The symptomatic effects of intra-articular administration of hylan G-F 20 on osteoarthritis of the hip: clinical data of 6 months follow-up

Migliore, Alberto; Tormenta, Sandro; Martin, Luis Severino Martin; Iannessi, F.; Massafra, Umberto; Carloni, Emilia; Monno, D.; Alimonti, Andrea; Granata, M.

doi:10.1007/s10067-005-0052-x

Cited by 57 publications

(38 citation statements)

References 17 publications

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“…Patients with mild morphological alterations, and with preserved articular space, are more responsive to treatment (22,48,50); the results are less encouraging in patients with severe OA (K-L IV) , only few studies report good therapeutic effects (20,22,48). In this regard, Bekerom has observed that VS may delay or avoid hip replacement in 45% of patients, so reducing costs and mortality (22).…”

Section: Discussionmentioning

confidence: 99%

“…From the papers retrieved in the search the following data were extracted: sample size, inclusion / exclusion criteria, treatment procedures, evaluation methods, clinical results and follow-up duration. The case series, published by Migliore et al (16)(17)(18)(19)(20)(21) and Van den Bekerom et al (22,23), at different times, were considered cumulative. Methodological quality of included studies was assessed by assigning Levels of Evidence as previously defined by the Centre for Evidence Based Medicine (CEBM) (24).…”

Section: Methods Of Literature Analysismentioning

confidence: 99%

“…In the majority of cases the Kellgren-Lawrence (K-L) score (51) was intermediate; only few patients with low score (K-L I) were included (45,(49)(50)(51) and only Vad, Migliore, Van Den Bekerom, Qvistgaard, Gaston (17,18,20,22,23,29,46,48) included patients which were candidates for hip replacement (K-L IV).…”

Section: Inclusion Criteriamentioning

confidence: 99%

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Viscosupplementation with Hyaluronic Acid in Hip Osteoarthritis (a review)

Abate¹,

Pelotti²,

Amicis³

et al. 2008

Upsala Journal of Medical Sciences

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Background: Viscosupplementation (VS) with hyaluronic acid (HA) is largely used for knee osteoarthritis therapy, but the evidences for its usefulness in hip osteoarthritis (OA) are limited. Methods: In this review, an extensive search of published trials on VS in hip OA was performed. From the selected papers the following data were extracted: sample size, inclusion / exclusion criteria, treatment procedures, evaluation methods, follow-up duration and clinical outcomes. Results: The level of evidence was low in quite all the trials (no placebo controlled groups). A reduction of pain and an improvement of function after 3 months, persistent in the long term (12 -18 months), was observed. Patients with mild morphological alterations responded better to therapy. Side effects were negligible, and were limited to pain and a sensation of heaviness in the injection site. No clear differences among Low (LMW) and High Molecular Weight (HMW) HA preparations were found in the clinical outcomes. However, for HMW-HA preparations, a lower number of injections was, in general, necessary in order to reach the therapeutic effect. Conclusions: Despite the initial promising results, some questions still remain open : 1) the characteristics of responders must be more precisely defined; 2) the treatment schedules, at present mainly based on the individual clinical experience, need a proper and accepted standardization. Finally, larger and placebo controlled trials are necessary to confirm the efficacy of VS in hip OA.

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Section: Discussionmentioning

confidence: 99%

Section: Methods Of Literature Analysismentioning

confidence: 99%

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Viscosupplementation with Hyaluronic Acid in Hip Osteoarthritis (a review)

Abate¹,

Pelotti²,

Amicis³

et al. 2008

Upsala Journal of Medical Sciences

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“…In several previous studies, we reported on the short and medium-term clinical outcome obtained with different HA preparations when using this technique for treating patients with hip OA (30)(31).…”

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confidence: 99%

Intra-Articular Ultrasound-Guided Injection of Sinovial® Forte 1.6% in Patients Affected by Symptomatic Hip Osteoarthritis: Effectiveness and Safety in a Large Cohort of Patients

et al. 2012

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The aim of this prospective observational study is to assess the efficacy and safety profile of intraarticular Sinovial® Forte 1.6% administered under ultrasound-guidance in a large cohort of patients affected by symptomatic hip osteoarthritis (OA). Patients with symptomatic hip OA referred to our clinic in 2008–2010 received one 4 ml (2 vials) intra-articular injection of Sinovial® Forte 1.6% under ultrasound guidance. Patients were followed-up every 3 months for a total of 6 months and were offered an optional, additional injection at the 3-month follow-up visit if clinically justified. At each visit, pain scores [0–10 Visual Analogue Scale (pain VAS)], Lequesne index scores and NSAID intake were recorded. Adverse events (AEs) were recorded throughout the study. An effect size of 30% and 50% reduction in Lequesne index and Pain VAS scores was evaluated for each patient to ascertain the number of patients achieving partial remission of symptoms and functional impairment by the use of intra-articular hyaluronic acid in hip osteoarthritis. One hundred and fourteen patients completed the 6-month follow-up and received a total of 142 injections. A statistically significant reduction in Lequesne index scores, VAS pain scores and NSAID consumption was observed at all time-points ( p < 0.05). No systemic, severe or even moderate side effects were observed. Only 7 patients reported mild local reaction at the injection site, consisting of mild pain and localized warmth, which resolved spontaneously without any additional medication. This study provides evidence of the efficacy and tolerability of Sinovial® Forte 1.6% in the treatment of patients affected by symptomatic hip OA. Sinovial® Forte may also offer economical benefits, owing to the reduction in NSAID consumption associated with this treatment. The percentage of patients achieving the effect size of 30% and 50% reduction in Lequesne index and pain VAS scores encourages the use of intra-articular hyaluronic acid in patients with hip osteoarthritis.

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“…Patients with mild morphological alterations, and with preserved articular space, are more responsive to treatment (Brocq et al, 2002;Gaston et al, 2007;Van den Bekerom et al, 2006); the results are less encouraging in patients with severe osteoarthritis (Kellgreen -Lawrence IV), only few studies reporting a good therapeutic effects (Migliore et al, 2006b). Articular effusion usually is associated to a reduced therapeutic efficacy due to the "dilution effect" of the drug (Qvistgaard et al, 2006).…”

Section: Discussionmentioning

confidence: 99%