The Effect of Intra-Articular Injections of Hyaluronic Acid for the Treatment of Trapezio-Metacarpal Joint Osteoarthritis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Protocol and Study Design
2.2. Inclusion and Exclusion Criteria
- ○
- they were aged 40 years old and above;
- ○
- they had clinical symptoms for over 6 months (TMC joint pain, joint stiffness, decreased mobility, deformity, instability, functional impairment);
- ○
- they had radiological observations indicative of TMOA (Eaton and Litter Stage II or III); and
- ○
- they had a NRS score of pain ≥4 for over 6 months.
- ○
- they had a history of allergic reactions to an IA injection of HA;
- ○
- they received IA injections of corticosteroids or other medical devices during the previous 3 months;
- ○
- they underwent rehabilitation and physical therapies during the previous 4 weeks;
- ○
- they were pregnant;
- ○
- they had a heart pacemaker;
- ○
- they had coagulopathy;
- ○
- they had neurological degenerative and non-degenerative diseases;
- ○
- they had a history of rheumatic or metabolic or other autoimmune diseases; or
- ○
- they had a history of severe hand and thumb trauma.
2.3. Patients’ Screening, Baseline and Follow-Up Visits
2.4. Therapeutic Intervention
2.5. Outcomes and Follow-Up Periods
2.5.1. Primary Outcomes—Pain and Function
2.5.2. Secondary Outcomes—Adverse Events and Disability/Quality of Life
2.6. Calculation of Sample Size
2.7. Statistical Analysis
3. Results
3.1. Primary Outcomes—Pain and Function
3.2. Secondary Outcomes—Safety and Disability/Quality of Life Perception
4. Discussion
Limitations of the Present Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Cormier, G.; Le Goff, B.; Denis, A.; Varin, S.; Auzanneau, L.; Dimet, J.; Le Thuaut, A. Corticosteroids injections versus corticosteroids with hyaluronic acid injections in rhizarthrosis: The randomised multicentre RHIZ’ART trial study protocol. BMJ Open. 2019, 9, e022553. [Google Scholar] [CrossRef] [PubMed]
- Tenti, S.; Cheleschi, S.; Mondanelli, N.; Giannotti, S.; Fioravanti, A. New Trends in Injection-Based Therapy for Thumb-Base Osteoarthritis: Where Are We and where Are We Going? Front. Pharmacol. 2021, 12, 637904. [Google Scholar] [CrossRef] [PubMed]
- Spielman, A.F.; Sankaranarayanan, S.; Lessard, A.S. Joint Preserving Treatments for Thumb CMC Arthritis. Hand Clin. 2022, 38, 169–181. [Google Scholar] [CrossRef] [PubMed]
- Hasiba-Pappas, S.; Kamolz, L.P.; Luze, H.; Nischwitz, S.P.; Lumenta, D.B.; Winter, R. Regenerative Therapies for Basal Thumb Arthritis-A Systematic Review. Int. J. Mol. Sci. 2023, 24, 14909. [Google Scholar] [CrossRef]
- Wilkens, S.C.; Meghpara, M.M.; Ring, D.; Coert, J.H.; Jupiter, J.B.; Chen, N.C. Trapeziometacarpal Arthrosis. JBJS Rev. 2019, 7, e8. [Google Scholar] [CrossRef] [PubMed]
- Bakri, K.; Moran, S.L. Thumb carpometacarpal arthritis. Plast. Reconstr. Surg. 2015, 135, 508–520. [Google Scholar] [CrossRef] [PubMed]
