Diagnosis and Management of Osteoarthritis with Hyaluronic Acid

Authors

  • Sandër Kola Department of Imaging, University Hospital Center “Mother Teresa”, Tirana, Albania
  • Irena Kola Department of Rheumatology, University Hospital Center “Mother Teresa”, Tirana, Albania
  • Erinda Frroku Department of Imaging, University Hospital Center “Mother Teresa”, Tirana, Albania
  • Erjona Abazaj National Reference Laboratories, Institute of Public Health, Tirana, Albania

DOI:

https://doi.org/10.3889/oamjms.2022.9640

Keywords:

Hyaluronic acid, Osteoarthritis, Radiography, Rehabilitation

Abstract

BACKGROUND: Osteoarthritis (OA) of the genu joint is a degenerative disease of the genu joint, which due to functional limitations leads to deterioration of the quality of life of these patients. In many cases, surgical therapy prosthesis of articular surfaces represents the gold standard of treatment for these patients.

AIM: In this study, it is proposed to evaluate the effectiveness of hyaluronic acid (HA) injected under the direction of Echo (ultrasound) in the genu articulation accompanied by a rehabilitation program.

MATERIALS AND METHODS: Fifteen patients with knee OA were studied. According to the Kellgren-Lawrence radiological classification, Grade II-III arthrosis does not qualify for surgical treatment. Patients underwent intra-articular injection with HA, under ultrasound guidance, and after 6 days continued with rehabilitative treatment aimed at combating the patient’s analgesic posture, recovery of muscle traction participating in genu joint movement, decompression maneuvers, and decompaction in monopodial load. Patients were evaluated at the beginning and after 3 months.

RESULTS: In the evaluation of patients at the beginning and after 3 months, a reduction in> 60% of the pain was found, and the Western Ontario and McMaster University Osteoarthritis test in 40% of patients after the first intra-articular injection. No significant side effects were observed during infiltrative procedures.

CONCLUSIONS: This study confirms the effectiveness of the combined treatment of the rehabilitation program and intra-articular therapy under the guidance of Echos, in patients suffering from knee OA, significantly reducing pain and recovery of functional capacity.

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References

Richmond SA, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA. Are joint injury, sports activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review. J Orthop Sports Phys Ther. 2013;43(8):515-B19. https://doi.org/10.2519/jospt.2013.4796 PMid:23756344

Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745-59. https://doi.org/10.1016/S0140-6736(19)30417-9 PMid:31034380

Losina E, Weinstein AM, Reichmann WM, Burbine SA, Solomon DH, Daigle ME, et al. Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US. Arthritis Care Res. 2013;65(5):703-11. https://doi.org/10.1002/acr.21898 PMid:23203864

Zhang H, Zhang K, Zhang X, Zhu Z, Yan S, Sun T, et al. Comparison of two hyaluronic acid formulations for safety and efficacy (CHASE) study in knee osteoarthritis: A multicenter, randomized, double-blind, 26-week non-inferiority trial comparing Durolane to Artz. Arthritis Res Ther. 2015;17(1):51. https://doi.org/10.1186/s13075-015-0557-x PMid:25889322

GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016;388(10053):1545-602. https://doi.org/10.1016/S0140-6736(16)31678-6 PMid:27733282

Dixon T, Shaw M, Ebrahim S, Dieppe P. Trends in hip and knee joint replacement: Socioeconomic inequalities and projections of need. Ann Rheum Dis. 2004;63(7):825-30. https://doi.org/10.1136/ard.2003.012724 PMid:15194578

Mahomed NN, Barrett J, Katz JN, Baron JA, Wright J, Losina E. Epidemiology of total knee replacement in the United States Medicare population. J Bone Joint Surg. 2005;87(6):1222-8. https://doi.org/10.2106/JBJS.D.02546 PMid:15930530

Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, et al. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59(9):1207–13. https://doi.org/10.1002/art.24021 PMid:18759314

O’Hanlon CE, Newberry SJ, Booth M, Grant S, Motala A, Maglione MA, et al. Hyaluronic acid injection therapy for osteoarthritis of the knee: Concordant efficacy and conflicting serious adverse events in two systematic reviews. Syst Rev. 2016;5(1):186 https://doi.org/10.1186/s13643-016-0363-9 PMid:27814744

