The Experts below are selected from a list of 1062 Experts worldwide ranked by ideXlab platform

George Habib - One of the best experts on this subject based on the ideXlab platform.

  • the effect of periarticular injection of Methylprednisolone Acetate in patients with primary osteoarthritis of the proximal interphalangeal joints a case controlled study
    Pain Research and Treatment, 2018
    Co-Authors: George Habib, Fahed Sakas, Suheil Artul, Fadi Khazin
    Abstract:

    Backgrounds. Primary osteoarthritis of the proximal interphalangeal joints (PIPJ) is a common entity. It could be associated with local pain that has no effective treatment. Local subcutaneous periarticular injection of Methylprednisolone Acetate (MPA) was evaluated in a prospective case-control study. Methods. Patients with painful osteoarthritis of the PIPJ for more than 1 month not responding to nonsteroidal meds were prospectively recruited. Radiographic, demographic, clinical, and lab parameters were documented. Visual analogue scale (VAS) was documented regarding the level of PIPJ pain prior to the injection. Patients had local subcutaneous periarticular injection at the medial and lateral sides of each painful PIPJ of one hand, of 8 mg (0.2 ml) of MPA mixed with 0.1 ml of lidocaine 1% (group 1) at each side. Age- and sex-matched control group were given 0.3 ml of normal saline using the same approach (group 2) at each side. VAS was evaluated 1, 4, and 10 weeks following the injection and compared to baseline levels using Wilcoxon’s ranks signed test. Results. Eighteen and sixteen patients were recruited in group 1 and group 2, respectively. There were 11 females in group 1 with mean age of 52.7 ± 9.2 years. Mean VAS in group 1 at baseline was 67 and at weeks 1, 4, and 10 was 23 (p=0.001), 29 (p=0.001), and 55 (p=0.043), respectively. Mean VAS in group 2 at baseline was 65 and at weeks 1, 4, and 10 was 43 (p=0.005), 64 (p=0.534), and 69 (0.698), respectively. Conclusions. Subcutaneous periarticular injection of MPA + lidocaine at the PIP joints resulted in a small but significant improvement that gradually diminished with time across the week 10, among patients with primary OA of hands.

  • the effect of local injection of Methylprednisolone Acetate on the hypothalamic pituitary adrenal axis among patients with greater trochanteric pain syndrome
    Clinical Rheumatology, 2017
    Co-Authors: George Habib, Adel Jabbour, Shada Elias, Muhanned Abuelhaija, Fahed Sakas, Fadi Khazin, Suheil Artul, Haneen Jabalyhabib
    Abstract:

    Greater trochanteric pain syndrome (GTPS) is a common clinical entity for which the most effective treatment is local corticosteroid injection (LCI). There are no studies on the effect of LCI among patients with GTPS on the hypothalamic-pituitary-adrenal axis. The present study recruited nonselected patients diagnosed with GTPS. After consenting, participants received low dose (1 μg) of adrenocorticotropin hormone (ACTH) stimulation test at 09:00. Immediately following the test, participants received a LCI of 80 mg of Methylprednisolone Acetate at the greater trochanteric region. The ACTH stimulation test was repeated 1, 2, 4, and 6 weeks following the LCI. Cortisol samples were obtained at just prior to (basal) and 30 min (post-stimulation) following every ACTH stimulation test. Serum cortisol levels of <500 μmol/l obtained 30 min following the ACTH stimulation test were considered evidence of secondary adrenal insufficiency. The study enrolled 22 patients, 21 of whom completed participation. There were 19 female participants (~90%), and mean age of all the participants was 55.2 ± 8.6 years. Four participants showed evidence of secondary adrenal insufficiency, which was observed only at weeks 1 and 2 following the LCI. Mean serum cortisol level among these four participants 30 min following the ACTH stimulation test was 354 μmol/l, with a range of 268–430 μmol/l. LCI of 80 mg of Methylprednisolone Acetate in the greater trochanteric area among patients with GTPS was associated with transient secondary adrenal insufficiency in ~20% of the patients, mainly 1 week following the injection.

