Single versus multiple dose hyaluronic acid: Comparison of the results.
OBJECTIVE
The purpose of this study was to compare the effectiveness of three injections of standard linear HA versus single injection of lightly cross-linking HA in patients with knee OA.


METHODS
Forty subjects were randomized into two groups. The first group received single dose intraarticular injection of 4 ml lightly cross-linking sodium hyaluronate (Monovisc), and the second group received three consecutive intraarticular injections of 2.5 ml standard linear sodium hyaluronate (Adant) with one week intervals. Visual analog scale (VAS)-pain and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores were measured.


RESULTS
In both groups, VAS-pain and WOMAC scores (except WOMAC-stiffness) were improved statistically lasting up to the 6th month with respect to before injection values (p< 0.001). There were no statistical differences in VAS-pain and WOMAC scores after injections (p> 0.05) in both groups. But in the 6th month visit, VAS-resting values were found to be statistically improved in standard linear HA group compared to lightly cross-linking HA group (p< 0.05).


CONCLUSIONS
Although three-dose administration was significantly superior to single-dose at the sixth month, current knowledge is not sufficient to decide whether single-dose or multiple-dose HA injection should be chosen. There is a clear need for verification of our results with long-term studies on larger patient groups.
Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Demirhan
D
Dıraçoğlu
Department of Physical Medicine and Rehabilitation, Avicenna Umut Hospital, Istanbul, Turkey.
Tuğba Baysak
TB
Tunçay
Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Tuğba
T
Şahbaz
Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Cihan
C
Aksoy
D000368:Aged; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D011446:Prospective Studies; D055675:Viscosupplements / Q000008:administration & dosage*; D064232:Visual Analog Scale
D055675:Viscosupplements; D006820:Hyaluronic Acid
Hyaluronan; intraarticular injection; knee osteoarthritis