Prospective randomized clinical trial: single and weekly viscosupplementation

Area of Science:

• Orthopedics
• Rheumatology
• Pharmacology

Background:

• Knee osteoarthritis (OA) is a prevalent degenerative joint disease.
• Sodium hyaluronate (HA) injections are a common viscosupplementation treatment for OA.
• Optimal HA dosing and administration frequency for OA treatment are still under investigation.

Purpose of the Study:

• To compare the effectiveness of a single 6 ml dose of intermediate molecular weight sodium hyaluronate (HA) against the traditional three-weekly 2 ml dose for knee OA.
• To evaluate if a single high-volume HA injection can match the efficacy of multiple lower-volume injections.

Main Methods:

• A prospective randomized clinical trial involving 108 patients with knee OA.
• Patients were randomized into two groups: a single 6 ml HA dose group and a three-weekly 2 ml HA dose group.
• Both groups received triamcinolone hexacetonide with the first HA application. Efficacy was assessed using WOMAC, Lequesne, IKDC, and VAS questionnaires at baseline, one month, and three months.

Main Results:

• No statistically significant difference in overall functional improvement was observed between the single 6 ml HA application and the three-weekly 2 ml HA injections.
• The three-weekly regimen demonstrated a statistically significant improvement in baseline pain scores (WOMAC pain and VAS) compared to the single application.
• Both treatment protocols led to improvements in joint function.

Conclusions:

• Both single high-volume and multiple lower-volume HA injection regimens can improve function in knee OA patients.
• The traditional three-weekly 2 ml HA regimen appears more effective for pain reduction than a single 6 ml dose.
• Further research may explore optimal HA viscosupplementation strategies for knee OA pain management.