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Changes in sagittal ground reaction forces after intra-articular hyaluronate injections for knee osteoarthritis
Simon F Tang1, Carl P Chen, Max J Chen
1Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kwei-Shan, Tao-Yuan 333, Taiwan. fttang@adm.cgmh.org.tw
Objectives:
To examine the gait patterns and the sagittal ground reaction forces (GRFs) in persons with knee osteoarthritis (OA) after intra-articular injection of hyaluronate and to investigate the duration of its treatment effectiveness.
Design:
Case-comparison study.
Setting:
Gait laboratory in a tertiary care center.
Participants:
Fifteen subjects (30 knees) with symptomatic knee OA (stage I or II, according to the Ahlbäck grading system), and 15 age-, mass-, and gender-matched non-OA control subjects (30 knees).
Intervention:
After initial gait analysis, the group with knee OA received 5 weekly intra-articular injections of hyaluronate to bilateral knees. Gait analysis was performed again for the group with knee OA after the completion of hyaluronate injections.
Main Outcome Measures:
Forceplate sagittal GRFs and gait parameters of velocity, cadence, step length, and stride time.
Results:
The distinctive 2-peak force vector GRF was lost in persons with knee OA. The first peak rise time was significantly delayed (P<.05). The group with knee OA also revealed slower walking velocity and cadence, as well as longer stride time, than the control group (P<.05). The distinctive 2-peak force vector GRF diagram could be recovered in patients with knee OA after the completion of hyaluronate injections.
Conclusions:
Gait patterns and GRFs improved significantly after intra-articular knee injection of hyaluronate in persons with Ahlbäck stages I and II knee OA. The clinical treatment effect was immediate and may last for 6 months or more.