An evaluation of role of intraarticular hyaluronic acid in treatment of osteoarthritis of knee

Abstract

Objective: To evaluate the role of intraarticular hyaluronic acid in treatment of osteoarthritis of knee among the patients admitted in a north Indian hospital. Methods: This was a prospective study conducted on 80 patients attending the out patient department of the hospital with a diagnosis of osteoarthritis of one or both knees were enrolled in this study. All the patients were symptomatic for osteoarthritis of knee and did not respond adequately to conservative treatment for osteoarthritis. 3 patients were lost to follow-up. The results are finally presented on 96 knees of 77 patients who underwent series of 5 intraarticular injections of hyaluronic acid at weekly interval. Results:The mean age of patients was 59.13 ± 2.3 years. Duration of symptom ranged from 6 months to 5 years. Most of the knees (55.2%) had moderate grade of osteoarthritis. The pain at rest and joint tenderness were significantly (p=0.0001) lower among mild grade of osteoarthritis as compared to moderate and severe. There was significant effect of intraarticular myaluronic acid in decreasing VAS and joint tenderness from baseline to 6 month. Conclusion: Visco-supplementation with hyaluronicacid may be considered an alternative option to major surgical procedure in developing countries provided the injections are given before mechanical changes take place and patient complies with regular exercise, weight control and postural habits. Keywords: Osteoarthritis, intraarticular, hyaluronicacid IntroductionGlobal statistics reveal over 100 million people worldwide suffer from OA, which is one of the most common causes of disability [1,2] . In addition, younger individuals may be susceptible to injury-induced OA. More than 50% of the population around the world (>65 years) show Xray evidence of OA in one of the joints, thus demonstrating the high incidence of this disease. While OA is equally present in men and women, it appears to be more common among younger men (<45 years) and in the older women (>45 years) [3,4] . Between the ages of 30 and 65 years, the general incidence and prevalence of knee OA has been reported to increase by as much as 10 times that of younger age groups, affecting nearly 33.6% of people >65 years or an incidence of 1 in 10. Persons aged >65 years are more commonly affected by knee OA, due to the ongoing drop in birth rates and the overall increase in life expectancy; there is an alarming trend for future growth in the prevalence of knee OA in older population to be seen [5] . Along with the increase in age, there is an exponential increase in the associated risk factor of obesity, due to progressive sedentary behavior, changes in lifestyle patterns, diet routine, and work environment conditions among the adult population