Efficacy of intra-articular hyaluronic acid in relief of pain in Kellgren and Lawrence grade 2 and 3 osteoarthritis knee

Abstract

Introduction: Intra-Articular Hyaluronic Acid (IA-HA) supplementation not only improvises the synovial fluid flow dynamics and viscoelasticity but also potentially offers a positive effect on the arthritic disease process by promoting in vivo IAHA production and by providing an intra-articular anti-inflammatory effect. Objective: The primary objective of this study was to compare a single 6ml, intra-articular injection of hylan GF-20 with conservative treatment in patients with symptomatic mild to moderate knee Osteoarthritis (OA). Methodology: Patients with primary OA knee pain were randomly assigned to arthrocentesis plus a 6ml intra -articular injection of either hylan G-F 20 or conservative methods of treatment in a prospective, single-blinded (evaluator) randomised control study. Results were evaluated at Pre Injection, 3, 8, 16 and 24 weeks post-injection. The primary outcome criterion was change from baseline over 24 weeks in Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and VAS Score. Results: A total of 70 patients (Kellgren–Lawrence grade II or III) was randomly assigned. Patients receiving hylan G-F 20 experienced statistically significantly greater improvements in WOMAC scores and VAS scores, than patients receiving conservative treatment. No increased risk of local adverse events was observed. Conclusions: This prospective randomised control study demonstrated that, in patients with knee osteoarthritis, a single 6 ml intra-articular injection of hylan G-F 20 is safe and effective in providing statistically significant, clinically relevant pain relief over 24 weeks, with a modest difference versus conservative treatment.