  • The impact of intra-articular Methylprednisolone Acetate injection on fructosamine levels in diabetic patients with osteoarthritis of the knee, a case-control study
    Clinical Rheumatology, 2016
    Co-Authors: George Habib, Adel Jabbour, Geries Hakim, Fahed Sakas, Fadi Khazin, Suheil Artul, Haneen Jabaly-habib
    Abstract:

    Fructosamine is a glycated protein that reflects blood glucose control over the last 2–3 weeks. There are no studies that address the impact of intra-articular injection (IAI) of Methylprednisolone Acetate (MPA) on fructosamine levels among patients with type-2 diabetes and osteoarthritis of the knee (OAK). Non-selected patients attending the rheumatology or orthopedic clinic with type-2 diabetes and painful OAK, who failed non-steroidal anti-inflammatory drugs (NSAIDS) and physical therapy, were asked to participate in our study. After consent blood tests were drown for fructosamine, hemoglobin A1c (HbA1c) level, complete blood count, lipid profile, serum albumin, serum protein, c-reactive protein, and erythrocyte sedimentation rate. Demographic and different clinical parameters were also documented. Immediately after that, patients had IAI of 80 mg of MPA at the knee joint (group 1). Two to three weeks later, the same blood tests were repeated (except for HbA1c). Age- and sex-matched group of patients with type-2 diabetes and painful OAK attending the same clinics, but who were managed by NSAIDS were asked to participate as a control group (group 2) and had the same evaluation at enrollment and 2–3 weeks later, after consent. Eighteen patients from either group completed the study. Mean fructosamine level in group 1 patients was 263.7 ± 31.8 mg% prior to the IAI vs. 274.6 ± 39.3 mg% ( p  = 0.035), 2–3 weeks later, while mean fructosamine level in the control group (group 2) at enrollments was 274.2 ± 31.2 mg% vs. 269 ± 30.2 mg%, p  = 0.509, 2–3 weeks later. There was no significant change in any other parameter tested at enrollment in either group, compared to those obtained 2–3 weeks afterwards. Body mass index was on the edge of significance as a predictor for a significant change in fructosamine level in group 1 patients. IAI of 80 mg of MPA in patients with type-2 diabetes and OAK had resulted in a significant, though mild increase in fructosamine levels 2–3 weeks later.

  • simultaneous bilateral knee injection of Methylprednisolone Acetate and the hypothalamic pituitary adrenal axis a single blind case control study
    Journal of Investigative Medicine, 2014
    Co-Authors: George Habib, Adel Jabbour, Fadi Khazin, Mark Chernin, Samih Badarny, Jeries Hakim, Suheil Artul
    Abstract:

    Objective The objective of this study was to evaluate the effect of simultaneous bilateral intra-articular injection (IAI) of Methylprednisolone Acetate (MPA) on the hypothalamic-pituitary-adrenal axis in patients with knee osteoarthritis. Methods Nonselected patients with symptomatic bilateral knee osteoarthritis had simultaneous IAI of 80 mg MPA at each knee (group 1). Just before the injection and on weeks 1, 2, 4, 6, and 8 after it, patients had 1 µg adrenocorticotropin hormone stimulation test. Age- and sex-matched patients had simultaneous IAI of 60 mg of hyaluronic acid in each knee (group 2) and the same protocol of adrenocorticotropin hormone stimulation tests. Demographic, clinical, and laboratory parameters were documented in all the patients. Secondary adrenal insufficiency (SAI) was defined as poststimulation serum cortisol levels of less than 18 µg/dL. Results Twenty patients were enrolled in each group. There were 15 women and 5 men in each group. Mean age of the patients in group 1 was 60.3 (SD, 7.6) years. Twelve patients (60%) from group 1 had evidence of SAI versus 3 patients in group 2 ( P = 0.003). In all the patients who had SAI in group 1, it was observed in week 1 with decreasing frequency of SAI at the subsequent time points. Yet, 2 patients (10%) from group 1 had evidence of SAI 8 weeks after the IAI. Secondary adrenal insufficiency did not significantly correlate with any demographic, clinical, or laboratory parameter. Conclusions Secondary adrenal insufficiency was very common following simultaneous bilateral IAI of 80 mg of MPA. Although it was transient, SAI could still be observed nearly 2 months after the IAI, in 10% of the patients.

