Effect of Intra-Articular Hyaluronic Injection on Postural Stability and Risk of Fall in Patients with Bilateral Knee Osteoarthritis

Abstract

Knee osteoarthritis is a common cause of disability which influences the quality of life. It is associated with impaired knee joint proprioception, which affects postural stability. Postural stability is critical for mobility and physical activities. Different types of treatment including nonsurgical and surgical are used for knee osteoarthritis. Hyaluronic acid injection is a nonsurgical popular treatment used worldwide. The aim of this study was to demonstrate the effect of hyaluronic acid injections on postural stability in individuals with bilateral knee osteoarthritis. Fifty patients aged between 50 and 70 years with mild and moderate bilateral knee osteoarthritis participated in our study. They were categorized into treatment (n = 25) and control (n = 25) groups. The treatment group received five weekly hyaluronic acid injections for both knees, whereas the control group did not receive any treatment. Postural stability and fall risk were assessed using the Biodex Stability System and clinical “Timed Up and Go” test. All the participants completed the study. The treatment group showed significant decrease in postural stability and fall risk scores after five hyaluronic acid injections. In contrast, the control group showed significant increase. This study illustrated that five intra-articular hyaluronic acid injections could significantly improve postural stability and fall risk in bilateral knee osteoarthritis patients. This trial is registered with: NCT02063373.

Viscosupplementation improves pain, function and muscle strength, but not proprioception, in patients with knee osteoarthritis: a prospective randomized trial

“…Then, in a prospective, randomized, placebo-controlled trial involving 63 patients with grade II-III knee OA, an increase in isokinetic strength and proprioception after infiltration with Hylan G-F 20 was demonstrated (31). Finally, another study including patients between 50 and 70 years old with bilateral knee OA verified an increase in postural stability and a decrease in the risk of fall in patients treated with HA infiltration compared to worsening conditions in those who received the placebo (32). It has been previously demonstrated that aspirating joint effusion and/or injecting a local anesthetic into the joint abolishes arthrogenic muscle inhibition (33-34).…”

Postural stability and risk of falls per decade of adult life – a pilot study

“…Early detection of dysfunction in system of balance is essential for prevention and implementation of procedures aimed at minimizing the risk of age-related falls, and also an important part of functional diagnostics and rehabilitation (Khalaj et al 2014). The ability to comprehensively and objectively assess the status of the balance system is essential for the effectiveness of therapy and for function-al balance abilities in sport.…”

Métodos fisioterapêuticos utilizados na reabilitação do equilíbrio postural em indivíduos com osteoartrite: uma revisão sistemática

“…A perda de controle postural nos indivíduos com OA pode estar associada à fraqueza muscular, à redução dos mecanismos proprioceptivos e à limitação da funcionalidade, consequências estas que destacam a necessidade do envolvimento do tornozelo, do quadril e do treino de marcha no tratamento do EP de indivíduos com OA, especialmente através de exercícios cinesioterapêuticos ativos 8,9,18 . Dois estudos 12,13 utilizaram técnicas cinesioterapêuticas ativas (exercícios de fortalecimento, propriocepção, equilíbrio, treino de marcha, alongamento), sendo que um 12 realizou o tratamento domiciliar e outro 13 utilizou a cinesioterapia por meio da wiiterapia (tratamento por meio de jogos eletrônicos).…”

“…Os aspectos supracitados podem atuar como fatores desencadeantes para impacto em diversos âmbitos da saúde do indivíduo com OA, como a qualidade de vida e a propriocepção articular. Esta última afeta diretamente a estabilidade postural, fundamental para a mobilidade e atividades da vida diária, gerando alterações no equilíbrio postural (EP) e risco de quedas [7][8][9][10][11] .…”