Clinical comparison of oral administration and viscosupplementation of hyaluronic acid (HA) in early knee osteoarthritis.

Abstract

Osteoarthritis (OA) is a progressive, chronic and degenerative joint disease characterized by a loss of articular cartilage. Treatment of OA is largely palliative based on nonsteroidal anti-inflammatory drugs, opioids and injections of steroids. Regarding conservative treatment, intra-articular injections of hyaluronic acid (HA) can play a role in early symptomatic knee OA. Between August 2015 and September 2015, sixty patients (32 males and 28 females) between 40 and 70years old were randomly allocated into two groups: Half were treated with three weekly intra-articular injections of hyaluronic acid 1.6% (group A), while the others were treated with Syalox 300 Plus® (hyaluronic acid 300mg+Boswellia serrata extract 100mg) 1 tab/die for 20days and afterward Syalox 150® (hyaluronic acid 150mg) 1 tab/die for other 20days (group B). All patients were evaluated clinically with American Knee Society Score (AKSS) and visual analogue scale (VAS) for the pain before the treatment and after 3months. AKSS of the patients in both groups was significantly increased by the treatment, and VAS score was significantly reduced. In both groups, two subgroups were created with patients older than 60years and patients younger than 60years. Better results are reported in younger patients of group A and older subjects in group B. Despite several limitations, the results of the study have shown that HA injection and oral administration may have beneficial therapeutic effects on patients with early osteoarthritis. Different outcomes in younger and older subject suggested a combined therapy first with local infiltrations and then with oral composition.