  • intra articular Methylprednisolone Acetate injection at the knee joint and the hypothalamic pituitary adrenal axis a randomized controlled study
    Clinical Rheumatology, 2014
    Co-Authors: George Habib, Adel Jabbour, Suheil Artul, Geries Hakim
    Abstract:

    The objective of this study was to evaluate the effect of intra-articular corticosteroid injection (IACI) of Methylprednisolone Acetate (MPA) on the hypothalamic–pituitary–adrenal (HPA) axis in patients with osteoarthritis of the knee. Patients with symptomatic osteoarthritis of the knee who failed to respond to nonsteroidal anti-inflammatory medications and physical therapy were randomized between group 1 and group 2. Group 1 patients had an IACI of 80 mg of MPA at the knee joint and group 2 patients had an intra-articular injection (IAI) of 6 ml (60 mg) of sodium hyaluronate (control group). Immediately prior to the IAI and on weeks 1, 2, 3, 4, and 8 following IAI, patients from both groups underwent a low-dose (1 μg) adrenocorticotropin hormone (ACTH) stimulation test. Demographic, clinical, laboratory, and radiologic variables were documented in all patients. Both criteria of <7 μg/dl increase in the serum cortisol level and absolute levels of <18 μg/dl 30 min following the ACTH stimulation test were used to define secondary adrenal insufficiency (SAI). Twenty patients were randomized in each group. In group 1, 25 % of patients had SAI vs. none in group 2 (p = 0.0471). The earliest SAI was observed at week 2, and latest SAI was observed at week 4. SAI was observed at one time point, two consecutive time points, or two separate time points in the same patient. There was no correlation between SAI and any of the demographic, clinical, or laboratory variables. An IACI of 80 mg MPA at the knee joint induced a transient SAI in 25 % of the patients, an effect that was observed between week 2 and week 4 following the IACI.

C Chuaychoosakoon - One of the best experts on this subject based on the ideXlab platform.

  • Methylprednisolone Acetate versus dexamethasone injection for trigger finger a double blind randomized controlled trial
    Journal of Health Science and Medical Research, 2021
    Co-Authors: Porames Suwanno, C Chuaychoosakoon
    Abstract:

    Objective: The study investigated the resolution of triggering by either a soluble Methylprednisolone Acetate or dexamethasone injection for idiopathic trigger finger at 24-week after injection. Material and Methods: One hundred and six patients were enrolled in a prospective randomized controlled trial (53 Methylprednisolone Acetate arms, 53 dexamethasone arms). The outcome was evaluated at 2, 6, 12 and 24-week follow-up. Results: The absence of triggering was documented in 32 of 43, 36 of 41 patients in the Methylprednisolone cohort and in 20 of 43, 29 of 32 patients in the dexamethasone cohort at 6 and 24-week after injection. The Methylprednisolone Acetate cohort had significantly better satisfaction on a visual analog scale, tenderness, and locking at 2-week follow-up, and had significantly better satisfaction on resolution of triggering, tenderness, snapping, locking and the Disabilities of the Arm, Shoulder and Hand score at 6-week follow-up compared to those in the dexamethasone cohort. Conclusion: Methylprednisolone Acetate is better in short term clinical outcomes than dexamethasone

  • Methylprednisolone Acetate versus dexamethasone injection for trigger finger
    Orthopaedic Proceedings, 2018
    Co-Authors: C Chuaychoosakoon
    Abstract:

    To study in resolution of triggering 12 months after injection with either a soluble Methylprednisolone Acetate or dexamethasone for idiopathic trigger finger.Twenty-eight patients were enrolled in...

