Evidence map›Paper›PMID 26685691›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016

Efficacy of intra-articular hyaluronic acid injections and exercise-based rehabilitation programme, administered as isolated or integrated therapeutic regimens for the treatment of knee osteoarthritis.

Maristella F Saccomanno, Fabrizio Donati, Silvia Careri, Matteo Bartoli, Gabriele Severini, Giuseppe Milano

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 5 pooled it
0.3field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 5 syntheses or guidelines pooled it, 29 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Maristella F SaccomannoDepartment of Orthopaedics, "A. Gemelli" University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, Italy.
Fabrizio DonatiDepartment of Orthopaedics, "A. Gemelli" University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, Italy.
Silvia CareriDepartment of Orthopaedics, "A. Gemelli" University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, Italy.
Matteo BartoliDepartment of Orthopaedics, "A. Gemelli" University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, Italy.
Gabriele SeveriniPrivate Practice, Via A. Baldi 53, Rome, 00136, Italy.
Giuseppe MilanoDepartment of Orthopaedics, "A. Gemelli" University Hospital, Catholic University, Largo A. Gemelli 8, 00168, Rome, Italy. giuseppe.milano@rm.unicatt.it.
Agostino Gemelli University Polyclinic · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the efficacy of intra-articular hyaluronic acid (HA) injections and exercise-based rehabilitation (EBR) programme, administered as isolated or integrated for the treatment of knee osteoarthritis.

methodsOne hundred sixty-five patients affected by moderate degrees of knee OA were randomly divided into three groups. Group 1 (HA) underwent three HA injections (one every 2 weeks); group 2 (EBR) underwent 20 treatment sessions in a month of an individualized programme; and group 3 (HA + EBR) received both treatments simultaneously. Primary outcome was the Italian version of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index; secondary outcome was the evaluation of active range of movement (AROM). All patients were evaluated before and 1, 3 and 6 months after treatment. Significance was set at p < 0.05.

resultsTwo patients in each group were lost to follow-up. No adverse events occurred. All groups experienced improvements at 1-month follow-up. No further improvements could be detected within groups over time. At 1-month follow-up, WOMAC pain subscale showed significant improvement in group 3 compared to group 1 (p = 0.043). WOMAC pain, stiffness and function subscales showed that group 2 significantly worsened between 1 and 6 months after treatment (p = 0.004, p = 0.026 and p = 0.025, respectively). AROM revealed no significant differences between and within groups over time.

conclusionsIntra-articular HA injections and individualized rehabilitation programmes administered in isolation or in combination are effective in improving knee function and pain relief. The combined treatment showed the greatest pain relief at 1-month follow-up compared to either in isolation. Compared to the previous studies, this is the first study, which proposed an EBR programme tailored to the compartment of the knee joint most involved in the degenerative process. LEVEL OF EVIDENCE: I.

Indexed as

Knee JointAgedCombined Modality TherapyExercise TherapyFemaleHumansHyaluronic AcidInjections, Intra-ArticularMaleMiddle AgedOsteoarthritis, KneeProspective StudiesSingle-Blind MethodTreatment OutcomeHyaluronic AcidExercise-based programmesHyaluronic acidInjectionsKnee osteoarthritis

Identifiers

PMID26685691
OpenAlexW2260288734

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.