To Look at the Characteristics of Synovial Fluid and Cartilage Matrix in Osteoarthritic Knee After Hyaluronic Acid Injection
| Status: | Recruiting |
|---|---|
| Conditions: | Arthritis, Osteoarthritis (OA) |
| Therapuetic Areas: | Rheumatology |
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 4/21/2016 |
| Start Date: | August 2013 |
| End Date: | August 2016 |
| Contact: | Stephanie Murphy |
| Email: | stephanie.taylor@ucsf.edu |
| Phone: | 415-353-9446 |
Quantifications of Biochemical Changes of Synovial Fluid and Cartilage Matrix in Osteoarthritic Knee After Hyaluronic Acid Injection Using Novel MRI (Magnetic Resonance Imaging) and NMR (Nuclear Magnetic Resonance) Techniques
The purpose of this study is to identify novel imaging markers for characterizing the
biochemical profiles in synovial fluid and cartilage matrix in OA knee joints after
intra-articular HA (Euflexxa) injection using high field NMR and MRI techniques.
We hypothesize that:
1. High-field HRMAS NMR spectroscopy will provide sensitive measures for biochemical
changes within knee synovial fluid after HA injection;
2. Baseline HRMAS spectroscopy, in particular N-acetyl peaks, as well as early changes of
glutamate will predict patient response of pain relief after HA injection;
3. MR cartilage T1p and T2 quantifications will provide sensitive measures for biochemical
changes within knee cartilage matrix after HA injection. Specifically cartilage T1p and
T2 will decrease in patients who respond to the treatment, indicating potential
beneficial effects of HA injection to cartilage preservation.
biochemical profiles in synovial fluid and cartilage matrix in OA knee joints after
intra-articular HA (Euflexxa) injection using high field NMR and MRI techniques.
We hypothesize that:
1. High-field HRMAS NMR spectroscopy will provide sensitive measures for biochemical
changes within knee synovial fluid after HA injection;
2. Baseline HRMAS spectroscopy, in particular N-acetyl peaks, as well as early changes of
glutamate will predict patient response of pain relief after HA injection;
3. MR cartilage T1p and T2 quantifications will provide sensitive measures for biochemical
changes within knee cartilage matrix after HA injection. Specifically cartilage T1p and
T2 will decrease in patients who respond to the treatment, indicating potential
beneficial effects of HA injection to cartilage preservation.
Inclusion Criteria:
- Age 18 to 80 years
- Symptomatic knee OA as defined by the American College of Rheumatology criteria
- Kellgren-Lawrence grade I, II or III on prior x-rays (take within 6 months of
screening visit)
- knee pain score >40 mm on a 100 mm visual analogue scale for > 15 days in the last
month
- NSAIDs permitted if the dose has been stable for at least one month prior to baseline
and stays stable during the study
- Have been recommended for Euflexxa treatment by physician
- Knee effusion based on clinical exam or imaging
Exclusion Criteria:
- Any contraindication to MRI (pregnancy, metallic fragments in the eyes, vascular
clips, Pacemakers etc)
- History of knee replacement
- Known sensitivity or allergy to any component of Euflexxa
- Inflammatory arthritis
- Previously received viscosupplementation therapy within 6 months of study enrollment
- Intra-articular injection of corticosteroid to study joint within the past 3 months
- Arthroscopic or open surgery within the previous 12 months or planned surgery to the
study joint
- Concomitant medications of oral/parenteral corticosteroids
- Morbid obesity defined as body mass index (BMI) >40 kg/m2
- Active malignancy; an active systemic infection; recent high impact or high energy
trauma (clinically defined) to the study joint
- Large knee effusion based on clinical exam or imaging
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