Effect of highly cross-linked hyaluronic acid in synovitis of knee osteoarthritis

Abstract

Purpose: The purpose of this study is to compare the synovial thickening by US evaluation, before and after Intra-articular highly cross-linked HA injection in OA knee patients. Methods: 107 knees in 73cases OA patients were underwent US measurement of synovial thickening before intra-articular injections of highly cross-linked HA, at 4 weeks and at 3 months after injections. The US were performed with the knee flexion 30° and probe in longitudinal midline position at suprapatellar pouch. All knees were classified by Kellgren-Lawrence (KL) radiographic staging. Comparison of synovial thickening before & after Intra articulation highly cross-linked HA injection were analyzed. Results: The overall synovial thickening was significantly decreased after highly cross-linked HA injection at 4 weeks (p=0.01) but significantly increased after highly cross-linked HA injection at 3 months (p=0.047). In different group of knee OA. At 4 weeks after highly cross-linked HA injection, the synovial thickening was significantly decrease only in KL II (p=0.01) but not significantly different in KL III (p=0.96) & IV (p=0.83). At 3 months after highly cross-linked HA injection, the synovial thickening were not significantly different in KL II (p=0.058) & III (p=0.127). The synovial thickening in KL IV was significantly increase (p=0.02). Conclusions: Highly cross-linked hyaluronic acid injection can prevent structural damage by controlling inflammation in early stage knee OA. For advanced OA, it provides pain relief by better viscoselastic properties.