Objective To assess the clinical efficacy and safety of intra-articular injection of hyaluronic acid (HA) combined with polydeoxyribonucleotide (PDRN) in patients with knee osteoarthritis in comparison with that of HA alone.
Methods The current single-center, prospective, randomized, double-blind, controlled study was conducted in 36 patients with knee osteoarthritis at our medical institution. All the eligible patients (n=30) were equally assigned to two treatment arms (trial group ‘HA+PDRN’ and control group ‘HA’). For efficacy assessment, the patients were evaluated for the visual analogue scale (VAS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Knee Society Scores (KSS), all of which served as efficacy outcome measures. We monitored time-dependent changes in efficacy outcome measures at baseline and 1, 3 and 6 months. Subsequently, we compared differences in changes in efficacy outcome measures at 6 months from baseline between the two groups. Moreover, we assessed the safety based on the treatment-emergent adverse events (TEAEs), adverse drug reactions (ADRs) and any other complications serving as safety outcome measures.
Results There were significant differences in changes in the VAS scores, the WOMAC scores in all domains, except ‘Stiffness’, the total WOMAC scores, and the KSS scores in all the domains at 6 months from baseline between the two groups (p<0.05). In our series, there were no TEAEs, ADRs, and any other complications.
Conclusion Intra-articular injections of HA combined with PDRN can also be considered in the treatment of knee osteoarthritis. However, further large-scale and multi-center studies are required to demonstrate the potential of the proposed combination.
Citations
Citations to this article as recorded by
Emerging wound-healing injectable polydeoxyribonucleotide: potential as a prohibited doping method and its simple detection via CRISPR/Cas12a system Joon-Yeop Yi, Sanghwa Park, Minyoung Kim, Yujin Jeong, HyunA Shin, Yeojeong Cho, Mijin Jeon, Min-Kyu Oh, Changmin Sung International Journal of Biological Macromolecules.2025; 309: 142999. CrossRef
Polydeoxyribonucleotide as a Regenerative Agent in Dermatology and Wound Healing: Mechanisms, Clinical Applications, and Safety Gi Young Park, Byeong-Churl Jang Keimyung Medical Journal.2025; 44(1): 9. CrossRef
Points to ponder on the role of polynucleotides in regenerative and aesthetic medicine: a systematic review William Richard Webb, Eqram Rahman, Parinitha Rao, Hany Niamey Abu-Farsakh, Nanze Yu, Patricia E. Garcia, Sotirios Ioannidis, Karim Sayed, Elias Tam, Wolfgang G. Philipp-Dormston, Mohammad Najlah, Zakia Rahman, Jean D. A. Carruthers, Ash Mosahebi European Journal of Plastic Surgery.2024;[Epub] CrossRef
An injectable hyaluronic acid-Polydeoxyribonucleotides (HA-PDRN) crosslinked hydrogel as a dermal filler Guo jiahong, Fang wei, Wang feifei European Polymer Journal.2024; 219: 113395. CrossRef
Recent advances on polydeoxyribonucleotide extraction and its novel application in cosmeceuticals Thi Hanh Nguyen, San-Lang Wang, Van Bon Nguyen International Journal of Biological Macromolecules.2024; 282: 137051. CrossRef
Injectable “Skin Boosters” in Aging Skin Rejuvenation: A Current Overview Nark-Kyoung Rho, Hyun-Seok Kim, Soo-Young Kim, Won Lee Archives of Plastic Surgery.2024; 51(06): 528. CrossRef
Clinical Updates in Polydeoxyribonucleotide Injection Tae-Yeong Kim, Yong-Tae Kim, Jung-Taek Hwang Journal of the Korean Orthopaedic Association.2024; 59(6): 386. CrossRef
Pseudoseptic Reaction to an Intra-Articular Polydeoxyribonucleotide Injection into the Ankle: A Case Report Seungcheol Yu, Hangaram Kim, Youngwoong Choi, Jeongsoo Kim International journal of Pain.2024; 15(2): 106. CrossRef
Intra-articular injections of polynucleotides for joint preconditioning before the injections of bionic cross-link hyaluronic acid. Case report Irina S. Svintsitskaya, Konstantin Yu. Volkov, Aleksei Chetaikin Storm Terapevticheskii arkhiv.2024; 96(12): 1238. CrossRef