  • Methylprednisolone Acetate versus dexamethasone injection for trigger finger
    Journal of Bone and Joint Surgery-british Volume, 2015
    Co-Authors: C Chuaychoosakoon
    Abstract:

    To study in resolution of triggering 12 months after injection with either a soluble Methylprednisolone Acetate or dexamethasone for idiopathic trigger finger. Twenty-eight patients were enrolled in a prospective randomized controlled trial comparing Methylprednisolone Acetate and dexamethasone injection for idiopathic trigger finger. Twenty-seven patients completed the 6-week follow-up (11 Methylprednisolone Acetate arm, 16 dexamethasone arm) and thirteen patients completed the 3-month follow-up (4 Methylprednisolone Acetate arm, 9 dexamethasone arm). Outcome measures included resolution of triggering, recurrence rate of trigger finger, satisfaction on a visual analog scale, tender, snapping, locking, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and tip to palm distance (mm.) at 2, 6, 12 and 24 weeks follow-up. Eight patients were repeated a second injection (3 Methylprednisolone Acetate arm, 5 dexamethasone arm) at 6-week follow-up. To preserve autonomy, patients were permitted operative treatment any time. The analysis was according to intention to treat principles. Six weeks after injection. Absence of triggering was documented in 6 of 11 patients in the Methylprednisolone cohort and in 6 of 16 patients in the dexamethasone cohort. The rate 3-month after injection were 2 of 4 patients in the Methylprednisolone cohort and in 8 of 9 patients in the dexamethasone cohort. There were no significant difference between recurrence rate of trigger finger, satisfaction on a visual analog scale, tender, snapping, locking, the Disabilities of the Arm, Shoulder and Hand (DASH) scores and tip to palm distance (mm.) at 2, 6, 12 and 24 weeks follow-up. Although there were no differences 3months after injection, our data suggest that in the dexamethasone cohort was better in resolution of triggering than the Methylprednisolone cohort at 12-week follow-up.

P. V. Vijayaraghavan - One of the best experts on this subject based on the ideXlab platform.

  • Methylprednisolone Acetate Versus Triamcinolone Acetonide for Pain Relief in
    2015
    Co-Authors: Spinal Nerve, Root Block, Low Back Pain, Ganesan G Ram, S. Sundar, P. Kunal, J. K. Giriraj, P. V. Vijayaraghavan
    Abstract:

    Objective: The aim of the present study is to compare the effectiveness (pain relief) of two largely used steroids Methylprednisolone Acetate (Depomedrol) and Triamcinolone acetonide (Kenacort) in spinal nerve root block for low back pain management. Method: Prospective randomized study of fifty patients with low back pain done in Sri Ramachandra Medical College from June 2012 to June 2014. The inclusion criteria were lumbar radicular pain with a disc herniation or central, foraminal stenosis without neurological deficit, in patients who have completed their 6 week trial of non-operative management and had no relief and with minimal follow up of 1 year. Patients were evaluated using VAS score. Result: All patients had immediate relief following the first block (to varying degrees). Conclusion: There is no significant difference whether depomedrol or Kenocort was used for spinal nerve root block. Both the steroids gives equally good results

  • Methylprednisolone Acetate versus triamcinolone acetonide for pain relief in spinal nerve root block for low back pain
    American Journal of Pharmacology and Pharmacotherapeutics, 2015
    Co-Authors: Ganesan G Ram, S. Sundar, P. Kunal, J. K. Giriraj, P. V. Vijayaraghavan
    Abstract:

    Objective: The aim of the present study is to compare the effectiveness (pain relief) of two largely used steroids Methylprednisolone Acetate (Depomedrol) and Triamcinolone acetonide (Kenacort) in spinal nerve root block for low back pain management. Method: Prospective randomized study of fifty patients with low back pain done in Sri Ramachandra Medical College from June 2012 to June 2014. The inclusion criteria were lumbar radicular pain with a disc herniation or central, foraminal stenosis without neurological deficit, in patients who have completed their 6 week trial of non-operative management and had no relief and with minimal follow up of 1 year. Patients were evaluated using VAS score. Result: All patients had immediate relief following the first block (to varying degrees). Conclusion: There is no significant difference whether depomedrol or Kenocort was used for spinal nerve root block. Both the steroids gives equally good results.

