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Clinical comparison of oral administration and viscosupplementation of hyaluronic acid (HA) in early knee osteoarthritis

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Abstract

Purpose

Osteoarthritis (OA) is a progressive, chronic and degenerative joint disease characterized by a loss of articular cartilage. Treatment of OA is largely palliative based on nonsteroidal anti-inflammatory drugs, opioids and injections of steroids. Regarding conservative treatment, intra-articular injections of hyaluronic acid (HA) can play a role in early symptomatic knee OA.

Materials and methods

Between August 2015 and September 2015, sixty patients (32 males and 28 females) between 40 and 70 years old were randomly allocated into two groups: Half were treated with three weekly intra-articular injections of hyaluronic acid 1.6 % (group A), while the others were treated with Syalox 300 Plus® (hyaluronic acid 300 mg + Boswellia serrata extract 100 mg) 1 tab/die for 20 days and afterward Syalox 150® (hyaluronic acid 150 mg) 1 tab/die for other 20 days (group B). All patients were evaluated clinically with American Knee Society Score (AKSS) and visual analogue scale (VAS) for the pain before the treatment and after 3 months.

Results

AKSS of the patients in both groups was significantly increased by the treatment, and VAS score was significantly reduced. In both groups, two subgroups were created with patients older than 60 years and patients younger than 60 years. Better results are reported in younger patients of group A and older subjects in group B.

Conclusions

Despite several limitations, the results of the study have shown that HA injection and oral administration may have beneficial therapeutic effects on patients with early osteoarthritis. Different outcomes in younger and older subject suggested a combined therapy first with local infiltrations and then with oral composition.

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Authors and Affiliations

  1. Orthopedic and Traumatology Unit, Surgery Department, University of Verona, 37126, Polo Confortini, Verona, Italy

    M. Ricci, G. M. Micheloni, M. Berti, E. Sambugaro, E. Vecchini & B. Magnan

  2. Orthopedic and Traumatology Unit, Ospedale di Rovereto, Trento, Italy

    F. Perusi

Authors
  1. M. Ricci
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  2. G. M. Micheloni
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  3. M. Berti
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  4. F. Perusi
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  5. E. Sambugaro
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  6. E. Vecchini
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  7. B. Magnan
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Correspondence to G. M. Micheloni.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ricci, M., Micheloni, G.M., Berti, M. et al. Clinical comparison of oral administration and viscosupplementation of hyaluronic acid (HA) in early knee osteoarthritis. Musculoskelet Surg 101, 45–49 (2017). https://doi.org/10.1007/s12306-016-0428-x

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  • DOI: https://doi.org/10.1007/s12306-016-0428-x

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