Efficacy of Intra-articular Sodium Hyaluronate in Patients with Osteoarthritis of the Knee

Noh, Seung Sook; Lee, Jae Jun; Hwang, Sung Mi; Lim, So Young; Chung, Il Young; Choi, Young Ryong

Abstract

BACKGROUND
Osteoarthritis of the knee joint is a chronic disease associated with degenerative change in the constituents of the knee joint, which is characterized by the slow degradation of cartilage, pain and increasing disability. Traditional treatments for osteoarthritis include weight loss, muscle strengthening exercise, simple analgesics, non-steroidal anti-inflammatory drugs, intra- articular corticosteroids and surgery, but drug treatments have various adverse reactions. Although some assessments of sodium hyaluronate have indicated clinical improvement in the majority of cases, the therapeutic effects of an intra-articular injection of sodium hyaluronate on osteoarthritis of the knee is still in question. Therefore, the present study was undertaken to elucidate the therapeutic efficacy and safety of an intra-articular injection of sodium hyaluronate for osteoarthritis of the knee. METHODS: A randomized clinical trial was carried out in 35 patients with osteoarthritis of the knee to evaluate the efficacy and tolerability of an intra-articular injection of 25 mg sodium hyaluronate once a week, for 5 consecutive weeks. The final evaluation was assessed by pain at rest, pain on walking, tenderness of the joint line before the study initiation, and at the 2nd, 4th and 6th weeks after the end of the injections. The level of knee pain was evaluated using a 100 mm VAS (visual analog scale). RESULTS: The pain at rest, as assessed by the visual analog scale (VAS), showed a statistically significant (P< 0.05) reduction from that at the baseline through to the follow-ups at the 2nd, 4th and 6th weeks. The pain on walking also showed a statistically significant (P< 0.05) reduction with a similar pattern as that for pain at rest. However, the pain with pressure did not show a statistically significant reduction. CONCLUSIONS: These results indicate that a course of intra-articular injections of sodium hyaluronate (25 mg) is generally well tolerated in patients with osteoarthritis of the knee, and results in significant reductions in the knee pain of such patients.