High-concentration nonavian high-molecular weight hyaluronan injections and time-to-total knee replacement surgery

Abstract

<jats:p> Aim: To examine the time-to-total knee replacement (TKR) surgery among patients with high-concentration nonavian high-molecular-weight hyaluronan injection (HMW-HA) compared with those without HA injections. Materials &amp; methods: Using MarketScan<jats:sup>®</jats:sup> Commercial claims all patients aged 18–64 who underwent TKR surgery between 2008 and 2017 were identified. Time-to-TKR surgery was compared between patients receiving Orthovisc<jats:sup>®</jats:sup> (Anika Therapeutics Inc. Bedford MA, USA, referred to as nonavian HMW-HA) injections and patients who did not receive an HA injection. Results: The median time-to-TKR surgery was 893 days in the nonavian HMW-HA cohort and 399 days in the non-HA cohort (p &lt; 0.001), a difference of 494 days (16.2 months). Conclusion: This study demonstrates that the time-to-TKR surgery is 16.2 months longer in patients who received treatment with nonavian HMW-HA injections. </jats:p>

Time to Total Knee Arthroplasty after Intra-Articular Hyaluronic Acid or Platelet-Rich Plasma Injections: A Systematic Literature Review and Meta-Analysis

“…A total of 25 studies met the selection criteria and were included in the descriptive analysis ( Figure 1 ): 23 of HA injections, 1 of PRP injections and 1 of HA or PRP injections. The studies were from the United States [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ], Spain [ 53 , 54 ], France [ 55 , 56 , 57 ], Turkey [ 58 ], Thailand [ 59 ], Finland [ 60 ] and Australia [ 61 ]. The mean STROBE quality score was 63% [ 34 , 35 ], but the results were heterogeneous (I² = 99%).…”

“…In total, 2,824,401 patients were included; the mean age was 55.1 ± 12.8 years [ 58 ] to 70.5 ± 9.2 years [ 47 ] and the mean prevalence of women was 49.3% [ 47 ] to 83% [ 58 ]. In studies using a database, patients with a diagnosis of KOA were identified according to the International Classification of Diseases, 9th revision (ICD-9) or ICD-10 codes, and the comparison involved those receiving or not receiving IA HA or PRP injections [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 50 , 51 , 55 ]. In the other studies, in addition to the KOA diagnosis, IA injection was an inclusion criterion [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 52 , 53 , 56 , 58 , 59 , 60 , 61 , 62 ].…”

“…In the 10 studies included [ 37 , 38 , 39 , 40 , 41 , 42 , 50 , 51 , 55 , 57 ], 418,266 patients underwent TKA ( Table 2 ); 142,210 (34%) had received HA injections.…”

“…In seven studies giving appropriate data for such analyses [ 37 , 38 , 39 , 40 , 42 , 50 , 55 ], the median time from a KOA diagnosis to TKA was significantly longer for patients receiving (range 15.8 months [ 38 ] to 29.8 months [ 37 ]) than not receiving HA injections (3.7 [ 38 ] to 12 months [ 40 , 42 , 55 ], p < 0.001), and the mean time was significantly longer for patients receiving injections (19.7 ± 14.2 [ 38 ] to 39.4 months (SD unknown) [ 42 ] vs. 8.9 ± 11.6 [ 38 ] to 27.4 months (SD unknown) [ 42 ]). Only in the French cohort KHOALA did the mean time from a declared diagnosis of KOA to TKA not significantly differ between the HA injection and control group: 9.67 ± 6.77 and 10.56 ± 9.14 years ( p = 0.58) [ 57 ].…”

Intra-articular injections in the treatment of osteoarthritis

“…Об аналогичных результатах сообщают K. Etter и соавт. [29], которые изучали материалы базы данных медицинского страхования за 2008-2017 гг. В исследование было включено 30 028 пациентов, которым проводилось ЭП КС.…”