- Pickrell, B.B.; Eberlin, K.R. Thumb Basal Joint Arthritis. Clin. Plast. Surg. 2019, 46, 407–413. [Google Scholar] [CrossRef] [PubMed]
- Villafañe, J.H.; Valdes, K.; Pedersini, P.; Berjano, P. Thumb carpometacarpal osteoarthritis: A musculoskeletal physiotherapy perspective. J. Bodyw. Mov. Ther. 2019, 23, 908–912. [Google Scholar] [CrossRef] [PubMed]
- Wang, P.H.; Wu, C.H.; Ma, C.H.; Chiu, Y.C.; Wu, P.T.; Jou, I.M. Comparison of intra-articular injection of ArtiAid®-Mini with Ostenil®-Mini for trapeziometacarpal osteoarthritis: A double-blind, prospective, randomized, non-inferiority trial. Jt. Dis. Relat. Surg. 2023, 34, 50–57. [Google Scholar] [CrossRef]
- Tortora, S.; Messina, C.; Albano, D.; Serpi, F.; Corazza, A.; Carrafiello, G.; Sconfienza, L.M.; Gitto, S. Ultrasound-guided musculoskeletal interventional procedures around the elbow, hand and wrist excluding carpal tunnel procedures. J. Ultrason. 2021, 21, e169–e176. [Google Scholar] [CrossRef]
- Oo, W.M.; Hunter, D.J. Efficacy, Safety, and Accuracy of Intra-articular Therapies for Hand Osteoarthritis: Current Evidence. Drugs Aging 2023, 40, 1–20. [Google Scholar] [CrossRef] [PubMed]
- de Sire, A.; Marotta, N.; Sconza, C.; Lippi, L.; Ferrante, V.D.; Respizzi, S.; Invernizzi, M.; Ammendolia, A. Oxygen-ozone therapy for pain relief in patients with trapeziometacarpal osteoarthritis: A proof-of-concept study. Disabil. Rehabil. 2024. Epub ahead of print. [Google Scholar] [CrossRef] [PubMed]
- Valachová, K.; Šoltés, L. Hyaluronan as a Prominent Biomolecule with Numerous Applications in Medicine. Int. J. Mol. Sci. 2021, 22, 7077. [Google Scholar] [CrossRef] [PubMed]
- Turley, E.A.; Noble, P.W.; Bourguignon, L.Y. Signaling properties of hyaluronan receptors. J. Biol. Chem. 2002, 277, 4589–4592. [Google Scholar] [CrossRef]
- Balazs, E.A. Analgesic effect of elastoviscous hyaluronan solutions and the treatment of arthritic pain. Cells Tissues Organs 2003, 174, 49–62. [Google Scholar] [CrossRef] [PubMed]
- Pinto, I.; Duarte, C.; Vilabril, F.; Brito, I. Impact of Hyaluronic Acid Treatment on Rhizarthrosis: A Systematic Review. ARP Rheumatol. 2022. Epub ahead of print. [Google Scholar] [PubMed]
- Tran, K.; Loshak, H. Intra-Articular Hyaluronic Acid for Viscosupplementation in Osteoarthritis of the Hand, Shoulder, and Temporomandibular Joint: A Review of Clinical Effectiveness and Safety [Internet]; Canadian Agency for Drugs and Technologies in Health: Ottawa, ON, USA, 2019. [Google Scholar]
- Schulz, K.F.; Altman, D.G.; Moher, D.; CONSORT Group. CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. J. Clin. Epidemiol. 2010, 63, 834–840. [Google Scholar] [CrossRef]
- Spaans, A.J.; van Minnen, L.P.; Kon, M.; Schuurman, A.H.; Schreuders, A.R.; Vermeulen, G.M. Conservative treatment of thumb base osteoarthritis: A systematic review. J. Hand Surg. Am. 2015, 40, 16–21.e1–6. [Google Scholar] [CrossRef] [PubMed]
