PM&R
Volume 2, Issue 4 , Pages 268-276 , April 2010

Efficacy of Intra-Articular Botulinum Toxin Type A in Painful Knee Osteoarthritis: A Pilot Study

  • Andrea J. Boon, MD

      Affiliations

    • Departments of Physical Medicine and Rehabilitation and Neurology, Mayo Clinic College of Medicine, Rochester, MN
    • Corresponding Author InformationAddress correspondence to A.J.B.; 200 1st St SW, Rochester, MN 55905
  • ,
  • Jay Smith, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN
  • ,
  • Diane L. Dahm, MD

      Affiliations

    • Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN§
  • ,
  • Eric J. Sorenson, MD

      Affiliations

    • Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN
  • ,
  • Dirk R. Larson, MS

      Affiliations

    • Department of Biostatistics, Mayo Clinic College of Medicine, Rochester, MN
  • ,
  • Patrick D. Fitz-Gibbon, BS

      Affiliations

    • Department of Biostatistics, Mayo Clinic College of Medicine, Rochester, MN#
  • ,
  • Dennis D. Dykstra, MD, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Minnesota Department of Biostatistics, Mayo Clinic College of Medicine, Rochester, MN††
  • ,
  • Jasvinder A. Singh, MD, MPH

      Affiliations

    • Division of Rheumatology, VA Medical Center & University of Minnesota, Minneapolis & Departments of Health Sciences and Orthopaedic Surgery, Mayo Clinic College of Medicine, Rochester, MD‡‡

Received 7 August 2009 ,Accepted 23 February 2010.

