title: Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid.
abstract: Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA) in a single injection with standard preparations of hyaluronic acid (HA) in five injections in osteoarthritis (OA) of the knee. Fifty-four patients with knee osteoarthritis (Kellgren-Lawrence Grade II and III) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane®) and Group II with HA (Go-ON®). Patient's evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA.
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Virgen de la Victoria University Hospital, Málaga E-29010, Spain. fjestades@hotmail.com.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Estades-Rubio
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Hospital Regional Universitario Carlos Haya, Malaga, Málaga E-29010, Spain. mgp_jam@hotmail.com.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Reyes-Martín
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Hospital Quirónsalud Málaga, Málaga E-29004, Spain. juanjogv965@gmail.com.
authors.forename: Victor
authors.initials: V
authors.lastname: Morales-Marcos
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Virgen de la Victoria University Hospital, Málaga E-29010, Spain. zambua@hotmail.com.
authors.forename: Mercedes
authors.initials: M
authors.lastname: García-Piriz
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Virgen de la Victoria University Hospital, Málaga E-29010, Spain. victortrauma@yahoo.es.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: García-Vera
authors.affiliation: Department of Health Sciences, University of Jaén, Jaén E-23071, Spain. mperan@ujaen.es.|Biopathology and Regenerative Medicine Institute (IBIMER), Centre for Biomedical Research, University of Granada, Granada E-18071, Spain. mperan@ujaen.es.
authors.forename: Macarena
authors.initials: M
authors.lastname: Perán
authors.affiliation: Biopathology and Regenerative Medicine Institute (IBIMER), Centre for Biomedical Research, University of Granada, Granada E-18071, Spain. jmarchal@ugr.es.|Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada E-18016, Spain. jmarchal@ugr.es.|Biosanitary Institute of Granada (ibs. GRANADA), University Hospitals of Granada-University of Granada, Granada, Granada E-18016, Spain. jmarchal@ugr.es.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Marchal
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Virgen de la Victoria University Hospital, Málaga E-29010, Spain. elvira0511@gmail.com.|Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga E-29010, Spain. elvira0511@gmail.com.
authors.forename: Elvira
authors.initials: E
authors.lastname: Montañez-Heredia
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017048:Health Care Costs; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000191:economics; D007270:Injections, Intra-Articular / Q000191:economics; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy* / Q000191:economics; D011897:Random Allocation; D055676:Viscosupplementation / Q000191:economics* / Q000379:methods
chemical_list: D006820:Hyaluronic Acid
keywords: Stabilized hyaluronic acid (NASHA); hyaluronic acid; knee osteoarthritis