- Esteban Lopez, L.M.J.; Hoogendam, L.; Vermeulen, G.M.; Tsehaie, J.; Slijper, H.P.; Selles, R.W.; Wouters, R.M.; The Hand-Wrist Study Group. Long-Term Outcomes of Nonsurgical Treatment of Thumb Carpometacarpal Osteoarthritis: A Cohort Study. J. Bone Jt. Surg. Am. 2023, 105, 1837–1845. [Google Scholar] [CrossRef]
- Orlandi, D.; Corazza, A.; Silvestri, E.; Serafini, G.; Savarino, E.V.; Garlaschi, G.; Mauri, G.; Cimmino, M.A.; Sconfienza, L.M. Ultrasound-guided procedures around the wrist and hand: How to do. Eur. J. Radiol. 2014, 83, 1231–1238. [Google Scholar] [CrossRef]
- Gummesson, C.; Ward, M.M.; Atroshi, I. The shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH): Validity and reliability based on responses within the full-length DASH. BMC Musculoskelet. Disord. 2006, 7, 44. [Google Scholar] [CrossRef]
- Kodraliu, G.; Mosconi, P.; Groth, N.; Carmosino, G.; Perilli, A.; Gianicolo, E.A.; Rossi, C.; Apolone, G. Subjective health status assessment: Evaluation of the Italian version of the SF-12 Health Survey. Results from the MiOS Project. J. Epidemiol. Biostat. 2001, 6, 305–316. [Google Scholar] [CrossRef] [PubMed]
- Ware, J.E., Jr. SF-36 health survey update. Spine 2000, 25, 3130–3139. [Google Scholar] [CrossRef] [PubMed]
- Ware, J., Jr.; Kosinski, M.; Keller, S.D. A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Med. Care 1996, 34, 220–233. [Google Scholar] [CrossRef] [PubMed]
- Coaccioli, S.; Sarzi-Puttini, P.; Zis, P.; Rinonapoli, G.; Varrassi, G. Osteoarthritis: New Insight on Its Pathophysiology. J. Clin. Med. 2022, 11, 6013. [Google Scholar] [CrossRef] [PubMed]
- Goldring, S.R.; Goldring, M.B. Changes in the osteochondral unit during osteoarthritis: Structure, function and cartilage-bone crosstalk. Nat. Rev. Rheumatol. 2016, 12, 632–644. [Google Scholar] [CrossRef] [PubMed]
- Cai, X.; Yuan, S.; Zeng, Y.; Wang, C.; Yu, N.; Ding, C. New Trends in Pharmacological Treatments for Osteoarthritis. Front. Pharmacol. 2021, 12, 645842. [Google Scholar] [CrossRef]
- Algar, L.; Naughton, N.; Ivy, C.; Loomis, K.; McGee, C.; Strouse, S.; Fedorczyk, J. Assessment and treatment of nonsurgical thumb carpometacarpal joint osteoarthritis: A modified Delphi-based consensus paper of the American Society of Hand Therapists. J. Hand Ther. 2023, 36, 982–999. [Google Scholar] [CrossRef]
- Kroon, F.P.B.; Carmona, L.; Schoones, J.W.; Kloppenburg, M. Efficacy and safety of non-pharmacological, pharmacological and surgical treatment for hand osteoarthritis: A systematic literature review informing the 2018 update of the EULAR recommendations for the management of hand osteoarthritis. RMD Open 2018, 4, e000734. [Google Scholar] [CrossRef] [PubMed]
- Kloppenburg, M.; Kroon, F.P.; Blanco, F.J.; Doherty, M.; Dziedzic, K.S.; Greibrokk, E.; Haugen, I.K.; Herrero-Beaumont, G.; Jonsson, H.; Kjeken, I.; et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann. Rheum. Dis. 2019, 78, 16–24. [Google Scholar] [CrossRef]