References 

  1. MacLean CH, Knight K, Paulus H, Brook RH, Shekelle PG. Costs attributable to osteoarthritis. J Rheumatol. 1998;25:2213–2218
  2. Tugwell P. Economic evaluation of the management of pain in osteoarthritis. Drugs. 1996;52(suppl 3):48–58
  3. Kelsey J. Epidemiology of Musculoskeletal Disorders. In: New York: Oxford University Press; 1982;p. 78–86
  4. Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998;41:778–799
  5. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update (American College of Rheumatology Subcommittee on Osteoarthritis Guidelines). Arthritis Rheum. 2000;43:1905–1915
  6. Shamoon M, Hochberg MC. Treatment of osteoarthritis with acetaminophen: Efficacy, safety, and comparison with nonsteroidal anti-inflammatory drugs. Curr Rheumatol Rep. 2000;2:454–458
  7. Bjordal JM, Klovning A, Ljunggren AE, Slordal L. Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: A meta-analysis of randomised placebo-controlled trials. Eur J Pain. 2007;11:125–138
  8. Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. [see comment][update of Cochrane Database Syst Rev. 2005;(2):CD005321; PMID: 15846754] Cochrane Database of Syst Rev. 2006;CD005321
  9. Borodic GE, Acquadro M, Johnson EA. Botulinum toxin therapy for pain and inflammatory disorders: Mechanisms and therapeutic effects. Expert Opin Invest Drugs. 2001;10:1531–1544
  10. Brin MF, Fahn S, Moskowitz C, et al. Localized injections of botulinum toxin for the treatment of focal dystonia and hemifacial spasm. Mov Disord. 1987;2:237–254
  11. Gobel H, Heinze-Kuhn K, Austermann K. Botulinum toxin A in the treatment of headache syndromes and pericranial pain syndrome. Pain. 2001;91:195–199
  12. O'Brien C. Clinical applications of botulinum toxin: Implications for pain management. Pain Digest. 1998;8:342–345
  13. Wissel J, Muller J, Dressnandt J, et al. Management of spasticity associated pain with botulinum toxin A. J Pain Symptom Manage. 2000;20:44–49
  14. Aoki KR. Evidence for antinociceptive activity of botulinum toxin type A in pain management. Headache. 2003;43(suppl 1):S9–S15
  15. Arezzo JC. Possible mechanisms for the effects of botulinum toxin on pain. Clin J Pain. 2002;18:S125–S132
  16. Argoff CE. A focused review on the use of botulinum toxins for neuropathic pain. Clin J Pain. 2002;18:S177–S181
  17. Ishikawa H, Mitsui Y, Yoshitomi T, et al. Presynaptic effects of botulinum toxin type A on the neuronally evoked response of albino and pigmented rabbit iris sphincter and dilator muscles. Jpn J Ophthalmol. 2000;44:106–109
  18. Purkiss J, Welch M, Doward S, Foster K. Capsaicin-stimulated release of substance P from cultured dorsal root ganglion neurons: Involvement of two distinct mechanisms. Biochem Pharmacol. 2000;59:1403–1406
  19. Welch MJ, Purkiss JR, Foster KA. Sensitivity of embryonic rat dorsal root ganglia neurons to Clostridium botulinum neurotoxins. Toxicon. 2000;38:245–258
  20. Mahowald ML, Singh JA, Dykstra D. Long term effects of intra-articular botulinum toxin A for refractory joint pain. Neurotoxicity Res. 2006;9:179–188
  21. Singh JA, Mahowald ML. Intra-articular botulinum toxin A as an adjunctive therapy for refractory joint pain in patients with rheumatoid arthritis receiving biologics: A report of two cases. Joint Bone Spine. 2009;76:190–194
  22. Singh JA, Mahowald ML, Kushnaryov A, Goelz E, Dykstra D. Repeat injections of intra-articular botulinum toxin a for the treatment of chronic arthritis joint pain. J Clin Rheumatol. 2009;15:35–38
  23. Singh JA, Mahowald ML, Noorbaloochi S. Intra-articular botulinum toxin A for refractory shoulder pain: a randomized, double-blinded, placebo-controlled trial. Transl Res. 2009;153:205–216
  24. Kellgren J, Lawrence JS. Atlas of Standard Radiographs: The Epidemiology of Chronic Rheumatism. In: Oxford: Blackwell Scientific; 1963;p. 2
  25. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8:1153–1157
  26. Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale [see comment]. Ann Emerg Med. 2001;38:633–638
  27. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840
  28. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36) (I. Conceptual framework and item selection). Med Care. 1992;30:473–483
  29. Pham T, Van Der Heijde D, Lassere M, et al. Outcome variables for osteoarthritis clinical trials: The OMERACT-OARSI set of responder criteria. J Rheumatol. 2003;30:1648–1654
  30. Hochberg MC, Altman RD, Brandt KD, Moskowitz RW. Design and conduct of clinical trials in osteoarthritis: Preliminary recommendations from a task force of the Osteoarthritis Research Society. J Rheumatol. 1997;24:792–794
  31. Adebajo AO, Nash P, Hazleman BL. A prospective double blind dummy placebo controlled study comparing triamcinolone hexacetonide injection with oral diclofenac 50 mg TDS in patients with rotator cuff tendinitis. J Rheumatol. 1990;17:1207–1210
  32. Altman RD, Moskowitz R. Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial (Hyalgan Study Group). [see comment][erratum appears in J Rheumatol 1999;26:1216] J Rheumatol. 1998;25:2203–2212
  33. Wobig M, Dickhut A, Maier R, Vetter G. Viscosupplementation with hylan G-F 20: A 26-week controlled trial of efficacy and safety in the osteoarthritic knee. Clin Ther. 1998;20:410–423
  34. Raynauld JP, Torrance GW, Band PA, et al. A prospective, randomized, pragmatic, health outcomes trial evaluating the incorporation of hylan G-F 20 into the treatment paradigm for patients with knee osteoarthritis (Part 1 of 2): Clinical results. Osteoarthritis Cartilage. 2002;10:506–517
  35. Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: A randomised, placebo-controlled clinical trial. Lancet. 2001;357:251–256
  36. Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: A randomized, controlled trial. Ann Intern Med. 2004;141:901–910
  37. Farrar JT, Portenoy RK, Berlin JA, Kinman JL, Strom BL. Defining the clinically important difference in pain outcome measures. [see comment] Pain. 2000;88:287–294
  38. Farrar JT, Young JP, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. [see comment] Pain. 2001;94:149–158
  39. Rosenberger PH, Kerns R, Jokl P, Ickovics JR. Mood and attitude predict pain outcomes following arthroscopic knee surgery. Ann Behav Med. 2009;37:70–76

 This study was supported by a grant from Mayo Clinic and Foundation.

 This CME activity is designated for 1.0 AMA PRA Category 1 Credit™ and can be completed online at me.aapmr.org. Log on to www.me.aapmr.org, go to Lifelong Learning (CME) and select Journal-based CME from the drop down menu. This activity is FREE to AAPM&R members and $25 for non-members.

PII: S1934-1482(10)00136-X

doi: 10.1016/j.pmrj.2010.02.011

PM&R
Volume 2, Issue 4 , Pages 268-276 , April 2010