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

Abstract

SummaryPurpose. Osteoarthritis (OA) is the most common joint disorder in the elderly, causing significant pain which negatively affects mobility and quality of life. The aim of the study was to assess the effectiveness of ultrasound image-guided intra-articular injections of Hyalubrix ® combined with exercise therapy in the treatment of hip osteoarthritis. Methods. This was a single site, prospective, open-label, Investigator-initiated study. Forty patients were enrolled and received three ultrasound image-guided injections of Hyalubrix ® , 45 days apart, combined with three sessions a week of physical therapy (proprioceptive rehabilitation of the lower limbs; gait training; balance training) up to a total of 30 sessions (10 weeks), starting from one week after the first injection. Results. The primary objective was to achieve a lasting reduction in OA symptoms related to pain during activity. During the course of the study the pain perceived by the patient during activity dropped from a mean value of 6.94 cm to a mean value of 1.46 cm and showed a statistically significant decrease from visit 1 compared to baseline (p < 0.05) which was confirmed at all the subsequent time points. Significant improvements were also observed in the evaluation of the secondary objectives: hip disability; OA-related pain at rest; daily functioning and NSAIDs intake. Conclusions. Results from this study including 40 patients for a total of 65 treated hips demonstrate a significant improvement in OA-related pain, hip disability, and patient's daily functioning as well as a reduction in NSAIDs intake. Patients suffering from hip OA seem to benefit from the treatment with Hyalubrix ® injections plus exercise therapy.

Brazilian Consensus Statement on Viscosupplementation of the Hip (Cobravi-Q)

“…Agreement: Unanimous in favor Mean: 10 Median: 10 Achieved values: 10 In the experts' opinion, there is a consensus in the literature that VS should be used together with other measures, as the treatment of OA is multimodal, encompassing weight loss, specific physical exercises, physical therapy, palliative drugs, among others. 2,18,28,29 Statement 6: The number of applications will depend on the clinical conditions of the patient and the viscosupplement used. Agreement: Unanimous in favor Mean: 8.81 Median: 9 Achieved values: 7-10 According to the specialists' experience, the number of applications will initially depend on the used VS and the patient's clinical conditions.…”

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

“…Such improvement was maintained over 2 years independently from the radiological degree of OA, with both HA derivatives; yet improvement was faster in the group treated with Hyalubrix. Mauro et al 59 enrolled 40 patients affected by hip OA who were subjected to three US-guided injections of Hyalubrix 45 days apart, combined with three physical therapy sessions a week, including proprioceptive rehabilitation of the lower limbs, gait training, balance training, for up to a total of 30 sessions (10 weeks), starting from one week after the first injection.…”

Hybrid Hyaluronic Acid versus High Molecular Weight Hyaluronic Acid for the Treatment of Hip Osteoarthritis in Overweight/Obese Patients

“…[17]. By effectively increasing viscosity and reducing friction, viscosupplementation with hyaluronic acid (HA) has been shown to achieve satisfactory pain relief and improved function in OA [18][19][20]. Furthermore, HA is known to mitigate the activity of pro-inflammatory mediators and stimulate the metabolism of fibroblasts, possibly resulting in analgesic, anti-inflammatory, and chondroprotective effects on the joint [21].…”