- Bernetti, A.; Agostini, F.; Paoloni, M.; Raele, M.V.; Farì, G.; Megna, M.; Mangone, M. Could Hyaluronic Acid Be Considered as a Senomorphic Agent in Knee Osteoarthritis? A Systematic Review. Biomedicines 2023, 11, 2858. [Google Scholar] [CrossRef]
- Ajeeshkumar, K.K.; Vishnu, K.V.; Navaneethan, R.; Raj, K.; Remyakumari, K.R.; Swaminathan, T.R.; Suseela, M.; Asha, K.K.; Sreekanth, G.P. Proteoglycans isolated from the bramble shark cartilage show potential anti-osteoarthritic properties. Inflammopharmacology 2019, 27, 175–187. [Google Scholar] [CrossRef] [PubMed]
- More, S.; Kotiya, A.; Kotia, A.; Ghosh, S.K.; Spyrou, L.A.; Sarris, I.E. Rheological properties of synovial fluid due to viscosupplements: A review for osteoarthritis remedy. Comput. Methods Programs Biomed. 2020, 196, 105644. [Google Scholar] [CrossRef] [PubMed]
- Bernetti, A.; Mangone, M.; Paolucci, T.; Santilli, V.; Verna, S.; Agostini, F.; Paoloni, M. Evaluation of the efficacy of intra-articular injective treatment with reticular hyaluronic acid (Mo.Re. Technology) in amateur athletes with over-use gonarthrosis. Med. Sport 2020, 73, 127–139. [Google Scholar] [CrossRef]
- Castro-Calderón, A.; Roccuzzo, A.; Ferrillo, M.; Gada, S.; González-Serrano, J.; Fonseca, M.; Molinero-Mourelle, P. Hyaluronic acid injection to restore the lost interproximal papilla: A systematic review. Acta Odontol. Scand. 2022, 80, 295–307. [Google Scholar] [CrossRef] [PubMed]
- Agostini, F.; Ferrillo, M.; Bernetti, A.; Finamore, N.; Mangone, M.; Giudice, A.; Paoloni, M.; de Sire, A. Hyaluronic acid injections for pain relief and functional improvement in patients with temporomandibular disorders: An umbrella review of systematic reviews. J. Oral Rehabil. 2023, 50, 1518–1534. [Google Scholar] [CrossRef] [PubMed]
- Lippi, L.; Ferrillo, M.; Turco, A.; Folli, A.; Moalli, S.; Refati, F.; Perrero, L.; Ammendolia, A.; de Sire, A.; Invernizzi, M. Multidisciplinary Rehabilitation after Hyaluronic Acid Injections for Elderly with Knee, Hip, Shoulder, and Temporomandibular Joint Osteoarthritis. Medicina 2023, 59, 2047. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Familiari, F.; Ammendolia, A.; Rupp, M.C.; Russo, R.; Pujia, A.; Montalcini, T.; Marotta, N.; Mercurio, M.; Galasso, O.; Millett, P.J.; et al. Efficacy of intra-articular injections of hyaluronic acid in patients with glenohumeral joint osteoarthritis: A systematic review and meta-analysis. J. Orthop. Res. 2023, 41, 2345–2358. [Google Scholar] [CrossRef] [PubMed]
- Snetkov, P.; Zakharova, K.; Morozkina, S.; Olekhnovich, R.; Uspenskaya, M. Hyaluronic Acid: The Influence of Molecular Weight on Structural, Physical, Physico-Chemical, and Degradable Properties of Biopolymer. Polymers 2020, 12, 1800. [Google Scholar] [CrossRef] [PubMed]
