Display options
Cite
Sun SF, Hsu CW, Lin HS, et al. Efficacy of intraarticular botulinum toxin A and intraarticular hyaluronate plus rehabilitation exercise in patients with unilateral ankle osteoarthritis: a randomized controlled trial. J Foot Ankle Res. 2014;7(1):9doi: 10.1186/1757-1146-7-9.
Sun, S. F., Hsu, C. W., Lin, H. S., Chou, Y. J., Chen, J. Y., & Wang, J. L. (2014). Efficacy of intraarticular botulinum toxin A and intraarticular hyaluronate plus rehabilitation exercise in patients with unilateral ankle osteoarthritis: a randomized controlled trial. Journal of foot and ankle research, 7(1), 9. https://doi.org/10.1186/1757-1146-7-9
Sun, Shu-Fen, et al. "Efficacy of intraarticular botulinum toxin A and intraarticular hyaluronate plus rehabilitation exercise in patients with unilateral ankle osteoarthritis: a randomized controlled trial." Journal of foot and ankle research vol. 7,1 (2014): 9. doi: https://doi.org/10.1186/1757-1146-7-9
Sun SF, Hsu CW, Lin HS, Chou YJ, Chen JY, Wang JL. Efficacy of intraarticular botulinum toxin A and intraarticular hyaluronate plus rehabilitation exercise in patients with unilateral ankle osteoarthritis: a randomized controlled trial. J Foot Ankle Res. 2014 Feb 06;7(1):9. doi: 10.1186/1757-1146-7-9. PMID: 24502534; PMCID: PMC3922455.
Copy Download .nbib Format: NLM
Share it on

J Foot Ankle Res. 2014 Feb 06;7(1):9. doi: 10.1186/1757-1146-7-9.

Efficacy of intraarticular botulinum toxin A and intraarticular hyaluronate plus rehabilitation exercise in patients with unilateral ankle osteoarthritis: a randomized controlled trial.

Journal of foot and ankle research

Shu-Fen Sun, Chien-Wei Hsu, Huey-Shyan Lin, Yi-Jiun Chou, Jun-Yang Chen, Jue-Long Wang

Affiliations

  1. Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. [email protected].

PMID: 24502534 PMCID: PMC3922455 DOI: 10.1186/1757-1146-7-9

Abstract

BACKGROUND: There was an increasing requirement for novel treatments of osteoarthritis (OA). The aim was to compare the efficacy of intraarticular Botulinum toxin type A (BoNT-A) and intraarticular hyaluronate plus rehabilitation exercise in patients with ankle OA.

METHODS: This was a prospective, randomized, assessor-blinded study with a 6-month follow-up period, conducted in the outpatient rehabilitation department at a university-affiliated tertiary care medical center. Seventy-five patients with symptomatic ankle OA (Kellgren-Lawrence grade 2) were randomized to receive either a single 100-unit BoNT-A injection into the target ankle (n = 38) or a single hyaluronate injection plus 12 sessions of rehabilitation exercise (30 minutes/day, 3 times/week for 4 weeks) (n = 37). The primary outcome measure was the Ankle Osteoarthritis Scale (AOS). Secondary outcome measures included American Orthopedic Foot and Ankle Society (AOFAS) Ankle/Hindfoot Score, visual analog scale (VAS) for ankle pain, single leg stance test (SLS), Timed "Up-and-Go" test (TUG), consumption of rescue analgesics and global patient satisfaction.

RESULTS: There were no significant between-group differences in total AOS scores, pain subscale and disability subscale scores (adjusted mean difference AMD = -0.2, 95% CI = (-0.5, 0.2), p = 0.39; AMD = -0.1, 95% CI = (-0.5, 0.3), p = 0.57; AMD = -0.2, 95% CI = (-0.6, 0.2), p = 0.36). The 2 groups showed no significant differences in AOFAS, VAS, SLS, TUG scores and consumption of rescue analgesics at each follow-up visit, except that the hyaluronate group improved more in SLS than the BoNT-A group at 1-month follow-up. Patients' satisfaction rate was high, with no serious adverse events. There was no difference in adverse events between the two groups (p = 1.00).

CONCLUSIONS: Treatment with intraarticular BoNT-A or hyaluronate injection plus rehabilitation exercise was associated with improvements in pain, physical function and balance in patients with ankle OA. These effects were rapid at 2 weeks and might last for at least 6 months. There was no difference in effectiveness between the two interventions.

TRIAL REGISTRATION: The trial was registered at clinical trials.gov (Registry number NCT01760577).

References

  1. N Engl J Med. 2002 Aug 8;347(6):382-3 - PubMed
  2. J Pain. 2008 Feb;9(2):105-21 - PubMed
  3. Osteoarthritis Cartilage. 1995 Dec;3(4):213-25 - PubMed
  4. Toxicon. 2009 Oct;54(5):658-67 - PubMed
  5. Iowa Orthop J. 2005;25:44-6 - PubMed
  6. Scand J Rehabil Med. 1997 Dec;29(4):213-21 - PubMed
  7. Ann Rheum Dis. 1991 Jan;50(1):8-13 - PubMed
  8. Neurotox Res. 2006 Apr;9(2-3):179-88 - PubMed
  9. Ann Rheum Dis. 1992 Aug;51(8):1014-8 - PubMed
  10. Foot Ankle Int. 2008 Jul;29(7):657-63 - PubMed
  11. Clin Exp Rheumatol. 1998 Jul-Aug;16(4):441-9 - PubMed
  12. Osteoarthritis Cartilage. 2006 Sep;14(9):867-74 - PubMed
  13. Arch Phys Med Rehabil. 2000 May;81(5):587-91 - PubMed
  14. Handb Exp Pharmacol. 2007;(177):3-28 - PubMed
  15. Foot Ankle Surg. 2008;14(3):145-52 - PubMed
  16. J Am Geriatr Soc. 1991 Feb;39(2):142-8 - PubMed
  17. Adv Drug Deliv Rev. 2006 May 20;58(2):323-42 - PubMed
  18. J Neurol. 2004 Feb;251 Suppl 1:I1-7 - PubMed
  19. Clin Podiatr Med Surg. 2003 Jul;20(3):469-85, ix - PubMed
  20. Foot Ankle Int. 1998 Jul;19(7):466-71 - PubMed
  21. Ann Rheum Dis. 1957 Dec;16(4):494-502 - PubMed
  22. Arch Phys Med Rehabil. 2009 Jul;90(7):1136-41 - PubMed
  23. Headache. 2004 Jan;44(1):35-42; discussion 42-3 - PubMed
  24. J Pain. 2003 Apr;4(3):159-65 - PubMed
  25. J Clin Rheumatol. 2009 Feb;15(1):35-8 - PubMed
  26. Arthritis Rheum. 1994 Jul;37(7):965-82 - PubMed
  27. J Bone Joint Surg Am. 2006 Feb;88(2):295-302 - PubMed
  28. Toxicon. 2000 Feb;38(2):245-58 - PubMed
  29. Foot Ankle Int. 1994 Jul;15(7):349-53 - PubMed
  30. Lancet. 1974 Nov 9;2(7889):1127-31 - PubMed
  31. J Bone Joint Surg Am. 2011 Sep 21;93(18):1720-6 - PubMed
  32. Transl Res. 2009 May;153(5):205-16 - PubMed
  33. Ann Rheum Dis. 2001 Jun;60(6):612-8 - PubMed
  34. Clin J Pain. 2002 Nov-Dec;18(6 Suppl):S125-32 - PubMed
  35. Exp Brain Res. 2009 Jun;196(1):153-62 - PubMed

Publication Types