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Journal Article
Randomized Controlled Trial
Origin and Efficacy of Hyaluronan Injections in Knee Osteoarthritis: Randomized, Double-Blind Trial.
Medical Science Monitor : International Medical Journal of Experimental and Clinical Research 2018 July 10
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.
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