- Bernetti, A.; Agostini, F.; Alviti, F.; Giordan, N.; Martella, F.; Santilli, V.; Paoloni, M.; Mangone, M. New Viscoelastic Hydrogel Hymovis MO.RE. Single Intra-articular Injection for the Treatment of Knee Osteoarthritis in Sportsmen: Safety and Efficacy Study Results. Front. Pharmacol. 2021, 12, 673988. [Google Scholar] [CrossRef]
- Veronese, N.; Smith, L.; Bolzetta, F.; Cester, A.; Demurtas, J.; Punzi, L. Efficacy of conservative treatments for hand osteoarthritis: An umbrella review of interventional studies. Wien. Klin. Wochenschr. 2021, 133, 234–240. [Google Scholar] [CrossRef]
- Perugia, D.; Lanzetti, R.; Vetrano, M.; Vavala, C.; Pascali, S.; Nusca, S.M.; Santoboni, F.; Vulpiani, M.C. Mind Term Effects of a Single Injecton versus three Injecton of Hyaluronic Acid in Patients with Rhizarthrosis. Muscle Ligaments Tendons J. 2020, 10, 130. [Google Scholar] [CrossRef]
- Monfort, J.; Rotés-Sala, D.; Segalés, N.; Montañes, F.J.; Orellana, C.; Llorente-Onaindia, J.; Mojal, S.; Padró, I.; Benito, P. Comparative efficacy of intra-articular hyaluronic acid and corticoid injections in osteoarthritis of the first carpometacarpal joint: Results of a 6-month single-masked randomized study. Jt. Bone Spine 2015, 82, 116–121. [Google Scholar] [CrossRef] [PubMed]
- Umphrey, G.L.; Brault, J.S.; Hurdle, M.F.; Smith, J. Ultrasound-guided intra-articular injection of the trapeziometacarpal joint: Description of technique. Arch. Phys. Med. Rehabil. 2008, 89, 153–156. [Google Scholar] [CrossRef] [PubMed]
- Conrozier, T.; Raman, R.; Chevalier, X.; Henrotin, Y.; Monfort, J.; Diraçoglù, D.; Bard, H.; Baron, D.; Jerosch, J.; Richette, P.; et al. Viscosupplementation for the treatment of osteoarthritis. The contribution of EUROVISCO group. Ther. Adv. Musculoskelet. Dis. 2021, 13, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Di Sante, L.; Cacchio, A.; Scettri, P.; Paoloni, M.; Ioppolo, F.; Santilli, V. Ultrasound-guided procedure for the treatment of trapeziometacarpal osteoarthritis. Clin. Rheumatol. 2011, 30, 1195–1200. [Google Scholar] [CrossRef] [PubMed]
- Frizziero, A.; Maffulli, N.; Masiero, S.; Frizziero, L. Six-months pain relief and functional recovery after intra-articular injections with hyaluronic acid (mw 500–730 KDa) in trapeziometacarpal osteoarthritis. Muscles Ligaments Tendons J. 2014, 4, 256–261. [Google Scholar] [CrossRef] [PubMed]
- Copeland, A.; Gallo, L.; Weber, C.; Moltaji, S.; Gallo, M.; Murphy, J.; Axelrod, D.; Thoma, A. Reporting Outcomes and Outcome Measures in Thumb Carpometacarpal Joint Osteoarthritis: A Systematic Review. J. Hand Surg. Am. 2021, 46, 65.e1–65.e11. [Google Scholar] [CrossRef]
- Calfee, R.; Chu, J.; Sorensen, A.; Martens, E.; Elfar, J. What Is the Impact of Comorbidities on Self-rated Hand Function in Patients With Symptomatic Trapeziometacarpal Arthritis? Clin. Orthop. Relat. Res. 2015, 473, 3477–3483. [Google Scholar] [CrossRef]
Characteristics of the Participants at Baseline | Participants (n = 29) |
---|---|
Sex, M/F (%M) | 6/23 (20.68%) |
Age (mean ± SD) | 65.0 ± 8.7 years |
Body weight (mean ± SD) | 65.5 ± 12.0 kg |
