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Final Program


Final Program

691 - Predictors of Successful Viscosupplementation in Osteoarthritis of the Knee

Thursday, February 27, 2025
5:00 PM - 6:30 PM MST

    Presenting Author(s)

  • AR

    Anish Rana, BA

    Medical Student
    University of Rochester Medical Center, Strong Memorial Hospital
    Glen Mills, Pennsylvania, United States

    • Co-Author(s)

  • GW

    Garret Waterstradt, MD

    Resident Physician
    University of Rochester Medical Center
    Rochester, New York, United States

  • KK

    Kenneth King, MD

    Physical Medicine and Rehabilitation Resident
    University of Rochester Medical Center, Strong Memorial Hospital
    Rochester, New York, United States

  • NB

    Nathan G. Barford, DO

    Assistant Professor of Clinical PM&R
    University of Rochester
    Irondequoit, New York, United States

  • Jennifer Paul, MD

    Residency Program Director/Associate Professor
    University of Rochester
    Pittsford, New York, United States

  • SL

    Samia Lopa, PhD

    Research Assistant Professor
    University of Rochester Medical Center
    Rochester, New York, United States

Objectives: Osteoarthritis (OA) of the knee is the most prevalent form of arthritis and a leading cause of disability among older adults, leading to reduced mobility, chronic joint pain, and diminished quality of life. Common treatments include intra-articular corticosteroids (IACS) and viscosupplementation (VS). Many insurance carriers either decline to cover VS or only cover when IACS fail. This study investigates whether a predictive relationship exists between response to IACS and subsequent response to VS. Additionally, the study explores whether factors like age, body mass index (BMI), and OA severity predict positive VS outcomes.

Design:

This was a retrospective cohort study of 548 patients from the Physical Medicine and Rehabilitation Department at the University of Rochester. Pain relief was categorized into three tiers based on patient-reported outcomes: no/ minimal relief (0-33%), some relief (34-66%), and good/excellent relief (67-100%). Responses in the some relief or good/excellent relief category were considered favorable. VS response was compared by IACS response, with Odds Ratio calculated using logistic regression.

Results: The favorable response rate to VS (95% CI) among those not responding to IACS was 55% (48%-62%) compared to 72% (67%-76%) in those responding to IACS (p < 0.0001). Patients responding to IACS had higher odds of responding to VS (OR =2.08, 95% CI: 1.45 - 2.99, p-value = < .001) than those not responding to IACS. After adjusting for age, sex, BMI, and OA severity, IACS response remained significantly associated with VS response (OR = 2.25, 95% CI: 1.54 - 3.28, p = < .001). Higher BMI was significantly associated with lower odds of VS response (OR = 0.92 per 5 kg/m2, 95% CI: 0.75-0.98, p =0.02).

Conclusions: Response to IACS predicts subsequent response to VS in knee OA patients. These findings provide valuable insights for clinicians in optimizing VS, improving treatment success and reducing healthcare costs.