previous trial, were followed up in month 12 following the treatment. The effectiveness of both the regimens was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the mean WOMAC scores were compared with those recorded at the baseline and in month 3. Additionally, the total treatment costs of the two regimens, taking account of both direct and indirect costs, were computed and compared. Results: A total of 125 patients (98.4%) completed the assessment. Despite the reduction of the overall mean WOMAC score from 39.24 to 19.93 ( p < 0.001) in the first 3 months following the treatment with GO-ON, no further changes were observed up to month 12 ( p > 0.95). In the meantime, the two regimens did not differ in the mean WOMAC scores ( p = 0.749) and in the subscale scores for pain ( p = 0.970), stiffness ( p = 0.526), and physical functioning ( p = 0.667) in month 12. The cost for single-dose injection was found to be approximately 30% lower compared to the repeated doses. Conclusion: These findings indicate that the single larger dose of GO-ON is as effective as the repeated doses over 12 months, and yet the total treatment cost is lowered.
During routine dissection for the undergraduate medical students, we encountered an unusual, additional muscle in the anterior compartment of the forearm. This muscle took origin from the anterior surface of the radius in common with the flexor digitorum superficialis muscle. It had a tendon of origin and a tendon of insertion. Its fleshy radial belly and the tendon of insertion, crossed superficial to the median nerve. The muscle was inserted partly to the flexor retinaculum and partly to the undersurface of palmar aponeurosis. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for hand surgeons as it could possibly compress the median nerve because of its close relationship to it.
The peroneus tertius (PT) is a small muscle with a small single tendon which gets inserted to the dorsal surface of the 5 th metatarsal base. Normally, the tendon of extensor digitorum longus (EDL) muscle divides into 4 slips on the dorsum of the foot which go to the lateral 4 toes. Variations in the tendons of these muscles are very rare. We observed a case where the tendon of EDL divided into only 3 slips which were inserted into the 2 nd , 3 rd and 4 th toes through dorsal digital expansion. The PT tendon was quite thick and it divided into 2 slips. The lateral slip was getting inserted to the dorsal surface of the 5 th metatarsal base and medial slip was continuing on to the little toe to form the dorsal digital expansion. This variation was observed during routine dissection on the left lower limb of about 55 year old female cadaver. Such anomalies are important clinically to the treating surgeon, being a tendon of importance in normal function and surgeries of the foot. Functional significance and the clinical relevance of the variations are discussed.
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