Effect of therapeutic exercise on knee osteoarthritis after intra-articular injection of botulinum toxin type A, hyaluronate or saline: A randomized controlled trial

Osteoarthritis (OA) is a common degenerative disease that affects the vast majority of the elderly and may eventually embark on the road of the total knee arthroplasty (TKA), although controversy still exists in the medical community about the best therapies for osteoarthritis. Compared with physical therapy, oral analgesics and other non-operative treatments, intra-articular injection is more safe and effective. Moreover, intra-articular injection is much less invasive and has fewer adverse reactions than surgical treatment. This article reviews mechanism, benefits and adverse reactions of corticosteroids (CS), hyaluronic acid (HA), platelet-rich plasma (PRP), mesenchymal stem cell (MSCs), stromal vascular fraction (SVF) and other new therapies (for example: gene therapy). The application prospect of intra-articular injection was analyzed according to the recent progress in drug research.

show abstract

“…Meanwhile, it was suggested that botulinum toxin type A plus therapeutic exercise seems to get better results. 122…”

Section: Other Therapiesmentioning

confidence: 99%

<p>Development and Prospect of Intra-Articular Injection in the Treatment of Osteoarthritis: A Review</p>

Yin

Chen

Yu³

et al. 2020

JPR

View full text Add to dashboard Cite

show abstract

“…The analysis found that BoNT-A IA injection had a greater improvement than placebo in terms of the VAS pain scale and WOMAC questionnaire score in both the short-term and long-term treatment periods. Additionally, in the studies of Bao et al 16 and Mendes et al, 17 BoNT-A IA injection demonstrated an acceptable safety profile, with improvements in the Physical Component Summary-36, Mental Component Summary-36, and ultrasound measurement of synovial hypertrophy.…”

Section: Discussionmentioning

confidence: 92%

“…Among the remaining 19 studies, 14 studies were excluded for lack of useful data. Finally, 5 RCTs [13][14][15][16][17] were used to evaluate the efficacy and safety of BoNT-A in painful knee OA ( Figure 1 describes the search process in detail). Table 1 shows the baseline characteristics of these 5 studies.…”

Section: Characteristics Of Individual Studiesmentioning

confidence: 99%

The efficacy and safety of Botulinum Toxin Type A in painful knee osteoarthritis: a systematic review and meta-analysis

Zhai

Huang

2019

J Int Med Res

View full text Add to dashboard Cite

Objective: A systematic review and meta-analysis was carried out to evaluate the efficacy and safety of Botulinum Toxin Type A in painful knee osteoarthritis. Methods: The EMBASE and MEDLINE databases were searched to identify randomized controlled trials (RCTs) of Botulinum Toxin Type A in the treatment of painful knee osteoarthritis. The references of included literature were also searched. Results: Five articles involving 5 RCTs including 314 patients were included in this analysis. There was a significant difference between Botulinum Toxin Type A and placebo in the visual analog scale (VAS) pain scale and Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) questionnaire score in both the short-term ( 4 weeks) and long-term (!8 weeks) treatment period. There were no serious adverse events in the Botulinum Toxin Type A groups. Conclusions: This meta-analysis suggests that Botulinum Toxin Type A is effective and safe in the painful knee OA treatment. However, high-quality randomized controlled studies are still needed to further confirm our findings.

show abstract

“…After the screening selection through titles, abstracts, and full texts, 38 articles were screened for eligibility. Finally, six articles met the inclusion criteria and were included in this systematic review [ 36 , 37 , 38 , 39 , 40 , 41 ] (see Figure 1 ; PRISMA flow diagram). Only two studies openly disclosed having no conflict of interest concerning funding [ 36 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

The Use of Botulinum Toxin A as an Adjunctive Therapy in the Management of Chronic Musculoskeletal Pain: A Systematic Review with Meta-Analysis

Battista

Buzzatti

Gandolfi

et al. 2021

Toxins

View full text Add to dashboard Cite

Several studies have investigated the effect of botulinum toxin A (BoNT-A) for managing chronic musculoskeletal pain, bringing contrasting results to the forefront. Thus far, however, there has been no synthesis of evidence on the effect of BoNT-A as an adjunctive treatment within a multimodal approach. Hence, Medline via PubMed, EMBASE, and the Cochrane Library-CENTRAL were searched until November 2020 for randomised controlled trials (RCTs) that investigated the use of BoNT-A as an adjunctive therapy for chronic musculoskeletal pain. The risk of bias (RoB) and the overall quality of the studies were assessed through RoB 2.0 and the GRADE approach, respectively. Meta-analysis was conducted to analyse the pooled results of the six included RCTs. Four were at a low RoB, while two were at a high RoB. The meta-analysis showed that BoNT-A as an adjunctive therapy did not significantly decrease pain compared to the sole use of traditional treatment (SDM −0.89; 95% CI −1.91; 0.12; p = 0.08). Caution should be used when interpreting such results, since the studies displayed very high heterogeneity (I = 94%, p < 0.001). The overall certainty of the evidence was very low. The data retrieved from this systematic review do not support the use of BoNT-A as an adjunctive therapy in treating chronic musculoskeletal pain.

show abstract

Effect of therapeutic exercise on knee osteoarthritis after intra-articular injection of botulinum toxin type A, hyaluronate or saline: A randomized controlled trial

Abstract: Therapeutic exercise plus botulinum toxin type A or hyaluronate injection can significantly reduce pain and improve knee functioning. Botulinum toxin type A plus therapeutic exercise appears to be more effective.

Cited by 29 publications

References 33 publications

<p>Development and Prospect of Intra-Articular Injection in the Treatment of Osteoarthritis: A Review</p>

<p>Development and Prospect of Intra-Articular Injection in the Treatment of Osteoarthritis: A Review</p>

The efficacy and safety of Botulinum Toxin Type A in painful knee osteoarthritis: a systematic review and meta-analysis

The Use of Botulinum Toxin A as an Adjunctive Therapy in the Management of Chronic Musculoskeletal Pain: A Systematic Review with Meta-Analysis

Contact Info

Product

Resources

About