A Comparison of Intra-Articular Hyaluronic Acid Competitors in the Treatment of Mild to Moderate Knee Osteoarthritis

McGrath, AF McGrath AM

doi:10.4172/2167-7921.1000108

Cited by 14 publications

(36 citation statements)

References 16 publications

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“…Previously IAHA has been shown to improve the physical component but not the mental component of the short Form 36 version 2 (SF-36 V2) medical outcome questionnaire. 23 Our analysis of IAHA treatment is in-line with previously reported effects of IAHAs in knee OA management. Meta-analyses of IAHA in the management of knee OA reveal that IAHA has higher efficacy than NSAIDs and other pain relievers and reduces the incidence of total knee replacement surgery.…”

Section: Discussionsupporting

confidence: 86%

“…22 In this retrospective study, we examined medical records of knee OA patients who were treated with one injection of a high molecular weight gel of HA produced from a non-animal source. 23 The potential mechanisms of action of IAHA include chondroprotection, HA synthesis, antiinflammatory effect, and analgesic effect. At the molecular level, IAHA binds with CD44 receptors and mechano-sensitive ion channels to disrupt their downstream cytokine-mediated signaling pathways which could render the anti-inflammatory effect.…”

Section: Discussionmentioning

confidence: 99%

“…McGrath et al reported a study in which a single injection of IAHA significantly reduced knee pain VAS scores in knee OA patients for more than 6 months. 23 OA is characterized by the slow degradation of the cartilage, accompanied by pain and progressive disability. 25 In our study, a single dose of IAHA, at the four-week post-treatment time point, significantly reduced WOMAC pain, stiffness, and physical function scores (p<0.0001).…”

Section: Discussionmentioning

confidence: 99%

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Clinical outcome of intra-articular hyaluronic acid injection for knee joint osteoarthritis: a prospective interventional study from a tertiary care hospital

Chundarathil

2017

Int J Res Orthop

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Background: The prevalence of knee osteoarthritis (OA) is estimated to be 14% and 6% in rural and urban areas of India, respectively. In severe cases, the American Academy of Orthopedics Surgeons recommends non-steroidal anti-inflammatory drugs (NSAIDs). A prospective interventional study was conducted to evaluate the effectiveness of intra-articlular hyaluronic acid injection (IAHA) in knee OA patients.Methods: Medical records of 29 patients with knee OA, who were treated with IAHA injection, were analyzed using a 24 item WOMAC scale for the pain, stiffness, and physical function scores. Furthermore, the patients’ quality of life was evaluated based on the SF-12 scale and a global status assessment of knee OA was performed using the Likert scale and visual analogue scale (VAS). The data were analysed statistically.Results: The overall WOMAC pain, stiffness, and physical function scores decreased following the IAHA administration in patients with knee OA. The mean pain scores decreased from 10.82 to 3.62 and stiffness scores dropped from 4.34 to 2.03. The mean physical function scores decreased from 36.75 to 17.1 (p<0.0001). The Likert scale and VAS demonstrated statistically significant (P < 0.0001) improvement in the patient’s health status. Overall, nearly 80% of the patients expressed little-to-none physical or emotional problems four weeks after IAHA treatment.Conclusions: A single IAHA injection provided statistically significant improvement in pain, disability, and quality of life in knee OA patients.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical outcome of intra-articular hyaluronic acid injection for knee joint osteoarthritis: a prospective interventional study from a tertiary care hospital

Chundarathil

2017

Int J Res Orthop

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“…In addition to analgesics, non-steroidal anti-inflammatories, platelet-rich plasma and steroids, intra-articular injections of hyaluronic acid (HA), a slow-acting chondroprotective agent, are frequently administered to patients with OA ( 5 , 6 ). HA has a more prolonged effect and avoids several of the side effects associated with conventional OA treatment, including gastrointestinal toxicity or increased risk of the cardiovascular events ( 4 , 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

“…HA is a long chain polysaccharide present in loose connective tissue, skin, the eyes and synovial fluid ( 4 , 7 , 9 ). HA is concentrated at the surface of the articular cartilage and the superficial layers of the synovial membrane and forms a semi-permeable barrier between the synovial fluid and cartilage.…”

