Efficacy and safety of viscosupplementation in symptomatic knee osteoarthritis: An experience from a Tertiary Care Center in Mumbai

Abstract

Objective: To report on our clinical experience (safety and efficacy) of intraarticular injection of high molecular weight hyaluronic acid in symptomatic knee osteoarthritis. Methods: In this prospective, experimental pre post efficacy, non-comparative study, 39 patients with symptomatic knee osteoarthritis (OA) were treated with single intra-articular injection of high molecular weight (HMW) hyaluronic acid (Hylan G-F20). Pain visual analogue scale (VAS) and WOMAC scores were evaluated at baseline, after three and six months. The study as completed over one year. The change in VAS and WOMAC score from baseline was calculated for patients who completed all three visits. Results: The mean age of participants was 55.5 (+10.9) years; mean duration of OA was 4.8 (+3.1) years. Of the 39 patients, 12 patientshad grade 2 OA, 26 patients had grade 3 OA and one patient had grade 4 OA. Thirteen patients completed all three visits, and seven patients completed baseline and three month evaluation. The median VAS score reduced from 6.5 (+2.1) at baseline to 3.5 (+2.1) at 3 months and 4.5 (+2.2) at 6 months, P = 0.01 (vs Baseline). The median WOMAC score reduced from 52.5 (+18.5) baseline to 23 (+13.5) at 3 months and 33 (+17.5) at 6 months, P = 0.0004 (vs baseline). Study medication was well tolerated. None of the patients reported any adverse event. Conclusion: In our experience intra-articular HMW hyaluronic acid (Hylan G-F20) is a good and safe therapeutic option for patients with mild to moderate knee OA to reduce pain.