Single-Shot Glucosamine-Hyaluronic Acid Combination Injection for Knee Osteoarthritis: A Retrospective Observational...

Background Knee osteoarthritis is a common cause of chronic pain, stiffness, and functional limitation. Many patients use oral glucosamine, but daily intake may be limited by adherence, pill burden, tolerability, and inconsistent long-term use. This study reviewed clinical outcomes after a single intra-articular glucosamine-hyaluronic acid combination injection used as a practical injection-based option in routine knee osteoarthritis care. Methods This retrospective observational study included 60 adult patients with symptomatic knee osteoarthritis treated at the National Bank Hospital for Integrated Care, Cairo, Egypt. All patients received a single landmark-guided intra-articular injection of a commercially manufactured, CE-marked Class III fixed glucosamine-hyaluronic acid combination medical device (Viscoart™ Forte GGP; ERC Biyoteknoloji Sanayi ve Diş Ticaret Anonim Şirketi, Istanbul, Türkiye). Outcomes were assessed using the Lequesne Algofunctional Index and Visual Analog Scale (VAS) pain scores recorded at baseline, approximately six weeks, and approximately six months. Previous oral glucosamine-use pattern, patient satisfaction, follow-up status, and documented adverse events were also reviewed. Results The cohort had a mean age of 59.5±6.1 years and a mean body mass index of 35.5±4.6 kg/m². Forty-one patients were female (68.3%), and 38 patients (63.3%) had bilateral knee osteoarthritis. Fifty-three patients (88.3%) completed the six-month follow-up. The mean Lequesne score decreased from 19.23±3.22 at baseline to 16.33±3.37 at six weeks and 14.02±3.31 at six months. Paired analysis showed significant improvement at six weeks (cohort N=60; t(59)=-41.36; p<0.001; here, 59 represents the degrees of freedom) and six months (completers N=53; t(52)=-20.47; p<0.001). The mean VAS pain score decreased from 7.45±1.10 at baseline to 5.70±1.43 at six weeks and 4.60±1.36 at six months (p<0.001 for both comparisons). Most patients had current, previous, or irregular prior oral glucosamine use (55/60, 91.7%). The mean satisfaction score at six months was 4.21±0.74 out of 5. Documented adverse events were mild and transient, mainly short-duration post-injection pain, mild redness, and one case of mild swelling; no joint infection or serious treatment-related adverse event was recorded. Conclusions In this routine-care retrospective cohort, a single landmark-guided intra-articular injection of this CE-marked glucosamine-hyaluronic acid combination medical device was associated with improved pain and functional scores over six months in patients with symptomatic knee osteoarthritis. These findings support further evaluation of this injection-based option in selected patients, especially where daily oral glucosamine use may be inconvenient or inconsistently maintained. Interpretation should remain cautious because of the single-arm design, missing six-month data in a small proportion of patients, and absence of an oral-glucosamine, hyaluronic acid-only, or usual-care comparator. The study describes outcomes of a single-shot glucosamine-hyaluronic acid injection in a general clinical environment.