L Frizziero - One of the best experts on this subject based on the ideXlab platform.

  • intra articular treatment of osteoarthritis of the knee an arthroscopic and clinical comparison between sodium hyaluronate 500 730 kda and Methylprednisolone Acetate
    Journal of Orthopaedics and Traumatology, 2002
    Co-Authors: L Frizziero, Pasquali I Ronchetti
    Abstract:

    Corticosteroids have long represented the drugs of choice for intra-articular treatment of osteoarthritis (OA), but their use has drawbacks, indicating the need for alternatives devoid of these effects. This comparative study examined the clinical efficacy and the structural effects of intra-articular injections of sodium hyaluronate (HA) of molecular weight (MW) 500–730 kDa (one injection weekly for 5 weeks) versus Methylprednisolone Acetate (MP) (one injection weekly for 3 weeks) in the treatment knee OA. We studied 99 patients with knee OA, primary or secondary to a traumatic event, classified according to criteria of the American College of Rheumatology. Pain assessments by VAS and arthroscopic examinations of synovial membrane and cartilage were performed at baseline and 180 days after the start of the treatment. Arthroscopic features were evaluated under blind conditions. Initially, MP showed a more immediate beneficial clinical effect in reducing pain than HA, but after 180 days the symptomatic effect of HA was more long lasting than that of MP. Arthroscopic findings at day 180, in comparison with baseline conditions, showed that both drugs were decreased synovial membrane inflammation but HA was superior to MP in reducing the grade and extent of cartilage damage. HA of 500–730 kDa represents a valid alternative to corticosteroids in the intra-articular treatment of OA with a beneficial effect on the structural alterations. This study supports previous data on a potential structure-modifying activity of HA in OA of the knee.

  • morphological analysis of articular cartilage biopsies from a randomized clinical study comparing the effects of 500 730 kda sodium hyaluronate hyalgan and Methylprednisolone Acetate on primary osteoarthritis of the knee
    Osteoarthritis and Cartilage, 2001
    Co-Authors: D D Guidolin, Pasquali I Ronchetti, Deanna Guerra, E Lini, L Frizziero
    Abstract:

    Abstract Objective Histomorphometric study on cartilage samples taken from osteoarthritic human knees before and 6 months after intraarticular injections of a specific fraction (500–730kDa) of hyaluronan. The results obtained with hyaluronan were compared with the results of Methylprednisolone Acetate treatment. Methods Twenty-four subjects with primary osteoarthritis (OA) of the knee were considered. Eleven patients were treated with Hyaluronan (Hyalgan ® , 20mg/2ml once a week for 5 weeks) and 13 with Methylprednisolone (Depo-Medrol ® , 40mg/1ml once a week for 3 weeks). At the time of baseline and after 6 months from the start of treatment, biopsies of cartilage were taken and processed for electron microscopy. Articular surface morphology, territorial matrix, chondrocyte number and ultrastructure were characterized by a set of morphometric parameters. Samples from 19 informed patients showing no arthroscopic sign of OA were also used for comparison. Results Six months after hyaluronan treatment a significant reconstitution of the superficial layer were observed together with an improvement in chondrocyte density and territorial matrix appearance. Furthermore, chondrocytes appeared significantly improved in their metabolism, as indicated by the increased extension of the synthetic structures and mitochondria with respect to the organelles having catabolic or storage functions. Hyaluronan treatment produced results that were significantly superior to those delivered with Methylprednisolone in almost all the morphometric estimators. Conclusions These results cannot be explained simply by temporary restoration of the synovial fluid viscoelasticity, and provide further evidence that the specific fraction of hyaluronan used in this study is a useful tool in OA treatment, with a potential structure-modifying activity.

  • morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate hyalgan and Methylprednisolone Acetate depomedrol in osteoarthritis
    Rheumatology, 2001
    Co-Authors: Pasquali I Ronchetti, Deanna Guerra, Francesca Taparelli, Federica Boraldi, G Bergamini, G Mori, F Zizzi, L Frizziero
    Abstract:

    Objective. The study was part of a randomized open-label clinical trial designed to evaluate the effects of intra-articular injections of hyaluronan (Hyalgan®) (HY) in osteoarthritis (OA) of the human knee. Data were compared with those obtained after treatment with Methylprednisolone Acetate (Depomedrol®) (MP). Methods, Synovial membranes from patients with OA of the knee, primary or secondary to a traumatic event and classified according to the American College of Rheumatology criteria, were examined by arthroscopy and by light and electron microscopy before and 6 months after local injection of HY (2 ml of 500-730 000 MW hyaluronan, 10 mg/ml in saline, one injection per week for 5 weeks) or MP ( ml of Methylprednisolone Acetate, 40 mg/ml, one injection per week for 3 weeks). Results. Arthroscopy revealed a significant decrease in inflammatory score after both treatments. Histology showed that HY treatment was effective (P ≤ 0.05) in reducing the number and aggregation of lining synoviocytes, as well as the number and calibre of the vessels. MP treatment significantly reduced the number of mast cells in primary OA. Both treatments tended to decrease the number of hypertrophic and to increase the number of fibroblast-like lining cells, to decrease the numbers of macrophages, lymphocytes, mast cells and adipocytes, and to decrease oedema, especially in primary OA, and to increase the number of fibroblasts and the amount of collagen. These phenomena were evident throughout the thickness of the synovial tissue. Conclusion, At least in the medium term, both HY and MP modified a number of structural variables of the synovial membrane of the osteoarthritic human knee towards the appearance of that of normal synovium. The effect was more evident in primary OA than in OA secondary to a traumatic event. This is the first evidence that local hyaluronan injections modify the structural organization of the human knee synovium in OA.

Pasquali I Ronchetti - One of the best experts on this subject based on the ideXlab platform.

  • intra articular treatment of osteoarthritis of the knee an arthroscopic and clinical comparison between sodium hyaluronate 500 730 kda and Methylprednisolone Acetate
    Journal of Orthopaedics and Traumatology, 2002
    Co-Authors: L Frizziero, Pasquali I Ronchetti
    Abstract:

    Corticosteroids have long represented the drugs of choice for intra-articular treatment of osteoarthritis (OA), but their use has drawbacks, indicating the need for alternatives devoid of these effects. This comparative study examined the clinical efficacy and the structural effects of intra-articular injections of sodium hyaluronate (HA) of molecular weight (MW) 500–730 kDa (one injection weekly for 5 weeks) versus Methylprednisolone Acetate (MP) (one injection weekly for 3 weeks) in the treatment knee OA. We studied 99 patients with knee OA, primary or secondary to a traumatic event, classified according to criteria of the American College of Rheumatology. Pain assessments by VAS and arthroscopic examinations of synovial membrane and cartilage were performed at baseline and 180 days after the start of the treatment. Arthroscopic features were evaluated under blind conditions. Initially, MP showed a more immediate beneficial clinical effect in reducing pain than HA, but after 180 days the symptomatic effect of HA was more long lasting than that of MP. Arthroscopic findings at day 180, in comparison with baseline conditions, showed that both drugs were decreased synovial membrane inflammation but HA was superior to MP in reducing the grade and extent of cartilage damage. HA of 500–730 kDa represents a valid alternative to corticosteroids in the intra-articular treatment of OA with a beneficial effect on the structural alterations. This study supports previous data on a potential structure-modifying activity of HA in OA of the knee.

