Effectiveness of Cingal™ for Improving Pain Scores and Function in Anterior Knee Pain

Anterior Knee Pain (AKP) is a common condition that can be challenging to treat effectively. The main goal of treatment regimens is to improve the function of the knee. However, treatment can be challenging due to the knee pain experience. Cingal™ contains hyaluronic acid (HA), which acts as a joint lubricant, and the corticosteroid triamcinolone hexacetonide (TH). Some studies have shown that Cingal™ can improve joint function and provide short-term pain relief.

Inclusion Criteria:Age 18 - 35 yearsStandard weight-bearing AP and skyline view knee x-raysRetropatellar or peripatellar knee pain for a minimum of 2 monthsConfirmed diagnosis of AKP that has failed to improve with a minimum of 6 weeks of conservative treatment (activity modification, supervised physiotherapy, exercise therapy, taping or bracing, NSAIDS)Pain aggravated by at least two of the following patellofemoral joint loading activities: squatting, running, ascending or descending stairs, or sitting with prolonged knee flexion.Exclusion Criteria:X-ray evidence of knee osteoarthritis or fractureMeniscal or ligamentous injury assessed or suspected on clinical examinationPrevious knee surgeryHistory of patellar instabilityAny contraindication to knee injection (overlying skin condition, joint infection, significant joint effusion, coagulopathy, previous adverse reaction, etc.)Known allergy to Cingal™ or its constituentsPrevious knee injection within the last 3 monthsBMI greater than 30 kg/m2Diabetes, inflammatory conditions (rheumatologic disease, ankylosing spondylitis), or concurrent medical conditions which may result in chronic pain or altered pain sensationPregnant or breastfeedingWorkers Compensation Board casePatient involved in litigation