Evaluation of the Effectiveness of Hyaluronic Acid Injections in Treatment of Small Joint Osteoarthritis.

Abstract

Osteoarthritis is an incurable, progressive, degenerative and debilitating joint disease, characterized by pain, stiffness and limitation of joint mobility. Treatment is limited to symptom management and includes pharmaco- and physiotherapy, rehabilitation and surgery. To evaluate safety and effectiveness of a selected hyaluronic acid injectable in the treatment of small joint osteoarthritis. 324 patients (F: 190, M: 134) aged 19-84 completed the study. Each participant received three, weekly intra-articular hyaluronic acid injections (Suplasyn®, Bioniche Life Sciences Inc, Belleville, Ontario; 700 kDa, 7 ml/7 mg). Morning stiffness and pain intensity (at rest and movement-induced) before and after treatment as well as post-treatment improvement in joint mobility were assessed based on questionnaires filled out by patients and their physicians prior to treatment commencement and at its conclusion. Participants used a Numerical Rating Scale (range 0-10 points) to quantify assessments. Data was analysed with chi-square and Fisher's exact tests and p = 0.05 was accepted as significant. A significant (p <0.001) post-treatment reduction in (1) morning stiffness (median NRS score decrease from 6 to 2 points), (2) pain intensity at rest (median NRS score decrease from 5 to 2 points) and movement induced (median NRS value decrease from 6 to 2 points). Improvement in joint mobility was reported by 97% of patients. Treatment tolerability (safety) was assessed as good to excellent by 25 % and 74% of patients, respectively. No serious adverse reactions were reported. Hyaluronic acid injections are a highly effective and safe treatment for symptomatic small joint osteoarthritis.