Martin-Martin LS, Massafra U, Bizzi E, Migliore A. A double-blind randomized active-controlled clinical trial on the intra-articular use of Md-Knee versus sodium hyaluronate in patients with knee osteoarthritis (“Joint”). BMC Musculoskelet Disord. 2016;17:94. https://doi.org/10.1186/s12891-016-0948-4 PMid:26905565

Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-74. https://doi.org/10.1002/acr.21596 PMid:22563589

Miller LE, Block JE. US-approved intra-articular hyaluronic acid injections are safe and effective in patients with knee osteoarthritis: Systematic revieë and meta-analysis of randomized, saline-controlled trials. Clin Med Insights Arthritis Musculoskelet Disord. 2013;6:57-63. https://doi.org/10.4137/CMAMD.S12743 PMid:24027421

Primorac D, Molnar V, Matiši´c V, Hudetz D, Jeleˇc Ž, Rod E, et al. Comprehensive review of knee osteoarthritis pharmacological treatment and the latest professional societies’ guidelines. Pharmaceuticals. 2021;14(3):205. https://doi.org/10.3390/ph14030205 PMid:33801304

Pavelka K, Uebelhart D. Efficacy evaluation of highly purified intra-articular hyaluronic acid (Sinovial(®)) vs. hylan G-F20 (Synvisc(®)) in the treatment of symptomatic knee osteoarthritis. A double-blind, controlled, randomized, parallel-group non-inferiority study. Osteoarthritis Cartilage. 2011;19(11):1294-300. https://doi.org/10.1016/j.joca.2011.07.016 PMid:21875678

American College of Rheumatology. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); 2013. Available from: http://www.rheumatology.org/practice/clinical/clinicianresearchers/outcomes-instrumentation/WOMAC.asp. [Last accessed on 2013 Jul 12].

Gupta RC, Lall R, Srivastava A, Sinha A. Hyaluronic acid: Molecular mechanisms and therapeutic trajectory. Front Vet Sci. 2019;6:192. https://doi.org/10.3389/fvets.2019.00192 PMid:31294035

Gigante A, Callegari L. The role of intra-articular hyaluronan (Sinovial) in the treatment of osteoarthritis. Rheumatol Int. 2011;31(4):427-44. https://doi.org/10.1007/s00296-010-1660-6 PMid:21113807

Hunter DJ. Viscosupplementation for osteoarthritis of the knee. N Engl J Med. 2015;372(11):1040-7. https://doi.org/10.1056/NEJMct1215534 PMid:25760356

Tasciotaoglu F, Oner C. Efficacy of intra-articular sodium hyaluronate in the treatment of knee osteoarthritis. Clin Rheumatol. 2003;22(2):112-7. https://doi.org/10.1007/s10067-002-0690-1 PMid:12740675

Vina ER, Kwoh CK. Epidemiology of osteoarthritis: literature update. Curr Opin Rheumatol. 2018;30(2):160-7. https://doi.org/10.1097/BOR.0000000000000479 PMid:29227353

Georgiev TS, Stoilov R, Penkov M, Ivanova M, Trifonov AN. Radiographic assessment of knee osteoarthritis. Revmatologiia. 2016;24(2): 16-24.

Bannuru RR, Natov NS, Dasi UR, Schmid CH, McAlindon TE. Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis – Meta-analysis. Osteoarthritis Cartilage. 2011;19(6):611-9. https://doi.org/10.1016/j.joca.2010.09.014 PMid:21443958

Conduah AH, Baker CL, Baker CL. Managing joint pain in osteoarthritis: Safety and efficacy of Hylan G-F 20. J Pain Res. 2009;2:87-98. https://doi.org/10.2147/jpr.s4732 PMid:21197297

Bruyère O, Cooper C, Pelletier JP, Branco J, Luisa Brandi M, Guillemin F, et al. An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: A report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Semin Arthritis Rheum. 2014;44(3):253-63. https://doi.org/10.1016/j.semarthrit.2014.05.014 PMid:24953861

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Published

2022-06-22

How to Cite

1.
Kola S, Kola I, Frroku E, Abazaj E. Diagnosis and Management of Osteoarthritis with Hyaluronic Acid. Open Access Maced J Med Sci [Internet]. 2022 Jun. 22 [cited 2026 Oct. 17];10(B):1801-5. Available from: https://oamjms.eu/index.php/mjms/article/view/9640