Therapeutic effects of polydeoxyribonucleotide in an in vitro neuronal model of ischemia/reperfusion injury Seongmoon Jo, Ahreum Baek, Yoonhee Cho, Sung Hoon Kim, Dawoon Baek, Jihye Hwang, Sung-Rae Cho, Hyun Jung Kim Scientific Reports.2023;[Epub] CrossRef
Skin boosters – The upcoming boom in cosmetic dermatology for healthy skin Maya Vedamurthy, Vaishnavi Duvvuru, Vijaya Lakshmi Chelikani Cosmoderma.2023; 3: 82. CrossRef
Role and Effectiveness of Intra-articular Injection of Hyaluronic Acid in the Treatment of Knee Osteoarthritis: A Systematic Review Sumant Chavda, Syed Arman Rabbani, Tarun Wadhwa Cureus.2022;[Epub] CrossRef
Polydeoxyribonucleotide: A promising skin anti-aging agent Aawrish Khan, Guobao Wang, Feng Zhou, Lunli Gong, Jun Zhang, Lili Qi, Haiyan Cui Chinese Journal of Plastic and Reconstructive Surgery.2022; 4(4): 187. CrossRef
Adenosine A2A receptor agonist polydeoxyribonucleotide ameliorates short-term memory impairment by suppressing cerebral ischemia-induced inflammation via MAPK pathway Il-Gyu Ko, Jun-Jang Jin, Lakkyong Hwang, Sang-Hoon Kim, Chang-Ju Kim, Jung Won Jeon, Jun-Young Chung, Jin Hee Han, Giuseppe Pignataro PLOS ONE.2021; 16(3): e0248689. CrossRef
Applications of Marine Organism-Derived Polydeoxyribonucleotide: Its Potential in Biomedical Engineering Tae-Hee Kim, Seong-Yeong Heo, Gun-Woo Oh, Soo-Jin Heo, Won-Kyo Jung Marine Drugs.2021; 19(6): 296. CrossRef
Mesenchymal Stem Cells Use in the Treatment of Tendon Disorders: A Systematic Review and Meta-Analysis of Prospective Clinical Studies Woo Sup Cho, Sun Gun Chung, Won Kim, Chris H. Jo, Shi-Uk Lee, Sang Yoon Lee Annals of Rehabilitation Medicine.2021; 45(4): 274. CrossRef
Viscosupplementation in the Therapy for Osteoarthritic Knee Junghyun Park, Hue Jung Park, Min Cheol Rho, Jin Joo Applied Sciences.2021; 11(24): 11621. CrossRef
A Comprehensive Review of Viscosupplementation in Osteoarthritis of the Knee Jacquelin Peck, Annabel Slovek, Paulo Miro, Neeraj Vij, Blake Traube, Christopher Lee, Amnon A. Berger, Hisham Kassem, Alan D. Kaye, William F. Sherman, Alaa Abd-Elsayed Orthopedic Reviews.2021;[Epub] CrossRef
Polydeoxyribonucleotide Regulation of Inflammation Maria Teresa Colangelo, Carlo Galli, Stefano Guizzardi Advances in Wound Care.2020; 9(10): 576. CrossRef
The efficacy and safety of polydeoxyribonucleotide for the treatment of knee osteoarthritis Man Soo Kim, Ryu Kyoung Cho, Yong In Medicine.2019; 98(39): e17386. CrossRef
Objective To assess the efficacy and safety of our 4-week caregiver-mediated exercise (CME) in improving trunk
control capacity, gait, and balance and in decreasing concerns about post-stroke falls when there is an increase in its efficacy.
Methods Acute or subacute stroke survivors were assigned to either the trial group (n=35) or the control group (n=37). Changes in Modified Barthel Index (MBI), Functional Ambulation Categories (FAC), Berg Balance Scale (BBS), and Trunk Impairment Scale (TIS) scores at 4 weeks from baseline served as primary outcome measures. Correlations of primary outcome measures with changes in Fall Efficacy Scale-International (FES-I) scores at 4 weeks from baseline in the trial group served as secondary outcome measures. Treatment-emergent adverse events (TEAEs) served as safety outcome measures.
Results There were significant differences in changes in MBI, FAC, BBS, TIS-T, TIS-D, TIS-C, and FES-I scores at 4 weeks from baseline between the two groups (all p<0.0001). There were no significant (p=0.0755) differences in changes in TIS-S scores at 4 weeks from baseline between the two groups. MBI, FAC, BBS, and TIS scores showed significantly inverse correlations with FES-I scores in patients receiving CME. There were no TEAEs in our series.
Conclusion CME was effective and safe in improving the degree of independence, ambulation status, dynamic and static balance, trunk function, and concerns about post-stroke falls in stroke survivors.
