Predictors of response to viscosupplementation in patients with hip osteoarthritis: results of a prospective, observational, multicentre, open-label, pilot study

BMC Musculoskeletal Disorders

Research Article

Bernard Maillet¹  Damien Loeuille²  Florent Eymard³  Xavier Chevalier³  Henri Lellouche⁴  Thierry Conrozier⁵  Olivier Brocq⁶  Sylvie Mellac-Ducamp⁷ 

[1] Clinique Saint Odilon, 03000, Moulins, France;Department of rheumatology and IMoPA (Ingénierie Moléculaire et Physiopathologie Articulaires), Brabois University Hospital, 54511, Vandoeuvre-les-Nancy, France;Department of rheumatology, AP-HP Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France;Department of rheumatology, AP-HP Lariboisière Hospital, 75010, Paris, France;Department of rheumatology, Nord Franche Comté Hospital, 90000, Belfort, France;Department of rheumatology, Princesse Grace Hospital, 98000, Monaco, Monaco;Pole A, Nevers Hospital, 58000, Nevers, France;

关键词: Predictive factors;    Hip OA;    Viscosupplementation;    Joint space narrowing;   

DOI  :  10.1186/s12891-016-1359-2

 received in 2016-06-18, accepted in 2016-12-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTo identify predictive factors of response to viscosupplementation (VS) in patients with hip osteoarthritis (HOA).MethodsProspective, multicentre, open-label trial, achieved in daily practice conditions. Patients with HOA were treated with a single intra-articular injection of a cross-linked hyaluronic acid combined with mannitol (HAnox-M-XL), using imaging guidance. WOMAC pain and function scores and patient global assessment (PGA) were assessed at baseline and day 90. Improvement, satisfaction and efficacy were self-assessed at day 90.Hip radiographs at baseline were scored using Kellgren-Lawrence grade and Osteoarthritis Research Society International (OARSI) score. Associations between clinical and radiological features and response to VS (pain improvement > 50% at day 90) were assessed in univariate analysis, and then using logistic regression, adjusted for confounding factors.ResultsThe intent-to-treat (ITT) population included 97 patients (57 females, mean age 63). Ninety completed the follow-up and 80 had full clinical and radiological data. Response to VS was achieved in 47.8% of patients. In univariate analysis, the only clinical outcome statistically and negatively related to response was PGA at baseline (p = 0.047). Radiologically, response to VS was negatively correlated with joint space narrowing (JSN) score (JSN < 2 vs. JSN ≥ 2, p = 0.01) and was related to the patterns of femoral head migration (p = 0.008). In multivariate analysis, only JSN grade (p = 0.03) remained significantly related to a poor response.ConclusionThis pilot study, which needs further confirmation by larger scale trials, suggests that radiological features might be of importance for the decision of VS in patients with HOA.Trial registration numberID RCB N°2013-A00165-40. Registered 31 January 2013.

【 授权许可】

CC BY   
© The Author(s). 2017