A Comparison of Intra-Articular Hyaluronic Acid Competitors in the Treatment of Mild to Moderate Knee Osteoarthritis
|AF McGrath1#*, AM McGrath1#, ZM Jessop MA2#, Surya Gandham3#, G Datta1, Sebastian Dawson-Bowling1 and SR Cannon1|
|1Royal National Orthopaedic Hospital Stanmore, UK|
|2London Deanery, London, UK|
|3Royal Free Hospital, London, UK|
|#These authors contributed equally and share combined first authorship|
|Corresponding Author :||Dr. AF McGrath
MRCSI, Bone Tumour Unit
Royal National Orthopaedic Hospital
Stanmore, United Kingdom
Fax: ++440208909 5273
E-mail: [email protected]
|Received September 06, 2013; Accepted October 04, 2013; Published October 11, 2013|
|Citation: McGrath A, McGrath AM, ZM Jessop MA, Gandham S, Datta G, et al. (2013) A Comparison of Intra-Articular Hyaluronic Acid Competitors in the Treatment of Mild to Moderate Knee Osteoarthritis. J Arthritis 2:108. doi:10.4172/2167-7921.1000108|
|Copyright: © 2013 McGrath A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Purpose: Viscosupplementation with Hyaluronic Acid (HA) is an established intervention for pain control in patients with mild to moderate Osteoarthritis (OA) of the hip and knee. Problems include inconvenience, expense and the logistical problems associated with multiple injections, injection technique and level of skill required by the administering physician, variable clinical response and adverse reactions.
Methods: In this independent, prospective, randomized trial, we compare efficacy and complications associated with treatment in 182 knees using durolaneTM and synviscTM using the Visual Analogue Score, SF-36 V2 questionnaire, and Oxford knee scores. Range of movement is recorded at each visit. These assessments are repeated at 3, 6, 9 and 12 months.
Results: Significant improvement is seen in the VAS, SF 36 V2 and Oxford Knee Scores (p=0.01) and reduction in the use of analgesics and anti-inflammatories is seen with both products at 3 months post injection, with a significant advantage to the durolane group (p=0.001). At 6 months, this difference is extended even further. Adverse reactions occur significantly less with the more effective product.
Conclusion: We conclude that intra-articular HA a useful intervention in patients with mild to moderate OA of the knee, can produce sustained pain relief at 6 months, and can reduce the requirement for analgesia and antiinflammatory medication during this time.