Knee OA: novel hyaluronan injection superior for reducing pain, disability

  • Guo Y & al.
  • Med Sci Monit
  • 9 Jul 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Hyaluronan, which is given to boost viscoelasticity of synovial fluid and reduce pain in osteoarthritis (OA), comes in several different preparations.
  • In this randomized controlled trial, a single intra-articular injection of chemically cross-linked hyaluronan (CCH) outperformed avian-derived hyaluronan (ADH) on almost all pain and disability measures.

Why this matters

  • Clinicians should favor the use of CCH.

Study design

  • Randomized, double-blind controlled trial (n=258) of CCH (60 mg/3 mL) vs ADH (60 mg/6 mL).
  • Funding: None disclosed.

Key results

  • The CCH group performed better on the following outcomes vs the ADH group (at 6 months compared with baseline):
    • Reduced pain by visual analog scale (P<.0001>
    • Lower total disability on the Western Ontario and McMaster Universities Osteoarthritis index (P<.0001>
    • Improved Lequesne index for activities of daily living, walking distance, and pain (P<.0001 and>
    • Better single-limb stance time for balancing on 1 knee (P<.0001>
  • The ADH group, after 6 months, had improved timed "Up-and-Go" (TUG) test, which measures time from getting up from a chair, walking 3 meters, walking back, and sitting down, vs the CCH group (P=.0148).
  • There was no difference between groups on Radiographic Kellgren-Lawrence Score measuring narrowing of joint space.

Limitations

  • Single-center study.
  • No placebo control.

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