Efficacy of intraarticular hyaluronic acid in patients with osteoarthritis—a prospective clinical trial

Miltner, Oliver; Schneider, Ulrich; Siebert, Christian H.; Niedhart, Christopher; Niethard, F. U.

doi:10.1053/joca.2002.0815

Cited by 49 publications

(35 citation statements)

References 33 publications

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“…23 The estimated total hyaluronic acid in a human knee joint is from 4-8 mg. 23 Intra-articular injections of hyaluronic acid with a molecular weight between 500 and 750 kilodaltons (kD) have been studied using corticosteroid injections [24][25][26][27][28] or NSAIDs 29 as control treatment, and by conducting placebo controlled clinical trials. [30][31][32][33][34][35][36][37] These studies suggested that intra-articular injection of hyaluronic acid may improve the clinical condition and have a long term beneficial effect in knee osteoarthritis patients especially if osteoarthritis was less than moderate in grade. [30][31][32][33][34][35][36][37] A review by Maheu looked at five different clinical trials, comparing different regimens of Hyalgan (a hyaluronan preparation; Sanofi-Synthelabo) versus corticosteroid injections in the osteoarthritis knee, with follow ups from 2-12 months.…”

Section: Hyaluronic Acidmentioning

confidence: 99%

“…[30][31][32][33][34][35][36][37] These studies suggested that intra-articular injection of hyaluronic acid may improve the clinical condition and have a long term beneficial effect in knee osteoarthritis patients especially if osteoarthritis was less than moderate in grade. [30][31][32][33][34][35][36][37] A review by Maheu looked at five different clinical trials, comparing different regimens of Hyalgan (a hyaluronan preparation; Sanofi-Synthelabo) versus corticosteroid injections in the osteoarthritis knee, with follow ups from 2-12 months. 38 One study showed initial superiority of Hyalgan over corticosteroid injections and in three studies, equal efficacy over time.…”

Section: Hyaluronic Acidmentioning

confidence: 99%

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Intra-articular therapy in osteoarthritis

Uthman

Haraoui

2003

Postgraduate Medical Journal

132

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The medical literature was reviewed from 1968–2002 using Medline and the key words “intra-articular” and “osteoarthritis” to determine the various intra-articular therapies used in the treatment of osteoarthritis. Corticosteroids and hyaluronic acid are the most frequently used intra-articular therapies in osteoarthritis. Other intra-articular substances such as orgotein, radiation synovectomy, dextrose prolotherapy, silicone, saline lavage, saline injection without lavage, analgesic agents, non-steroidal anti-inflammatory drugs, glucosamine, somatostatin, sodium pentosan polysulfate, chloroquine, mucopolysaccharide polysulfuric acid ester, lactic acid solution, and thiotepa cytostatica have been investigated as potentially therapeutic in the treatment of arthritic joints. Despite the lack of strong, convincing, and reproducible evidence that any of the intra-articular therapies significantly alters the progression of osteoarthritis, corticosteroids and hyaluronic acid are widely used in patients who have failed other therapeutic modalities for lack of efficacy or toxicity. As a practical approach for a knee with effusion, steroid injections should be considered while the presence of symptomatic “dry” knees may favour the hyaluronic acid approach. The virtual absence of serious side effects, coupled with the perceived benefits, make these approaches attractive.

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Section: Hyaluronic Acidmentioning

confidence: 99%

Section: Hyaluronic Acidmentioning

confidence: 99%

Intra-articular therapy in osteoarthritis

Uthman

Haraoui

2003

Postgraduate Medical Journal

132

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“…These agents are usually administered as a series of 3-5 weekly injections, but recent data suggests a single 6 ml injection of the agent hylan-GF 20(SynviscTM) may be effective as well [66]. There is great heterogeneity in existing trials of these agents, making strong conclusions as to their efficacy difficult, with many studies of small size and varying quality [67,68]. A systematic review assessing the efficacy of HA analyzed 76 blinded RCTs evaluating multiple HA agents.…”

Section: Hyaluronic Acid (Ha)mentioning

confidence: 99%

Non-surgical treatment of osteoarthritis-related pain in the elderly

Mushtaq

Choudhary

Scanzello

2011

Curr Rev Musculoskelet Med

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Osteoarthritis (OA), the third most common diagnosis in the elderly [1], causes significant pain leading to disability and decreased quality of life in subjects 65 years and older [2]. Traditionally, clinicians have relied heavily on the use of non-steroidal anti-inflammatory drugs (NSAIDs) to treat the pain of OA, as numerous studies have proven these agents to be effective. The cardiovascular, gastrointestinal, renal and hepatic toxicities of NSAIDs have limited their use, particularly in the elderly. Acetaminophen has been recommended as initial therapy due to relative safety. Several other topical, oral and intra-articular agents are available today, with use limited by efficacy and side effect profiles. Many non-pharmacologic approaches are available but underused, and may be attractive choices to avoid poly-pharmacy in older patients. We will attempt to highlight the evidence behind available non-surgical therapies for OA while paying specific attention to issues in geriatric patients.

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“…A review by Maheu looked at 5 different clinical trials, comparing different regimens of Hyalgan versus corticosteroids injections in osteoarthritis knee, with follow ups from 2-12 mths. [12][13][14][15] One study showed initial superiority of Hyalgan and in three studies equal efficacy over time. The fifth study used a combination of Hyalgan and corticosteroid injections initially.…”

Section: Introductionmentioning

confidence: 99%

Intra articular hyaluronic acid versus intra articular triamcinolone hexacetonide in primary osteoarthritis of knee: a comparative study

Kizhedath¹,

Valoth

Vasudevan

2017

Int J Basic Clin Pharmacol

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Background: Osteoarthritis (OA) is a painful, chronic disease with widespread burden on patients, communities, social and health care systems. Intraarticular (IA) Hyaluronic acid (HA) and corticosteroids are established treatments for OA knee. However, concerns exist regarding effect, duration, safety, effectiveness across population and heterogeneity. Aim of the study is to compare the efficacy and safety of IA HA with THA in the treatment of primary osteoarthritis knee.Methods: A descriptive cross-sectional study was done among 30 patients. One group (n=15) received IA THA 20mg/2mL on day 0 and other group (n=15) received IA HA 20mg/2 mL on day 0, 7 and 14 under aseptic precautions. The efficacy assessment using VAS for overall pain, joint line tenderness and 15m walking time in seconds were recorded. Side effects if any were noted.Results: Comparing both treatments IA THA provided superior short-term pain relief. But HA showed sustained benefit up to six months.Conclusions: OA being a chronic disease process, we need a drug which has a long-lasting effect. Additive effect of HA and THA can be considered for better efficacy.

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Efficacy of intraarticular hyaluronic acid in patients with osteoarthritis—a prospective clinical trial

Abstract: This controlled prospective clinical trial confirmed that 5 weekly intraarticular injections of HA (Hyalart) in patients with OA of the knee provide pain relief and functional improvements.

Cited by 49 publications

References 33 publications

Intra-articular therapy in osteoarthritis

Intra-articular therapy in osteoarthritis

Non-surgical treatment of osteoarthritis-related pain in the elderly

Intra articular hyaluronic acid versus intra articular triamcinolone hexacetonide in primary osteoarthritis of knee: a comparative study

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