Ensaio clínico prospectivo e randomizado: regime único e semanal de viscossuplementação

Abstract

OBJECTIVE: To compare two different dosages of an intermediate molecular weight sodium hyaluronate (HA) (Osteonil®-TRB Pharma) assessing whether a single 6 ml application of this HA has the same effectiveness as the classical three-weekly 2 ml dose. METHODS: 108 patients with knee osteoarthritis were randomized into two groups of 54 patients each. The groups were designated "single" (S) and "weekly" (W). Patients in group S underwent a viscosupplementation procedure by application of only 6 ml of sodium hyaluronate and 1 ml triamcinolone hexacetonide. Patients in group W underwent the procedure of viscosupplementation through three applications with 2 ml sodium hyaluronate with a week interval between them, and the first application was also performed with the infiltration of 1 ml (20 mg) of Triamcinolone Hexacetonide. Both groups were assessed before, at one month and three months after application, by responding to the WOMAC, Lequesne, IKDC and VAS questionnaires. RESULTS: There was no statistical difference between the single application of 6 ml of sodium hyaluronate and classic application with three weekly injections. However, only the classical regime showed statistically significant improvement in baseline pain (WOMAC pain and VAS). CONCLUSION: Our results suggest that both application schemes improve application function, but the three-weekly regimen of 2 ml was more effective in reducing pain. Level of Evidence I, Prospective Randomized, Clinical Trial.

Intra‐Articular Hyaluronic Acid Compared to Traditional Conservative Treatment in Dogs with Osteoarthritis Associated with Hip Dysplasia

“…In animals treated with HA, 75% of owners considered the quality of life of the animals after treatment to be very good to excellent. These results corroborate previous studies reported in humans, which attributed the best quality of life indices to patients who responded favorably to analgesic therapies, demonstrating a direct correlation between the relief of chronic pain and improved quality of life [15, 30]. …”

“…The majority of studies have shown a percent improvement from baseline of 28–54% for pain and 9–32% for function [13, 15, 17]. Similarly, in the current study, the most significant decreases in the owner-based assessment scores (≤40%) were observed from 30 to 90 days (4 to 12 weeks) after HA injection.…”

“…There is no consensus in the current literature with respect to the required number of IA applications of HA to obtain satisfactory results. Studies developed with humans have reported success with a single IA application [29, 30] and with multiple applications at weekly intervals [15, 31]. In dogs undergoing surgical correction of patellar luxation, a single IA application of HA at the end of surgery resulted in similar effects to the application of two doses at weekly intervals [20].…”

“…The majority of exogenous HA remains in the joint for a few days; however, the clinical therapeutic effects of HA treatment may be seen between 5 and 13 weeks after injection, although improvements have also been observed after 14–26 weeks and sometimes even longer [15]. …”

“…Several clinical trials have reported the beneficial effects following IA injection of HA, with reduction in pain and improvement in joint function [15–17]. However, few studies have evaluated the clinical efficacy of HA administered through IA in the management of hip OA in man [18, 19].…”