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Medical Science Monitor Basic Research


eISSN: 1643-3750

Origin and Efficacy of Hyaluronan Injections in Knee Osteoarthritis: Randomized, Double-Blind Trial

Yuanli Guo, Peiyan Yang, Liu Liu

Department of Orthopedics, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China (mainland)

Med Sci Monit 2018; 24: CLR4728-4737

DOI: 10.12659/MSM.908797

Available online: 2018-07-09

Published: 2018-07-09


BACKGROUND: Several hyaluronan preparations are available that have different dosage forms, origins, and concentrations. The objective of the study was to compare the efficacy of intra-articular chemically cross-linked hyaluronan (CCH) and avian-derived hyaluronan (ADH) injections in knee osteoarthritis (KOA) patients.
MATERIAL AND METHODS: In total, 258 patients were randomized into 2 groups of 129 each: patients who received CCH injection (CCH group) and patients who received ADH injection (ADH group). Radiographic Kellgren-Lawrence score, visual analog scale (VAS) pain score, Lequesne index score, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, single-limb stance (SLS) test, and timed “Up-and-Go” (TUG) test were performed. The Mann-Whitney U test or independent t-test following Bonferroni adjustment was performed for statistical analysis at 95% of confidence level.
RESULTS: The CCH group had improved VAS pain score (P<0.0001, q=54.803), total WOMAC score (P<0.0001, q=4.753), Lequesne index score (P<0.0001, q=3.208), and SLS time (P<0.0001, q=8.76) at the end of 6 months as compared to those in the ADH group. After 6 months of follow-up, the ADH group had improved TUG time (P=0.0148, q=3.385) as compared to baseline. Both groups of patients had the similar improvement in Kellgren-Lawrence score and mild to moderate adverse effects after 6 months.
CONCLUSIONS: CCH injection was superior to ADH injection.

Keywords: Hyaluronic Acid, Knee Joint, Osteoarthritis, Osteoarthritis, Knee, viscosupplementation, visual analog scale