title: Comparison of two hyaluronan drugs in patients with advanced osteoarthritis of the knee. A prospective, randomized, double-blind study with long term follow-up.
abstract: OBJECTIVE
  To compare the long-term effects of high and low molecular weight hyaluronic acid (HA) applications in severe (Kellgren Lawrence stage III) osteoarthritis (OA) of the knee.
  
  
  METHODS
  In a prospective clinical trial 184 knees (92 patients) with radiographic Kellgren Lawrence stage III OA were randomized to receive either 3 intra-articular high molecular weight HA (Hylan G-F 20) injections or 3 low molecular weight HA (Orthovisc) injections at one-week intervals. Patients were evaluated by the Hospital for Special Surgery (HSS) Knee Score and were followed-up for 12 months.
  
  
  RESULTS
  The total HSS score in high molecular weight HA patients improved from 71.8+/-11.6 to 86.7+/-11.6 and in low molecular weight HA patients from 66.7+/-11.0 to 86.6+/-9.1 at the end of the trial (p < 0.01). There were no statistically significant differences between the groups and both had improved in all parameters at the latest follow-up (p = 0.000).
  
  
  CONCLUSIONS
  Three intra-articular injections at intervals of 1 week of both HA preparations resulted in a pronounced reduction in pain and improved function as measured by the HSS score during a period of 52 weeks, without complications.
authors.affiliation: Department of Orthopaedic Surgery, Dokuz Eylul University Hospital, Balcova, Izmir, Turkey. vasfi.karatosun@deu.edu.tr
authors.forename: V
authors.initials: V
authors.lastname: Karatosun
authors.forename: B
authors.initials: B
authors.lastname: Unver
authors.forename: Z
authors.initials: Z
authors.lastname: Gocen
authors.forename: A
authors.initials: A
authors.lastname: Sen
mesh_terms: D004311:Double-Blind Method; D005260:Female; D006304:Health Status; D006801:Humans; D006820:Hyaluronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D020370:Osteoarthritis, Knee / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy / Q000503:physiopathology; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: C477349:orthovisc; C049816:hylan; D006820:Hyaluronic Acid