Efficacy of Intra-Articular Injection of Hyaluronic Acid in the Treatment of Knee Osteoarthritis

Abstract

This study was conducted to evaluate the efficacy of intraarticular injection of hyaluronic acid for the treatment of knee osteoarthritis. Patients with knee osteoarthritis were followed for a period of six months to assess the efficacy of intra-articular injection of hyaluronic acid given three times in three consecutive weeks. Fifty patients were reviewed at two, eight and 24 weeks post-injection. The average age was 60.9 years and female to male ratio was 3:1. Patients were assessed using the Lequesne Algofunctional Index for function, and the visual analogue score for pain and side effects. We found that the knee pain reduced and the function improved in most patients and these beneficial effects maintain till the last follow up. The only side effect noted was one case of acute non-septic joint effusion after the 3rd injection. We concluded that intra-articular injection of hyaluronic acid can produce pain relief and functional improvement for up to 6 months.

Intra-articular Hyaluronic Acid (HA) and Platelet Rich Plasma (PRP) injection versus Hyaluronic acid (HA) injection alone in Patients with Grade III and IV Knee Osteoarthritis (OA): A Retrospective Study on Functional Outcome

“…In our study, high molecular weight (HMW) HA was chosen instead of low molecular weight (LMW) HA mainly because the HMW HA (1.5x 10 6 Daltons) closely resembles the molecular weight of endogenous HA (~2 x106 Daltons) in the extracellular matrix 27 , 28 , 30 . Studies have demonstrated that HMW HA down regulates the gene expression of osteoarthritis associated cytokines and enzymes in fibroblast like synoviocytes (FLS) 14 , 15 , 29 .…”

“…We have standardized patient selection by only including patients who had received specific HA and PRP concentration or preparation method. All patients included in the study had received 4 ml high molecular weight (1.476 x 10 6 average Daltons) hyaluronic acid with concentration of 22mg/ml. HMW HA was specifically selected because many earlier studies showed greater and longer efficacy in reducing pain and other symptoms and recovering articular function as compared to LMW HA 25 , 26 .…”

“…Knee OA is characterized by degeneration of the articular cartilage which will eventually lead to the joint destruction 4 , 5 . The underlying causes of OA are multifactorial with several predisposing factors such as mechanical trauma, obesity, genetic factors, inflammatory joint disease, previous joint infection, advancing age, metabolic factors, osteoporosis, and ligamentous laxity 6 . Diagnosis of OA is made with clinical assessment and radiological investigation as an adjunct 7 , 8 .…”

Effects of low-intensity pulsed ultrasound on recovery of physical impairments, functional performance and quality of life after total knee arthroplasty

“…Patients with knee OA may receive electrotherapy, [5,6] joint mobilization, [7] therapeutic exercises, [8] virtual reality-based therapy, [9] or intra-articular injection of hyaluronic acid [10] to reduce pain and/or to improve functional ability. However, total knee arthroplasty (TKA) is recommended as an intervention for managing severe knee OA [11] or when the conservative treatments have failed.…”

In vitro and in vivo evaluation of doxycycline‐chondroitin sulfate/PCLmicrospheres for intraarticular treatment of osteoarthritis

“…5,7,9 In literature, several intraarticular injections of hyaluronan are recommended to provide a control for OA progression; but it is not known whether there is a need for repeated injections and if so, what is the ideal time between injections. 6,12 Biodegradable polymers are the most widely preferred systems in controlled release applications. 5,10,11 So, this approach has limitations including short term pain relief and requirement of frequent injections.…”