Research Day
PREDICTORS OF PATIENT EXPECTATIONS FOR FUNCTIONAL OUTCOMES FOLLOWING HYALURONIC ACID INJECTIONS
Document Type
Abstract
Date
2021
Abstract
Introduction: Hyaluronic acid injections(HA) are a widely utilized non-operative treatment for knee osteoarthritis. Patient expectations and emotional stress may affect functional outcomes after treatments. The purpose of this study was to identify factors predictive of greater patient expectations for knee function after HA injections.
Materials and Methods: This was a prospective cohort study of patients receiving HA injections. Exclusion criteria included prior history of HA injections or rheumatoid arthritis. Prior to treatment, Knee Osteoarthritis Outcome Score(KOOS), a KOOS expectation at 6 months(exp-KOOS), and Perceived Stress Scale(PSS) were completed. KOOS was re-evaluated 6 months post-injection.
Results: 142 patients enrolled(52 male, 90 female), with mean BMI 30.82(± 8.02) and age 61.51(± 11.55). Expected mean KOOS subscale improvements were 30.73(± 18.56) pain, 20.37(± 17.51) symptom, 26.27 ±(19.98) ADL, 33.22(± 25.40) Sports, and 37.13(± 25.60) QoL; actual improvements were 8.52(± 18.38), 4.80(± 16.81), 7.96(± 18.31), 7.81(± 28.30), and 10.64(± 22.05), respectively. KOOS 6-month outcomes were significantly improved for all subscale items(P<0.006), although fell short of expectations(P<0.001). Expectations weakly, but significantly, correlated with outcomes. Rho correlations ranged 0.20-0.37 for subscales(P<0.043). Age, BMI, and PSS were not correlated to expectations at(P<0.05). Older age was correlated with worse actual outcomes for pain, symptom, sport, and QoL subscales(P<0.029).
Conclusion: Patient expectations at for HA is higher than actual outcomes, although higher expectations were predictive of better outcomes. No single measure was predictive of expectations, and older age was predictive of worse actual outcomes.