Body height (mean ± SD) | 157.0 ± 9.2 cm |
Side of the affected hand, left/right (%Left) | 16/13 (55.17%) |
Dominant hand, left/right (%Left) | 1/28 (3.45%) |
T0 | T1 | T2 | T3 | T4 | ANOVA p-Value | |
---|---|---|---|---|---|---|
Participants (n = 29) | Participants (n = 29) | Participants (n = 27) | Participants (n = 23) | Participants (n = 15) | ||
Pain at rest, NRS (mean ± SD) | 5.31 ± 1.87 | 1.07 ± 1.71 | 0.93 ± 1.84 | 1.09 ± 2.04 | 1.00 ± 2.24 | <0.001 |
Pain during movements, NRS (mean ± SD) | 7.86 ± 1.66 | 3.14 ± 2.86 | 2.85 ± 2.78 | 3.32 ± 3.15 | 4.53 ± 3.09 | <0.001 |
Night pain, NRS (mean ± SD) | 2.07 ± 3.12 | 0.45 ± 1.35 | 0.41 ± 1.53 | 0.83 ± 1.99 | 0.93 ± 2.49 | 0.006 |
Mean pain during the day, NRS (mean ± SD) | 5.48 ± 1.81 | 1.17 ± 1.75 | 1.22 ± 2.15 | 1.61 ± 2.59 | 1.53 ± 2.47 | <0.001 |
Tenderness before injections, Yes/No (%Yes) | 2/29 (6.9%) | 0/29 (0%) | 0/27 (0%) | 0/23 (0%) | 0/15 (0%) |
T0 | T1 | T2 | T3 | T4 | ANOVA p-Value | |
---|---|---|---|---|---|---|
Lateral pinch (kg), mean (±SD) | 6.15 ± 2.23 | 6.78 ± 2.24 | 6.47 ± 1.98 | 6.60 ± 2.21 | 6.40 ± 2.48 | 0.693 |
Three-point pinch (kg), mean (±SD) | 5.28 ± 1.73 | 6.06 ± 1.98 | 5.96 ± 1.87 | 5.52 ± 2.12 | 5.85 ± 2.05 | 0.061 |
Two-point pinch (kg), mean (±SD) | 4.09 ± 1.36 | 4.69 ± 1.30 | 4.66 ± 1.45 | 4.00 ± 1.58 | 4.80 ± 1.31 | 0.060 |
Handgrip (kg), mean (±SD) | 25.76 ± 9.91 | 28.86 ± 9.66 | 28.37 ± 9.07 | 28.27 ± 9.55 | 26.55 ± 9.21 | 0.071 |
T0 | T1 | T2 | T3 | T4 | ANOVA p-Value | |
---|---|---|---|---|---|---|
Quick-DASH (mean ± SD) | 50.86 ± 19.91 | 22.02 ± 16.29 | 22.9 ± 19.25 | 13.18 ± 20.03 | 35.62 ± 23.97 | <0.001 |
SF-12 PCS (mean ± SD) | 39.73 ± 7.10 | 45.33 ± 7.97 | 47.52 ± 8.03 | 44.26 ± 9.23 | 44.10 ± 7.91 | 0.034 |
SF-12 MCS (mean ± SD) | 46.06 ± 11.00 | 50.41 ± 11.92 | 52.05 ± 9.81 | 51.39 ± 8.50 | 49.83 ± 7.14 | 0.15 |
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Agostini, F.; Bressanin, E.; de Sire, A.; Finamore, N.; Alviti, F.; Santilli, V.; Bernetti, A.; Paoloni, M.; Mangone, M. The Effect of Intra-Articular Injections of Hyaluronic Acid for the Treatment of Trapezio-Metacarpal Joint Osteoarthritis. J. Pers. Med. 2024, 14, 806. https://doi.org/10.3390/jpm14080806
Agostini F, Bressanin E, de Sire A, Finamore N, Alviti F, Santilli V, Bernetti A, Paoloni M, Mangone M. The Effect of Intra-Articular Injections of Hyaluronic Acid for the Treatment of Trapezio-Metacarpal Joint Osteoarthritis. Journal of Personalized Medicine. 2024; 14(8):806. https://doi.org/10.3390/jpm14080806
Chicago/Turabian StyleAgostini, Francesco, Elena Bressanin, Alessandro de Sire, Nikolaos Finamore, Federica Alviti, Valter Santilli, Andrea Bernetti, Marco Paoloni, and Massimiliano Mangone. 2024. "The Effect of Intra-Articular Injections of Hyaluronic Acid for the Treatment of Trapezio-Metacarpal Joint Osteoarthritis" Journal of Personalized Medicine 14, no. 8: 806. https://doi.org/10.3390/jpm14080806