  • morphological analysis of articular cartilage biopsies from a randomized clinical study comparing the effects of 500 730 kda sodium hyaluronate hyalgan and Methylprednisolone Acetate on primary osteoarthritis of the knee
    Osteoarthritis and Cartilage, 2001
    Co-Authors: D D Guidolin, Pasquali I Ronchetti, Deanna Guerra, E Lini, L Frizziero
    Abstract:

    Abstract Objective Histomorphometric study on cartilage samples taken from osteoarthritic human knees before and 6 months after intraarticular injections of a specific fraction (500–730kDa) of hyaluronan. The results obtained with hyaluronan were compared with the results of Methylprednisolone Acetate treatment. Methods Twenty-four subjects with primary osteoarthritis (OA) of the knee were considered. Eleven patients were treated with Hyaluronan (Hyalgan ® , 20mg/2ml once a week for 5 weeks) and 13 with Methylprednisolone (Depo-Medrol ® , 40mg/1ml once a week for 3 weeks). At the time of baseline and after 6 months from the start of treatment, biopsies of cartilage were taken and processed for electron microscopy. Articular surface morphology, territorial matrix, chondrocyte number and ultrastructure were characterized by a set of morphometric parameters. Samples from 19 informed patients showing no arthroscopic sign of OA were also used for comparison. Results Six months after hyaluronan treatment a significant reconstitution of the superficial layer were observed together with an improvement in chondrocyte density and territorial matrix appearance. Furthermore, chondrocytes appeared significantly improved in their metabolism, as indicated by the increased extension of the synthetic structures and mitochondria with respect to the organelles having catabolic or storage functions. Hyaluronan treatment produced results that were significantly superior to those delivered with Methylprednisolone in almost all the morphometric estimators. Conclusions These results cannot be explained simply by temporary restoration of the synovial fluid viscoelasticity, and provide further evidence that the specific fraction of hyaluronan used in this study is a useful tool in OA treatment, with a potential structure-modifying activity.

  • morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate hyalgan and Methylprednisolone Acetate depomedrol in osteoarthritis
    Rheumatology, 2001
    Co-Authors: Pasquali I Ronchetti, Deanna Guerra, Francesca Taparelli, Federica Boraldi, G Bergamini, G Mori, F Zizzi, L Frizziero
    Abstract:

    Objective. The study was part of a randomized open-label clinical trial designed to evaluate the effects of intra-articular injections of hyaluronan (Hyalgan®) (HY) in osteoarthritis (OA) of the human knee. Data were compared with those obtained after treatment with Methylprednisolone Acetate (Depomedrol®) (MP). Methods, Synovial membranes from patients with OA of the knee, primary or secondary to a traumatic event and classified according to the American College of Rheumatology criteria, were examined by arthroscopy and by light and electron microscopy before and 6 months after local injection of HY (2 ml of 500-730 000 MW hyaluronan, 10 mg/ml in saline, one injection per week for 5 weeks) or MP ( ml of Methylprednisolone Acetate, 40 mg/ml, one injection per week for 3 weeks). Results. Arthroscopy revealed a significant decrease in inflammatory score after both treatments. Histology showed that HY treatment was effective (P ≤ 0.05) in reducing the number and aggregation of lining synoviocytes, as well as the number and calibre of the vessels. MP treatment significantly reduced the number of mast cells in primary OA. Both treatments tended to decrease the number of hypertrophic and to increase the number of fibroblast-like lining cells, to decrease the numbers of macrophages, lymphocytes, mast cells and adipocytes, and to decrease oedema, especially in primary OA, and to increase the number of fibroblasts and the amount of collagen. These phenomena were evident throughout the thickness of the synovial tissue. Conclusion, At least in the medium term, both HY and MP modified a number of structural variables of the synovial membrane of the osteoarthritic human knee towards the appearance of that of normal synovium. The effect was more evident in primary OA than in OA secondary to a traumatic event. This is the first evidence that local hyaluronan injections modify the structural organization of the human knee synovium in OA.