Efficacy of Intra-articular Injection Hyaluronic Acid in Osteoarthritis of Knee: A Hospital Based Study
Background: Osteoarthritis (OA) is the most common disease of joints in adults around the world. The aim of the study was to assess functional outcome and results of injection of hyaluronic acid in symptomatic osteoarthritis knee.
Methods: It was a prospective clinical study with 3 months of follow-up was conducted in the Dept. of Orthopaedics, Pacific Medical College and Hospital, Udaipur. Clinically proven n=35 patients of osteoarthritis knee (OA) included in study on the basis of inclusion and exclusion. Enrolled patients were treated by weekly intra articular injection of Hyaluronic acid (20 mcg/2ml) in affected knee joint for 5 weeks. Functional outcome and clinical assessment was done by pain at visual analogue score (VAS) and by knee range of movements, patients global assessment of treatment and physician global assessment of treatment.
Results: Thirty Five patients participated in study and reported statistically significant improvement in VAS score in mild and moderate osteoarthritis of knee from 4.46±0.52 and 7.17±0.96 points respectively pre-treatment level to 3.36±0.63 and 5.26±0.44 points respectively at three months post Hyaluronic acid injection follow up, improvement in joint tenderness and patients & physician’s global assessment score also improved significantly clinically as well as statistically in mild to moderate group while in severe group no clinical and statistically significant improvement was observed in any parameter.
Conclusions: We concluded that intra articular injection hyaluronic acid should be considered as safe and effective modality of treatment in selected group of mild to moderate osteoarthritis only.
2. Fransen M, Bridgett L, March L, Hoy D, Penserga E, Brooks P. The epidemiology of osteoarthritis in Asia. Int J Rheum Dis. 2011;14(2):113-21.
3. Felson DT, Couropmitree NN, Chaisson CE, Hannan MT, Zhang Y, McAlindon TE, et al.
4. Evidence for a Mendelian gene in a segregation analysis of generalized radio-graphic osteoarthritis. The Framingham Study. Arthritis Rheum. 1998;41(6):1064-71.
5. Andrianakos AA, Kontelis LK, Karamitsos DG, Aslanidis SI, Georgountzos AI, Kaziolas GO, et al. Prevalence of symptomatic knee, hand and hip osteoarthritis in Greece. The ESORDIG study. J Rheumatology. 2006;33:2507-13.
6. Altman RD. The syndrome of osteoarthritis. J Rheumatol. 1997;24:766-7.
7. Lawrence RC, Helmick CG, Arnett FC, Deyo RA, Felson DT, Giannini EH, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998;41:778-99.
8. Padda AS, Mohan V, Singh J, Deepti SS, Singh G, Dhillon HS. Health profile of the aged persons in urban and rural field practice areas of Medical College, Amritsar. Indian J of Com Med. 1998;23:72-6.
9. Kishore S, Garg BS. Sociomedical problems of aged population in rural area of Wardha District. Ind J Pub Health. 1997;41:46-8.
10. Khan JA, Khan Z. A study of the leading causes of illness & physical disability in an urban aged population. Indian J Prev Soc. Med. 2000;32:121-4.
11. Davis MA. Epidemiology of osteoarthritis. Clin Geriatr Med. 1988;24:766-7.
12. Ringdahl E, Pandit S. Treatment of knee osteoarthritis. Am Fam Physician. 2011;83:1287-92.
13. Goldberg VM, Goldberg L. Intra-articular hyaluronans: the treatment of knee pain in osteoarthritis. J Pain Res. 2010:3;51-6.
14. Bellamy N1, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Visco-supplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006;2:CD005321.
15. Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006;2:CD005328.
16. Leopold SS, Redd BB, Warme WJ, Wehrle PA, Pettis PD, Shott S. Corticosteroid compared with hyaluronic acid injections for the treatment of osteoarthritis of the knee. J Bone Joint Surg. 2003