Comparison of two different viscosupplements in knee osteoarthritis - a pilot study

Abstract

A pilot study was designed to investigate the efficacy of two different hyaluronic acid preparations combined to physical therapy in patients with knee osteoarthritis in terms of reduction in pain and disability and muscle strengthening. Thirty-seven patients with symptomatic osteoarthritis of the knees were randomly assigned into three groups. First group received a lower molecular weight hyaluronic acid plus physical therapy, second group received a higher molecular weight hyaluronic acid plus physical therapy, and the third group received physical therapy alone. The isokinetic knee muscle strengths and index of severity for osteoarthritis of the knee scores were evaluated at baseline, at the end of treatment (3 weeks) and at 3 months of follow up. At both short-term (3 weeks) and long-term (3 months) evaluations, index of severity for osteoarthritis of the knee scores were reduced in all three groups, while there was no significant muscle strengthening.

Hylan Versus Corticosteroid Versus Placebo for Treatment of Basal Joint Arthritis: A Prospective, Randomized, Double-Blinded Clinical Trial

“…The implications of molecular weight in viscosupplementation therapy has been extensively discussed in the literature, 36 -39 but to date only in vitro experiments and animal models 15,16,40,41 have clearly supported the contention that higher molecular weight derivatives may lead to enhanced rheologic properties, more effective inflammatory inhibition, and potentially better symptomatic improvement than their lower molecular weight counterparts. One clinical pilot study in the literature demonstrated no difference between hylan and hyaluronan with regard to muscle strengthening and knee scores, 42 and a recent clinical trial showed no difference in functional outcome measures between hylan and sodium hyaluronate in patients with severe knee OA 1 year after 3 injections. 43 In the current investigation, at follow-up visits of approximately 3 months and 6 months, the hylan group was FIGURE 3: VAS pain scores.…”

Using Viscosupplementation to Treat Knee Osteoarthritis

“…Bayramoglu et al, 66 2003 Hylan G-F 20 = HA for HSS pain score for pain relief at 52 wk Karatosun et al, 63 2005 Hylan G-F 20 = HA for pain relief on HSS pain score at 52 wk Atamaz et al, 64 2006 Hylan G-F 20 = HA using the WOMAC pain scale for pain relief at 1, 3, 6, 9, and 12 mo Juni et al, 65 2007 Hylan G-F 20 = HA using the WOMAC pain scale for pain relief at 3 and 6 mo However, safety concerns about the use of acetaminophen and NSAIDs should be considered. Acetaminophen is prescribed for OA knee pain at a dose up to 4 g/d.…”

The effectiveness of intra-articular injections of Hyalubrix� combined with exercise therapy in the treatment of hip osteoarthritis

“…Published data suggest that intra-articular injections of HA in hip OA are effective in the relief of pain (13)(14)(15). Studies comparing a combination of intra-articular HA injections and exercise to exercise alone in patients with knee OA showed promising results (16,17). However, no similar studies have been performed in hip OA.…”