ABSTRACT
Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA) in a single injection with standard preparations of hyaluronic acid (HA) in five injections in osteoarthritis (OA) of the knee. Fifty-four patients with knee osteoarthritis (Kellgren-Lawrence Grade II and III) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane®) and Group II with HA (Go-ON®). Patient's evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA.
Subject(s)
Health Care Costs , Hyaluronic Acid/administration & dosage , Osteoarthritis, Knee/drug therapy , Viscosupplementation/economics , Adult , Aged , Female , Humans , Hyaluronic Acid/economics , Injections, Intra-Articular/economics , Male , Middle Aged , Osteoarthritis, Knee/economics , Random Allocation , Viscosupplementation/methodsABSTRACT
CASE: We describe the case of a 26-year-old patient diagnosed with Blount disease. She underwent a medial oblique supracondylar biplanar closing-wedge osteotomy of the distal femur followed by a medial oblique biplanar opening-wedge osteotomy of the proximal tibia. 3D printed cutting guides were used for the procedures. At 18 months after surgery, the patient is pain-free and walks without aids. CONCLUSIONS: Using 3D printed guides allowed for accurate correction of the deformity and reduced the risk of damaging critical structures. These guides could be an appropriate alternative for the surgical treatment of patients with Blount disease.
Subject(s)
Bone Diseases, Developmental/surgery , Osteochondrosis/congenital , Osteotomy/methods , Tibia/surgery , Adult , Female , Humans , Osteochondrosis/surgery , Printing, Three-Dimensional , Tibia/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
CASE: A 24-year-old female diagnosed with fibroblastic osteosarcoma of the patella underwent a total patellectomy and surgical reconstruction with a large bone-tendon allograft of the extensor mechanism and adjuvant chemotherapy. At 5 years' postoperative, the patient has adequate disease control and excellent joint function. CONCLUSIONS: Reconstruction with an extensor mechanism allograft is an appropriate alternative for patients with malignant patella tumors without tumor contamination of the joint, allowing for satisfactory knee function and disease control.