PMID- 28934876
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220409
IS  - 1947-6043 (Electronic)
IS  - 1947-6035 (Print)
IS  - 1947-6035 (Linking)
VI  - 8
IP  - 4
DP  - 2017 Oct
TI  - Comparison of Intra-articular Injection of Hyaluronic Acid and N-Acetyl Cysteine 
      in the Treatment of Knee Osteoarthritis: A Pilot Study.
PG  - 384-390
LID - 10.1177/1947603516675915 [doi]
AB  - Objective To compare the relative effectiveness of intra-articular N-acetyl 
      cysteine (NAC) and hyaluronic acid (HA) on pain, function and cartilage 
      degradation markers in patients with mild to moderate knee osteoarthritis (OA). 
      Design We prospectively conducted a clinical trial with 20 patients having a 
      diagnosis of Kellgren-Lawrence grade 2-3 knee OA, and randomly allocated to the 
      HA or NAC groups. Groups were matched on age, sex, and body mass index. 
      Injections of 3-mL HA (Hylan G-F 20) or 3-mL NAC (Asist ampoule) were 
      administered as a single shot. Functional status and pain were evaluated before 
      and after injection, using the Western Ontario and McMaster Universities 
      Arthritis Index (WOMAC) and the visual analogue scale (VAS) scores. Pre- and 
      posttreatment concentrations of serum C-reactive protein (CRP), synovial fluid 
      chondroitin-6-sulfate (C-6S), matrix metalloproteinase-3 (MMP-3), cross-linked 
      C-terminal telopeptide of type 2 collagen (CTX-II), total oxidant status (TOS), 
      and total antioxidant concentration (TAC) were obtained. Results WOMAC, VAS 
      scores, and CRP levels were comparable between groups prior to treatment. Both HA 
      and NAC produced comparable reductions in TOS and MMP-3. NAC was more effective 
      in reducing C-6S and CTX-II ( P < 0.05). No effects on TAC were noted. 
      Conclusions NAC is effective in lowering some cartilage degradation markers, with 
      comparable outcomes to HA for pain and function. NAC could provide a cheaper 
      alternative to HA for intra-articular injection treatment of mild to moderate 
      knee OA. Future placebo controlled trials are warranted to evaluate effectiveness 
      in a larger patient population with a wider range of age and OA severity.
FAU - Ozcamdalli, Mustafa
AU  - Ozcamdalli M
AD  - 1 Ahi Evran University Training and Research Hospital, Department of Orthopedics 
      and Traumatology, Kirsehir, Turkey.
FAU - Misir, Abdulhamit
AU  - Misir A
AD  - 2 Baltalimani Bone and Joint Diseases Training and Research Hospital, Department 
      of Orthopedics and Traumatology, Istanbul, Turkey.
FAU - Kizkapan, Turan Bilge
AU  - Kizkapan TB
AD  - 2 Baltalimani Bone and Joint Diseases Training and Research Hospital, Department 
      of Orthopedics and Traumatology, Istanbul, Turkey.
FAU - Uzun, Erdal
AU  - Uzun E
AD  - 3 Kayseri Training and Research Hospital, Kayseri, Turkey.
FAU - Duygulu, Fuat
AU  - Duygulu F
AD  - 3 Kayseri Training and Research Hospital, Kayseri, Turkey.
FAU - Yazici, Cevat
AU  - Yazici C
AD  - 4 Erciyes University, Department of Clinical Biochemistry, Kayseri, Turkey.
FAU - Kafadar, Ibrahim Halil
AU  - Kafadar IH
AD  - 5 Erciyes University, Department of Orthopedics and Traumatology, Kayseri, 
      Turkey.
LA  - eng
PT  - Journal Article
DEP - 20161129
PL  - United States
TA  - Cartilage
JT  - Cartilage
JID - 101518378
PMC - PMC5613896
OTO - NOTNLM
OT  - N-acetyl cysteine
OT  - biomarker
OT  - hyaluronic acid
OT  - osteoarthritis
OT  - oxidant status
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2017/09/25 06:00
MHDA- 2017/09/25 06:01
PMCR- 2018/04/01
CRDT- 2017/09/23 06:00
PHST- 2017/09/23 06:00 [entrez]
PHST- 2017/09/25 06:00 [pubmed]
PHST- 2017/09/25 06:01 [medline]
PHST- 2018/04/01 00:00 [pmc-release]
AID - 10.1177_1947603516675915 [pii]
AID - 10.1177/1947603516675915 [doi]
PST - ppublish
SO  - Cartilage. 2017 Oct;8(4):384-390. doi: 10.1177/1947603516675915. Epub 2016 Nov 
      29.