Predictive factors for response to viscosupplementation in patients with knee osteoarthritis: an analysis of clinical and imaging factors

Introduction

Despite the widespread use of viscosupplementation (VS) in the treatment of knee arthritis, the factors that may influence its effectiveness or failure are still controversial and little explored in the literature.

Objectives

To identify clinical, radiographic, and magnetic resonance imaging predictive factors associated with VS failure in the treatment of knee osteoarthritis.

Methods

In this prospective study, patients with knee osteoarthritis were evaluated for predictive factors before the intervention, including radiographic images (Kellgren-Lawrence [KL] classification and femorotibial angle), magnetic resonance images Osteoarthritis Knee Score (MOAKS) and meniscal extrusion, joint effusion, body mass index, previous surgery, sex, and age. All patients received a single intra-articular dose of Synolis-VA 4 mL (80 mg hyaluronic acid + 160 mg sorbitol). The WOMAC (Western Ontario Mcmaster Universities Arthritis Index), Visual Analog Scale, and SF-12v2 questionnaires were administered at baseline, 15 days, 3 months, and 6 months of clinical follow-up.

Results

The results showed a significant reduction in WOMAC and Visual Analog Scale scores for all evaluated times after VS compared to baseline. Using the OMERACT-OARSI (Outcome Measures in Rheumatoid Arthritis Clinical Trials-Osteoarthritis Research Society International) criteria, 53 patients were classified as the "success group" and 55 patients as the "failure group." The KL classification and MOAKS score showed a significant difference between these 2 groups, P = .042 and P = .009, respectively. Univariate logistic regression analysis revealed that a KL classification of 3 or 4 and MOAKS score predicted a higher risk of failure.

Conclusions

Patients with a KL classification of 3 or 4 or a high MOAKS score were more likely to fail VS, while the other analyzed factors showed no significant difference.