AF McGrath, AM McGrath, ZM Jessop MA, Surya Gandham, G Datta, Sebastian Dawson-Bowling and SR Cannon
Purpose: Viscosupplementation with Hyaluronic Acid (HA) is an established intervention for pain control in patients with mild to moderate Osteoarthritis (OA) of the hip and knee. Problems include inconvenience, expense and the logistical problems associated with multiple injections, injection technique and level of skill required by the administering physician, variable clinical response and adverse reactions.
Methods: In this independent, prospective, randomized trial, we compare efficacy and complications associated with treatment in 182 knees using durolaneTM and synviscTM using the Visual Analogue Score, SF-36 V2 questionnaire, and Oxford knee scores. Range of movement is recorded at each visit. These assessments are repeated at 3, 6, 9 and 12 months.
Results: Significant improvement is seen in the VAS, SF 36 V2 and Oxford Knee Scores (p=0.01) and reduction in the use of analgesics and anti-inflammatories is seen with both products at 3 months post injection, with a significant advantage to the durolane group (p=0.001). At 6 months, this difference is extended even further. Adverse reactions occur significantly less with the more effective product.
Conclusion: We conclude that intra-articular HA a useful intervention in patients with mild to moderate OA of the knee, can produce sustained pain relief at 6 months, and can reduce the requirement for analgesia and antiinflammatory medication during this time.