Section: Introductionmentioning

confidence: 99%

The association between different molecular weights of hyaluronic acid and CHAD, HIF-1α, COL2A1 expression in chondrocyte cultures

Şirin

Kaplan²,

Yılmaz

et al. 2018

Exp Ther Med

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The aim of the present study was to investigate the effects of three different formulations of hyaluronic acid (HA): Low molecular weight (MW) Sinovial One®, medium MW Viscoplus® and high MW Durolane®, on chondrocyte proliferation and collagen type II (COL2A1), hypoxia-inducible factor 1α (HIF-1α) and chondroadherin (CHAD) expression in primary chondrocyte cultures. Standard primary chondrocyte cultures were established from osteochondral tissues surgically obtained from 6 patients with gonarthrosis. Cell morphology was evaluated using an inverted light microscope; cell proliferation was determined with a MTT assay and confirmed with acridine orange/propidium iodide staining. Levels of CHAD, COL2A1 and HIF-1α expression were assessed using specific TaqMan gene expression assays. The results demonstrated the positive effect of HA treatment on cell proliferation, which was independent from the MW. COL2A1 expression increased in the medium and high MW HA treated groups. It was observed that HIF-1α expression increased in the high MW treated group alone. CHAD expression increased only in the medium MW HA treated group. Evaluation of gene expression revealed that levels of expression increased as the duration of HA application increased, in the medium and high MW HA treated groups. In terms of increased viability and proliferation, a longer duration of HA application was more effective. Taken together, it may be concluded that the administration of medium and high MW HA may be a successful way of treating diseases affecting chondrocytes in a clinical setting.

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One-year efficacy and safety of single or one to three weekly injections of hylan G-F 20 for knee osteoarthritis: a systematic literature review and meta-analysis

Lucia

Jerosch

Yoon³

et al. 2020

Clin Rheumatol

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The aim of this study was to evaluate the long-term efficacy and safety of single or 1–3 weekly injections of hylan G-F 20 at 1 year following the first injection for knee osteoarthritis (OA). Searches were conducted in PubMed/MEDLINE, Embase, and CENTRAL and included relevant conference proceedings (January 1, 1995–August 17, 2020). Randomized controlled trials (RCTs), non-randomized trials, and observational studies investigating 1-year efficacy and safety of 1–3 weekly injections or single hylan G-F 20 injection for knee OA were included. Primary outcomes were WOMAC pain, physical function, and stiffness. Meta-analyses of RCTs and non-randomized studies were conducted separately. Our search identified 24 eligible studies. Hylan G-F 20, in the meta-analyses of RCTs, showed statistically significant improvement in WOMAC pain (SMCC − 0.98, 95% CI − 1.50, − 0.46), physical function (SMCC − 1.05, 95% CI − 1.28, − 0.83), and stiffness (SMCC − 1.07, 95% CI −1.28, −0.86). Improvement was also seen for VAS pain, SF-36 MCS (mental component summary), and SF-36 PCS (physical component summary). Analyses of non-randomized studies showed similar efficacy estimates. There were no significant differences in efficacy based on injection schedule, nor between RCT and non-randomized studies. Rates of adverse events (AEs) were low for most types of AEs. Hylan G-F 20 (either as single or 1–3 weekly injections) showed improvement in 1-year efficacy outcomes in comparison to baseline and was generally well tolerated. While further research will inform the medical field regarding viscosupplementation treatment options for knee OA, these findings show that hylan G-F 20 at both frequencies/dosages are efficacious and generally well tolerated for long-term use.

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A Comparison of Intra-Articular Hyaluronic Acid Competitors in the Treatment of Mild to Moderate Knee Osteoarthritis

Cited by 14 publications

References 16 publications

Clinical outcome of intra-articular hyaluronic acid injection for knee joint osteoarthritis: a prospective interventional study from a tertiary care hospital

Clinical outcome of intra-articular hyaluronic acid injection for knee joint osteoarthritis: a prospective interventional study from a tertiary care hospital

The association between different molecular weights of hyaluronic acid and CHAD, HIF-1α, COL2A1 expression in chondrocyte cultures

One-year efficacy and safety of single or one to three weekly injections of hylan G-F 20 for knee osteoarthritis: a systematic literature review and meta-analysis

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