Treatment Efficacy with a Novel Hyaluronic Acid-Based Hydrogel for Osteoarthritis of the Knee

Octav Marius Russu,Octav Marius Russu,Andrei Marian Feier,Andrei Marian Feier,Zsuzsanna Incze-Bartha,Tudor Sorin Pop,Tudor Sorin Pop,István Gergely,Sándor-György Zuh,Paul Gabriel Borodi,István Gergely,Cristian Trâmbițaș,Cristian Trâmbițaș,Sándor-György Zuh

doi:10.3390/jpm11040303

Abstract

Background: Prior trials investigating the treatment of symptomatic osteoarthritis (OA) with hyaluronic-acid-derived products injections have provided optimistic results. The study was directed to assess the effectiveness of an innovative hyaluronic-acid-based hydrogel (Hymovis®) in the treatment of symptomatic knee OA. Methods: A prospective, single-center, clinical trial was performed. Thirty-five patients with degenerative knee OA were included. Inclusion criteria were: age between 45–80, radiographic Kellgren grade II or III osteoarthritis, minimum 35 mm score on the Visual Analogue Scale (VAS), pain for at least 6 months and agreement to participate in the study. Patients received two injections at a one-week interval. The evaluator assessed the patients using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and VAS. Evaluation was performed before, at 2 and 6 months after the injections. Results: A significant improvement on the WOMAC Index pain subscale was observed at 6 months after the injection. At two months, pain subscale score decreased from 10.34 to 9.34. At six months, a significant decrement in pain parameters compared to baseline was observed (from 10.34 to 7.72; p = 0.0004). Median points on VAS significantly ameliorated after 6 months (from 74.2 to 57.3 cm; p < 0.0001). Regarding physical function, a statistically significant difference compared to baseline was observed at the end of the study (from 29.74 to 25.18; p = 0.0025). WOMAC Index stiffness component did not differ from baseline at any time during follow-up. Conclusions: Pain relief installed with a delayed on-set but had a prolonged duration. The novel hyaluronic acid-based hydrogel (Hymovis®) had effective results, particularly after six months post-injections and offers a therapeutic advancement in the treatment of moderate to severe osteoarthritis.

Highlights

Knee osteoarthritis (OA) is a common chronic joint disorder and a leading cause of disability among the elder population [1]
Acetaminophen is proven to have no effects on pain control irrespective of dose [6] and some of the nonsteroidal anti-inflammatory drugs (NSAIDs) are well known in the literature for their adverse reactions causing toxicity [7,8,9,10] and are being recognized as responsible for most of the iatrogenic pathology [11]
The most important findings of the present study were that Hymovis® infiltrations were proven to have long-term effectiveness in patients with knee OA who had symptomatic pain

Summary

Introduction

Knee osteoarthritis (OA) is a common chronic joint disorder and a leading cause of disability among the elder population [1]. Improvement in joint mobility and functional impairment reduction are the main objectives in the treatment of knee OA. Most of the oral medications have weak or no effects when treating pain associated with knee OA. Acetaminophen is proven to have no effects on pain control irrespective of dose [6] and some of the NSAIDs are well known in the literature for their adverse reactions causing toxicity (gastric and cardiovascular) [7,8,9,10] and are being recognized as responsible for most of the iatrogenic pathology [11]

Methods

Results

Conclusion