Evaluation of Single and Multiple Hyaluronic Acid Injections at Different Concentrations with High Molecular Weight in The Treatment of Osteoarthritis

Abstract

Abstract Background Knee osteoarthritis is severe progressive and most commonly diagnosed articular disease and its incidence is increasing around the world depending on age. This pathologic condition which limit daily activity of patients can be characterized by degeneration of cartilage and inflammation. Although non-steroidal anti-inflammatory (NSAII) agents and other analgesics are routinely used treatment options, the potential effects of intraarticular injections including hyaluronic acid have also been demonstrated by various studies. However, there are few studies that comparing efficacy of single high molecular weight (HMW) high dose and triple HMW low dose. This study aimed to compare efficacy of single high molecular weight (HMW) high dose (2 mL / 60 mg) and triple HMW low dose (2 mL /30 mg) intra-articular injection of HA in knee osteoarthritis (OA) patients by evaluating function and pain parameters during a 12 months. Methods In this single-center, double-blind randomized clinical trial performed on 128 patients who randomly divided into two groups. Group I (n = 64) patients received 60 mg of HA injection with SEMICAL®. Group II (n = 64) patients received triple 30 mg of SEMICAL® HA injection. Lequesne Index, WOMAC and VAS scores were recorded to asses’ pain and function during 12 months. Results There was no significant difference characteristics of patient. Our results showed that WOMAC, VAS score values and Lequesne Index values of follow-up visits of patients were found lower with 30 mg of HA injection compared to the 60 mg of HA injection. Conclusion This study suggests that the triple low-dose injection of HMW HA is more effective in improving WOMAC, VAS scores and Lequesne Index values than a single high-dose injection.