Knee osteoarthritis (KOA) is an
intractable and devastating consequence of degeneration that results in
tremendous impact on daily activities. Painful disabling KOA occurs in more
than 10% of people who are over 55 years old. Those who are severely disabled
account for up to 25% of aging people and KOA is a major cause of total knee
replacement.
Current osteoarthritis therapies
largely rely on rest, weight loss, bracing and assistive devices, physical
modalities, therapeutic
exercises, and pharmacological interventions which are unsatisfactory for the majority of
severe disabled patients, who are left with ambulation deficit despite vigorous
treatment intervention. Although numerous patients can be treated with surgery,
some of them are not good candidates due to multiple co-morbidities. For these
reasons, intra-articular (IA) treatments that reduce chronic joint pain and
improve function is the long-term effective and safe alternative options.
In a number of recent studies,
pain intensity and functional performance resulted from osteoarthritis has been
improved after IA injection of botulinum toxin type A (BoNT-A).The Botulinum
neurotoxin has been comprehensively studied for its muscle-paralyzing effect by
proteolysis of membrane-associated proteins inhibiting of the exocytotic
release of acetylcholine, thereby blocking neurotransmission from motor nerve
terminals.
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