The Booster Effect of a Single Quarterly Dose of Hyaluronic Acid in Knee Osteoarthritis: Five-Year Results of a Registry-Based Study

Abstract

Viscosupplementation by hyaluronic acid (HA) is well established non-surgical treatment of knee osteoarthritis (KOA). This registry-based study investigated the booster effect of a quarterly intra-articular single knee injection (30mg/2ml) for five years. MethodsSixty patients, including 29 males and 31 females, with a mean ± SD age 61.07 ± 9.15 with Kellgren-Lawrence grade I-III KOA, have been selected from a registry of interventional treatments for musculoskeletal pain conditions. To be eligible, patients had to be treated with a single quarterly intraarticular injection of HA with a follow-up of at least five years and assessed with Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Numeric Rating Scale (NRS) at baseline and after each HA injection in the first 24 months and at 36, 48, and 60 months. ResultsSixty of 63 patients enrolled in this study completed the 60 months of follow-up. Patients had a marked improvement in knee function and pain, expressed by the significant reduction in WOMAC (T0 48.62±8.95 vs. T11 10.75±4.36; p<0.0001) and NRS scores (6.38±1.06 vs. T11 0.95±0.89 p<0.0001) from the baseline to the end of the follow-up period. ConclusionA quarterly injection of HA provides a rapid, safe, and stable long-term reduction of pain and improvement of function in elderly people with mild to moderate knee osteoarthritis along a five-year period of treatment and follow-up. Further investigations are necessary to confirm these findings.

Current Approaches to Four Challenging Pain Syndromes

“…They can suppress pro-inflammatory cytokines in the joint and relieve pain by reducing the knee joint inflammation which can make nociceptors excitable and increase proprioception. Quarterly injections of hyaluronic acid into the knee of patients afflicted with knee osteoarthritis provide rapid, safe, and effective analgesia in older patients with mild to moderate knee osteoarthritis over five years [ 47 ]. A meta-analysis confirmed a key benefit of hyaluronic acid injections is safety and tolerability [ 48 ].…”