Delay to TKA in Patients Treated with a Multimodal Approach Using High Molecular Weight, Biologically Derived...

Area of Science:

• Orthopedics
• Rheumatology
• Pharmacology

Background:

• Knee osteoarthritis (OA) is a prevalent condition necessitating effective management strategies.
• Intra-articular hyaluronic acid (IA-HA) injections are a common treatment modality for knee OA.
• The optimal use of IA-HA, including single versus multiple courses and combination therapy, requires further investigation.

Purpose of the Study:

• To evaluate the impact of single versus multiple intra-articular hyaluronic acid (IA-HA) treatments on delaying total knee arthroplasty (TKA) in patients with knee OA.
• To assess the added benefits of IA-HA when used concurrently with other multimodal treatment options.

Main Methods:

• Retrospective claims analysis of a large commercial database (over 100 million patients).
• Comparison of time to TKA for patients receiving one course of IA-HA (Euflexxa/IA-BioHA) versus two or more courses, and no IA-HA.
• Evaluation of multimodal treatment combinations: IA-HA alone, IA-HA with bracing, IA-HA with corticosteroid injection, and IA-HA with both.

Main Results:

• A total of 26,727 patients were analyzed for treatment courses and 31,034 for multimodal combinations.
• Repeated courses of IA-HA significantly prolonged the time to TKA (1.411 years, IQR: 1.44).
• The greatest delay in TKA (1.5 years, IQR: 1.52) was observed in patients receiving IA-HA combined with both corticosteroids and bracing.

Conclusions:

• Multimodal therapy, rather than focusing on single treatment options, should be considered for managing knee OA.
• Repeated courses of IA-HA offer prolonged benefits for patients experiencing symptomatic knee OA.
• Combining IA-HA with other therapies enhances its efficacy in delaying TKA.