Hyaluronic acid compared with corticosteroid injections for the treatment of osteoarthritis of the knee: a randomized control trail.
BACKGROUND
Osteoarthritis (OA) is the most common chronic condition of the joints that takes place when the cartilage or a low friction surface between joints breaks down which leads to pain, stiffness and swelling. The purpose of the present study was to evaluate the therapeutic effect of intra-articular hyaluronic acid (HA) in comparison to corticosteroids (CS) for knee osteoarthritis.


METHODS
140 patients with knee osteoarthritis, who were followed for 3 months, were randomized to receive intra-articular injection of either hyaluronic acid or corticosteroid. By receiving one injection of drug during the enrollment in the study, the patients were treated. With the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), and the visual analog pain scale, an independent, blinded evaluator assessed the patients three times.


RESULTS
The mean age of the patients in the corticosteroid group were 57 ± 1.9 years and in Hyaluronic acid group were 58.5 ± 8.3 years. WOMAC score represented that pain and stiffness did not improve in neither groups at any time points after intervention (P > 0.05). KOOS score suggested that symptoms improved after 3 months in both CS and HA groups. Besides, daily activity improved in both groups (P < 0.05).


CONCLUSIONS
As a conclusion, it is argued that the most important difference between the two intervention groups is the duration of effectiveness. HA is suggested to be superior in the duration of pain relief when compared to CS. We can propose that HA can be administered every 3 months intra-articular for knee joint OA. Therefore, when CS has to be injected every 2 months, it will be more convenient to use HA.
Department of Orthopedics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Alireza
A
Askari
School of Public Health, Fasa University of Medical Sciences, Fasa, Iran.
Tahereh
T
Gholami
Department of Community Medicine and Statistics, Fasa University of Medical Sciences, Fasa, Iran.
Mohammad Mehdi
MM
NaghiZadeh
Non-communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
Mojtaba
M
Farjam
Department of Pharmacology, Fasa University of Medical Science, Fasa, Iran.
Seyed Amin
SA
Kouhpayeh
School of Nursing, Shiraz University of Medical Sciences, Shiraz, Iran.
Zahra
Z
Shahabfard
Corticosteroids; Hyaluronic acid; Intra-articular injection; Iran; Osteoarthritis; Pain; Stiffness