Affiliations: [a] Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey | [b] Department of Physical Medicine and Rehabilitation, Avicenna Umut Hospital, Istanbul, Turkey
Correspondence:
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Corresponding author: Demirhan Dıraçoğlu, Istanbul Tip Fakultesi, Istanbul Universitesi, Fiziksel Tip ve, Rehabilitasyon Anabilim Dali 34093 Capa, Istanbul, Turkey. Tel.: +90 212 4142000 (600 line) Ext: 12840, Fax: +90 212 6311167; E-mail:demirhan1@yahoo.com
Abstract: OBJECTIVE: The purpose of this study was to compare the
effectiveness of three injections of standard linear HA versus single
injection of lightly cross-linking HA in patients with knee OA. METHODS: Forty subjects were randomized into two groups. The first
group received single dose intraarticular injection of 4 ml lightly
cross-linking sodium hyaluronate (Monovisc), and the second group received
three consecutive intraarticular injections of 2.5 ml standard linear sodium
hyaluronate (Adant) with one week intervals. Visual analog scale (VAS)-pain
and Western Ontario and McMaster University Osteoarthritis Index (WOMAC)
scores were measured. RESULTS: In both groups, VAS-pain and WOMAC scores (except
WOMAC-stiffness) were improved statistically lasting up to the 6th
month with respect to before injection values (p< 0.001). There were no
statistical differences in VAS-pain and WOMAC scores after injections
(p> 0.05) in both groups. But in the 6th month visit, VAS-resting values
were found to be statistically improved in standard linear HA group compared
to lightly cross-linking HA group (p< 0.05). CONCLUSION: Although three-dose administration was significantly
superior to single-dose at the sixth month, current knowledge is not
sufficient to decide whether single-dose or multiple-dose HA injection
should be chosen. There is a clear need for verification of our results with
long-term studies on larger patient groups.
