The safety and efficacy of single intra-articular hyaluronic acid injection in patients with knee osteoarthritis: a prospective study

Esat Uygur, Ismail Turkmen, Emre Koraman*, Ali Burak Bostan, Oguz Poyanli

Department of Orthopaedics and Traumatology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Prof. Dr. Suleyman Yalcin State Hospital, Istanbul, Turkey 

Introduction: To evaluate the effectiveness and safety of viscosupplementation with intra-articular hyaluronic acid injection (IA-HA) in patients with knee osteoarthritis (OA).

Materials and methods: This prospective study was carried out among the patients with grade II and III (Kellgren Lawrence classification) osteoarthritis of the knee attending outpatients clinic from March 2019 to January 2020. Patients, who did not achieve remission of pain despite receiving the first-line treatment for gonarthrosis were included in the study. A single dose of HA was injected into the target knee joint. Clinical evaluation was done using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the short form-36 questionnaires (SF-36 v2) at baseline, 3 months and 6 months by an independent evaluater.

Results: A total of 67 patients with knee OA enrolled and completed the study. Statistically significant improvements from baseline to 3 months were observed in the total WOMAC score that remained significant until the end of 6 months. Most of the domains of SF-36 also showed significant improvement from baseline to 3 and 6 months. No patient reported adverse effects during the study. 

Conclusion: Among the patients within this study, treatment with single IA-HA injection improved all domains of WOMAC score and the quality of patients’ life starting from week 12 that was sustained until 6 months at least. These findings suggest 90 mg/3 mL HA injection to be an effective and safe alternative in improving pain and functional status of patients with gonarthrosis.