High Molecular Weight Hyaluronic Acid (Hyalubrix/HyalOne) for Treating Symptomatic Hip Osteoarthritis

Abstract

Hip osteoarthritis (OA) causes a set of symptoms that may lead to severe patient impairment, social isolation and morbidity, especially in the elderly. Eventually, patients become candidates for total hip replacement (THR); yet surgery may cause morbidity, increase costs and too risky in some cases. Viscosupplementation (VS) by intra-articular hyaluronic acid (HA) injection has been shown to be effective to treat symptoms consequent to knee OA. VS is a viable option to treat hip OA too, provided that appropriate techniques are used to inject HA into the articular space. To this end, ultrasound-guided approaches have been developed that allow appropriate intra-articular injection eliminating the risk of exposure to ionizing radiation entailed by fluoroscopy. This review summarizes the results of clinical investigations concerning the use of a high molecular weight HA formulation, Hyalubrix/HyalOne, for treating hip OA symptoms. These results show that Hyalubrix/HyalOne has an enhanced safety profile, is effective from the first injection, significantly reduces NSAIDs consumption, and can be used for repeated therapy cycles over more years as a conservative therapy to delay THR. Nevertheless, it must be also considered that a significant placebo effect linked to intra-articular injections may exist, thus reducing the magnitude of HA benefits.

Hyaluronan: Sources, Structure, Features and Applications

“…The financial toll that OA takes is substantial and multifaceted, encompassing expenses for medical care, hospital stays, missed work, and home care. With up to 41% involvement, the knee is the most commonly affected joint in OA, followed by the hands (30%) and hips (19%) [62]. In particular, the prevalence of knee OA has doubled since the middle of the 20th century.…”

Hyaluronan as a Prominent Biomolecule with Numerous Applications in Medicine

“…This hydrogel was effective particularly after 6 months post-injection and provided a therapeutic tool in the treatment of moderate and severe OA [47]. Hyalubrix/HyalOne formulation of HMM HA had an enhanced safety profile and was effective after the first injection, significantly reduced consumption of nonsteroidal antirheumatoid drugs and can be used for repeated therapy cycles over more years as a conservative therapy to delay replacement of hips [48]. Viscosupplementation with IA Sinovial ® injections (molar mass 800-1200 kDa, 16 mg/2 mL) relieves pain and improves function in OA of the knee and other joints including the carpometacarpal joint of the thumb and the shoulder [49].…”