Safety and Efficacy of Intra-Articular 20 mg/2 ml Hyaluronic Acid Injection for the Non-Operative Palliation Treatment of Osteoarthritis of the Knee Joint

Abstract

PURPOSE OF THE STUDY In this study it is aimed to prospectively evaluate the safety and efficacy of 20 mg/2 ml Hyaluronic Acid (HA) injections for non-operative palliation treatment of osteoarthritis (OA) of the knee joint. MATERIAL AND METHODS After institutional review board approval was obtained for the study, 63 patients were enrolled and followed prospectively. All the patients have signed informed consent form. Patients who had diagnosis of gonarthrosis according to clinical and radiological evaluation, were given nonsteroid anti-inflammatory drug (NSAID) treatment for four weeks. Patients between 55-80 years old in both sexes, whose pain did not relieve were included to the study and were followed up for 6 months. They were applied HA injections in total; three times with one week of interval.Patients were evaluated three times during the study. First one at third week (at the control visit of third injection), secondly at third month and lastly at sixth month. Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and Short Form Health Survey (SF-36) scores were used to clinically evaluate the patients at follow ups. RESULTS 56 (88.9%) patients completed the study and 7 (11.1%) patients did not show up for follow-up examinations and they were excluded. The mean age of the patients was 63.6 +/- 6.90 (range 47 and 76) years old. 22 (39.2%) of the patients were male and 34 (60.7%) were female. Any adverse events and adverse effects were not seen in the enrolled patients group. CONCLUSIONS Results of this study revealed that the use of 20 mg/2 ml HA injection was effective in improving the WOMAC index score in patients of knee OA. Additionally, patients' quality of life as measured by SF-36 questionnaire was also significantly improved at the end of the study. None of the patient reported any of the adverse events during the study. Overall, the 20 mg/2 ml HA injection can be considered as a good treatment option for the knee OA in patients who do not respond to non-pharmacological therapy, NSAIDs or analgesics.