Intra-articular injection of gold micro-particles with hyaluronic acid for painful knee osteoarthritis

Sten Rasmussen; Kristian Kjaer Petersen; Christopher Aboo; Jacob Skallerup Andersen; Emilie Skjoldemose; Nia Kristine Jørgensen; Allan Stensballe; Lars Arendt-Nielsen

doi:10.1186/s12891-024-07321-4

Intra-articular injection of gold micro-particles with hyaluronic acid for painful knee osteoarthritis

BMC Musculoskelet Disord. 2024 Mar 12;25(1):211. doi: 10.1186/s12891-024-07321-4.

Authors

Sten Rasmussen^{1

2}, Kristian Kjaer Petersen^{3

4}, Christopher Aboo³, Jacob Skallerup Andersen³, Emilie Skjoldemose⁵, Nia Kristine Jørgensen⁵, Allan Stensballe^{5

3

6}, Lars Arendt-Nielsen^{3

4

7

8}

Affiliations

¹ Department of Clinical Medicine, Aalborg University, 249 Selma Lagerløfs Vej, Gistrup, 9260, Denmark. sten@dcm.aau.dk.
² Department of Orthopedic Surgery, Sport and Arthroscopy, Aalborg University Hospital, Aalborg, Denmark. sten@dcm.aau.dk.
³ Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
⁴ Center for Neuroplasticity and Pain, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
⁵ Department of Clinical Medicine, Aalborg University, 249 Selma Lagerløfs Vej, Gistrup, 9260, Denmark.
⁶ Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.
⁷ Department of Gastroenterology & Hepatology, Mech-Sense, Aalborg University Hospital, Aalborg, Denmark.
⁸ Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.

Abstract

Background: Recently, in an open pilot study, we found up to two years, a potential pain-relieving effect of intra-articular gold micro-particles using the patient's synovial fluid for patients with knee osteoarthritis (KOA). During the study the excluded group of patients, due to multisite pain, co-morbidities, and other exclusion criteria., received intra-articular gold micro-particles using hyaluronic acid,. We aimed to identify if pre-treatment characteristics influence the global outcome two years after intra-articular treatment for painful KOA with gold microparticles using hyaluronic acid.

Methods: Using hyaluronic acid as the carrier, 136 patients with KOA received intraarticular injections with 20 mg gold microparticles (72.000 particles, 20-40 μm in diameter). In the analysis, we included the Global Rating of Change Scale, Pain Detect Questionnaire (PDQ), Body Mass Index (BMI), and Kellgren & Lawrence score at the inclusion, Western Ontario, and McMaster Universities Osteoarthritis Index (WOMAC) sub-scores for pain, stiffness, and function at inclusion and two years.

Results: On the Global Rating Change Scale, 69.1% of patients reported a positive effect, 28.7% no effect, and 2.2% worse. PDQ and the three WOMAC subscores all improved at two years of follow-up. PDQ ≥ 13 (P = 0.028), BMI (P = 0.022) and Kellgren & Lawrence grade 4 (P = 0.028) at inclusion reduced the effect with a minor odds ratio compared to the baseline effect of treatment (P = 0.025). WOMAC subscores at inclusion did not influence the outcome (P > 0.5).

Conclusions: Severe osteoarthritis, obesity, and neuropathic pain, reduced the effect of intra-articular gold microparticles for knee OA.

Trial registration: The study followed the principles of the Declaration of Helsinki and was approved by the local ethics committee of the North Denmark Region by 27/07/2016 (N-20,160,045). The regional data protection agency approved the project by 06/07/2016 (2008-58-0028, ID 2016 - 116) and registered in ClinicalTrial.Gov by 04/01/2018 (NCT03389906).

Keywords: Gold microparticles; Hyaluronic acid; Intra-articular injection; Knee osteoarthritis; Outcomes.

Publication types

Clinical Study

MeSH terms

Humans
Hyaluronic Acid
Injections, Intra-Articular
Neuralgia*
Osteoarthritis, Knee* / therapy
Pilot Projects
Treatment Outcome

Substances

Hyaluronic Acid

Associated data

ClinicalTrials.gov/NCT03389906