title: Intra-articular hyaluronic Acid as treatment in elderly and middle-aged patients with knee osteoarthritis.
abstract: BACKGROUND
  Osteoarthritis is the most common age-related degenerative joint disease. It affects all the joints containing hyaline cartilage. Knee osteoarthritis is the most cumbersome in terms of prevalence and disability. The aim of this study to evaluate the efficacy of intra-articular hyaluronic acid in patients with knee osteoarthritis with regard to joint pain and function, as well as patient satisfaction, assessed at one month and at one year, and by age group.
  
  
  METHODS
  In this prospective randomised study, 172 patients who were diagnosed knee OA and who received three consecutive intra-articular injections of HA weekly were included. Patients 65 years of age or older were accepted as the "elderly group", and those under 65 were accepted as the "middle-aged group". Clinical evaluations of efficacy and safety were conducted at the beginning of the study, one month after the third injection, and one year after the third injection.
  
  
  RESULTS
  In the two groups, the intragroup analysis revealed significant improvements following injection when compared with preinjection values. According to the last followup controls (after 12 months) in the middle-aged group, VAS activity pain, VAS rest pain, WOMAC physical function, and WOMAC pain values were found to be statistically lower when compared with pre-injection values. In the elderly group, no statistically significant differences were found between pre-injection and after 12 months.
  
  
  CONCLUSIONS
  We can conclude that intra-articular joint HA injections are effective in both young and old patients with OA with regard to pain and functional status over a short-term period. Further, HA injections in patients younger than 65 years can be planned for a one-year period.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Dicle University Medical Faculty, Diyarbakir, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Uçar
authors.forename: Demirhan
authors.initials: D
authors.lastname: Dıraçoğlu
authors.forename: Türker
authors.initials: T
authors.lastname: Süleyman
authors.forename: Nalan
authors.initials: N
authors.lastname: Capan
keywords: Knee osteoarthritis; hyaluronic acid; knee pain.
references.citation: Osteoarthritis Cartilage. 2005 Jan;13(1):28-33
references.pmid: 15639634
references.citation: Clin Orthop Relat Res. 1971 Oct;80:25-32
references.pmid: 5002457
references.citation: Ann Rheum Dis. 1996 Jul;55(7):424-31
references.pmid: 8774159
references.citation: Knee. 2008 Aug;15(4):318-24
references.pmid: 18430574
references.citation: Clin Rheumatol. 2009 Sep;28(9):1021-4
references.pmid: 19455363
references.citation: Osteoarthritis Cartilage. 1993 Apr;1(2):97-103
references.pmid: 8886085
references.citation: Am J Orthop (Belle Mead NJ). 2000 Feb;29(2):80-8; discussion 88-9
references.pmid: 10695858
references.citation: Ann Rheum Dis. 1957 Dec;16(4):494-502
references.pmid: 13498604
references.citation: Joint Bone Spine. 2006 Dec;73(6):705-9
references.pmid: 16997602
references.citation: CMAJ. 2005 Apr 12;172(8):1039-43
references.pmid: 15824412
references.citation: Cochrane Database Syst Rev. 2006 Apr 19;(2):CD005321
references.pmid: 16625635
references.citation: Osteoarthritis Cartilage. 2002 Jul;10(7):506-17
references.pmid: 12127830
references.citation: Arthritis Rheum. 1986 Aug;29(8):1039-49
references.pmid: 3741515
references.citation: Can Fam Physician. 2004 Feb;50:249-56
references.pmid: 15000336
references.citation: Curr Med Res Opin. 2005 Aug;21(8):1261-9
references.pmid: 16083536
references.citation: Curr Med Res Opin. 2008 May;24(5):1309-16
references.pmid: 18373891
references.citation: Clin Ther. 1998 May-Jun;20(3):410-23
references.pmid: 9663358
references.citation: Pathol Biol (Paris). 1974 Oct;22(8):731-6
references.pmid: 4614175
references.citation: J Bone Joint Surg Am. 2004 Mar;86(3):538-45
references.pmid: 14996880
references.citation: Arthritis Rheum. 1995 Aug;38(8):1134-41
references.pmid: 7639811
references.citation: Knee. 2002 Dec;9(4):321-30
references.pmid: 12424042