Citations
Citations to this article as recorded by
Physical rehabilitation approaches for the recovery of function and mobility following stroke Alex Todhunter-Brown, Ceri E Sellers, Gillian D Baer, Pei Ling Choo, Julie Cowie, Joshua D Cheyne, Peter Langhorne, Julie Brown, Jacqui Morris, Pauline Campbell Cochrane Database of Systematic Reviews.2025;[Epub] CrossRef
Effects of Real-Time Feedback Methods on Static Balance Training in Stroke Patients: A Randomized Controlled Trial Il-Ho Kwon, Won-Seob Shin, Kyu-Seong Choi, Myung-Sun Lee Healthcare.2024; 12(7): 767. CrossRef
Impact of telehealth on stroke survivor–caregiver dyad in at‐home rehabilitation: A systematic review Davide Bartoli, Antonello Petrizzo, Ercole Vellone, Rosaria Alvaro, Gianluca Pucciarelli Journal of Advanced Nursing.2024; 80(10): 4003. CrossRef
Stroke survivor and caregiver experiences of virtual reality gaming to promote social participation: A qualitative study Suzanne Hoi Shan Lo, Janita Pak Chun Chau, Kai Chow Choi, Laveeza Butt, Alexander Yuk Lun Lau, Vivian Wing Yan Lee, Eddie Chi Fai Kwok, David R. Thompson, Nadinne Alexandra Roman PLOS ONE.2024; 19(12): e0315826. CrossRef
Physical activity according to sit-to-stand, standing, and stand-to-sit abilities in subacute stroke with walking difficulty: a cross-sectional study Natsuki Shimizu, Hiroyuki Hashidate, Tomohiro Ota, Yumi Kawai Physiotherapy Theory and Practice.2023; 39(11): 2327. CrossRef
Anosognosia for Hemiplegia and Falls After Stroke Elizabeth M. Byrd, Christianne E. Strang, Xiaofei Qiao, Lori Loan, Rebecca S. Miltner, Rita A. Jablonski Rehabilitation Nursing.2023; 48(1): 14. CrossRef
Effectiveness of caregiver‐mediated exercise interventions on activities of daily living, anxiety and depression post‐stroke rehabilitation: A systematic review and meta‐analysis Wen Ting Choo, Ying Jiang, Kendy Gui Fang Chan, Hadassah Joann Ramachandran, Jun Yi Claire Teo, Chuen Wei Alvin Seah, Wenru Wang Journal of Advanced Nursing.2022; 78(7): 1870. CrossRef
Exercise participation and promotion in the multiple sclerosis community; perspectives across varying socio-ecological levels Yvonne C. Learmonth, Zita Chan, Helen Correia, Dave Hathorn, Allan Kermode, Catherine Smith, Diana Walker Disability and Rehabilitation.2021; 43(25): 3623. CrossRef
Continuity of Care During COVID-19 Lockdown: A Survey on Stakeholders' Experience With Telerehabilitation Carla Assenza, Hilenia Catania, Clementina Antenore, Tiziana Gobbetti, Paola Gentili, Stefano Paolucci, Daniela Morelli Frontiers in Neurology.2021;[Epub] CrossRef
The effects of virtual reality augmented robot-assisted gait training on dual-task performance and functional measures in chronic stroke: a randomized controlled single-blind trial Büşra KAYABINAR, İpek ALEMDAROĞLU-GÜRBÜZ, Öznur YILMAZ European Journal of Physical and Rehabilitation Medicine.2021;[Epub] CrossRef
Physical fitness training for stroke patients David H Saunders, Mark Sanderson, Sara Hayes, Liam Johnson, Sharon Kramer, Daniel D Carter, Hannah Jarvis, Miriam Brazzelli, Gillian E Mead Cochrane Database of Systematic Reviews.2020;[Epub] CrossRef
Developing ActivABLES for community-dwelling stroke survivors using the Medical Research Council framework for complex interventions Steinunn A. Olafsdottir, Helga Jonsdottir, Charlotte Magnusson, Héctor Caltenco, Mikko Kytö, Laura Maye, David McGookin, Ingibjörg Bjartmarz, Solveig Asa Arnadottir, Ingibjörg Hjaltadottir, Thora B. Hafsteinsdottir BMC Health Services Research.2020;[Epub] CrossRef
Feasibility of ActivABLES to promote home-based exercise and physical activity of community-dwelling stroke survivors with support from caregivers: A mixed methods study Steinunn A. Olafsdottir, Helga Jonsdottir, Ingibjörg Bjartmarz, Charlotte Magnusson, Héctor Caltenco, Mikko Kytö, Laura Maye, David McGookin, Solveig Asa Arnadottir, Ingibjörg Hjaltadottir, Thora B. Hafsteinsdottir BMC Health Services Research.2020;[Epub] CrossRef
The effects of sitting Tai Chi on physical and psychosocial health outcomes among individuals with impaired physical mobility Jie Zhao, Janita Pak Chun Chau, Yuli Zang, Suzanne Hoi Shan Lo, Kai Chow Choi, Surui Liang Medicine.2020; 99(34): e21805. CrossRef
First
Prev
