Abstract

FENOLLOSA VAZQUEZ, P.; IZQUIERDO AGUIRRE, R. M.; CANOS VERDECHO, M. A.  and  PALLARES DELGADO, J.. Effects of intraarticular Botulinum Toxin A (Botox^®) on refractory knee osteoarthritis. Rev. Soc. Esp. Dolor [online]. 2011, vol.18, n.6, pp.320-325. ISSN 1134-8046.

Objective: osteoarthritis is the most common joint disease and it is among the most disabling health problems for middle aged and older people. Purpose: to test the effects of a single intraarticular injection of Botulinum Toxin A (BTA) on refractory knee osteoarthritis. Material and method: twelve women (mean age: 72) with refractory knee osteoarthritis who had failed other treatments and without possibilities of arthroplasty were injected with 100 units of BTA (Botox^®-Allergan). Patients were followed-up for 16 weeks. They were assessed by means of VAS, WOMAC questionnaire, daily analgesic consumption, and a verbal relief scale. Side effects were also evaluated. Results: a peak of pain relief was evident 2 weeks after BTA injection and lasted typically for 16 weeks. The median change in WOMAC total score and VAS were -7.5 and -1.9 respectively, with a statistically significant pain decrease over 16 weeks. Five out of 12 do not found any decrease in total Womac score; 3 patients described at least 20% of relief and the remaining 4 found more than 40% of reduction in that scale. Those cases who responded to the BTA injection noted improved function in activities of daily living. Daily analgesic necessity droped from 3.6 to 2 doses. No side effects were noted. Conclusion: beneficial effects lasted for at least 12 weeks and gave pain relief. Based on the positive findings of this study, we believe that further, randomized, controlled trials for the use of BTA in knee osteoarthritic pain would be warranted.

Keywords : Botulinum toxin A; Osteoarthritis; Knee; quality of life.

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