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

Abstract

IntroductionDespite the widespread use of viscosupplementation in the treatment of knee arthritis, the factors that may influence its effectiveness or failure are still controversial and little explored in the literature. ObjectiveTo identify clinical, radiographic, and magnetic resonance imaging (MRI) predictive factors associated with viscosupplementation failure in the treatment of knee osteoarthritis. DesignIn this prospective study, patients with knee osteoarthritis were evaluated for predictive factors before the intervention, including radiographic images (KL classification and femorotibial angle), magnetic resonance images (MRI) Osteoarthritis Knee Score (MOAKS) and meniscal extrusion), joint effusion, BMI, 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, VAS, and SF-12v2 questionnaires were administered at baseline, fifteen days, three months, and six months of clinical follow-up. ResultsThe results showed a significant reduction in WOMAC and VAS scores for all evaluated times after viscosupplementation compared to baseline. Using the OMERACT-OARSI 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 two groups, p = 0.042 and p = 0.009, respectively. Univariate logistic regression analysis revealed that a KL classification of 3 or 4 and MOAKS score predicted a higher risk of failure. ConclusionPatients with a KL classification of 3 or 4 or a high MOAKS score were more likely to fail viscosupplementation, while the other analyzed factors showed no significant difference.