title: Effectiveness of intra-articular injections of sodium hyaluronate-chondroitin sulfate in knee osteoarthritis: a multicenter prospective study.
abstract: BACKGROUND
  Intra-articular injection of hyaluronic acid is a well-established therapy for the treatment of knee osteoarthritis. The aim of the study was to assess the effectiveness and safety of the use of Arthrum HCS(®) (40 mg hyaluronic acid and 40 mg chondroitin sulfate in 2 mL).
  
  
  METHODS
  This was an open, multicenter, prospective study. Men or women over 40 years of age with documented knee osteoarthritis and WOMAC subscore A (severity of pain) ≥25 were enrolled. They received three weekly intra-articular injections of sodium hyaluronate 2 % and chondroitin sulfate 2 % in combination. WOMAC subscore A was assessed at 1, 3 and 6 months after the last injection.
  
  
  RESULTS
  One hundred and twelve patients were included (women, 66 %). The mean (SD) WOMAC subscore A decreased from 52.1 (15.2) at inclusion to 20.5 (19.7) at month 6 (P < 0.0001). The mean subscore was already significantly decreased 1 month after the last injection at 25.7 (P < 0.0001). Pain relief and consumption of analgesic drugs, both assessed with visual analogic scale (VAS), consistently decreased. The investigators were satisfied/very satisfied as regards the therapeutic effectiveness of sodium hyaluronate-chondroitin sulfate in reducing pain (77 %), improving mobility (78 %) and reducing the consumption of analgesics (74 %). Only one adverse effect was reported by one patient (knee tumefaction).
  
  
  CONCLUSIONS
  These results suggest that intra-articular injections of Arthrum HCS(®) (sodium hyaluronate plus chondroitin sulfate) in patients with knee osteoarthritis are efficient and safe. These results should be confirmed in a randomized controlled study.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopedic Trauma, SS Annunziata Hospital, Savigliano, CN, Italy. rivgio@libero.it.|, Via Servais 200 A 16, Turin, Italy. rivgio@libero.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Rivera
authors.affiliation: Sant'Anna Clinic, Casale Monferrato, AL, Italy.|Eporediese Hospital, Ivrea, TO, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bertignone
authors.affiliation: La Vialarda Clinic, Biella, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Grandi
authors.affiliation: La Vialarda Clinic, Biella, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Camisassa
authors.affiliation: Sestri Ponente Hospital, Genova, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Comaschi
authors.affiliation: Department of Orthopedics and Traumatology, IRCCS A.O.U. San Martino-IST, Genova, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Trentini
authors.affiliation: Department of Orthopedics and Traumatology, AO CTO Hospital, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Zanone
authors.affiliation: Department of Orthopedics and Traumatology, AO CTO Hospital, Turin, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Teppex
authors.affiliation: Department of Orthopedics and Traumatology, AO CTO Hospital, Turin, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Vasario
authors.affiliation: Santa Rita Clinic, Vercelli, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Fortina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000150:complications* / Q000175:diagnosis; D002809:Chondroitin Sulfates / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000188:drug therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; C501944:chondroitin sulfate, sodium hyaluronate drug combination; D006820:Hyaluronic Acid; D002809:Chondroitin Sulfates
keywords: Chondroitin sulfate; Intra-articular injection; Knee osteoarthritis; Sodium hyaluronate