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Eur J Orthop Surg Traumatol. 2018 Jul;28(5):915-922. doi: 10.1007/s00590-017-2083-9. Epub 2017 Nov 21.

Efficacy of a single intra-articular injection of ultra-high molecular weight hyaluronic acid for hip osteoarthritis: a randomized controlled study.

Author information

1
Azienda Socio Sanitaria Territoriale Rhodense, Presido Ospedaliero di Rho, Unità Operativa Ortopedia e Traumatologia, Rho, Italy.
2
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. riccardo.dambrosi@hotmail.it.
3
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy. riccardo.dambrosi@hotmail.it.
4
Azienda Socio Sanitaria Territoriale Rhodense, Presido Ospedaliero di Garbagnate, Unità Operativa Ortopedia e Traumatologia, Garbagnate, Italy.
5
Azienda Socio Sanitaria Territoriale Rhodense, Presido Ospedaliero di Bollate, Unità Operativa Ortopedia e Traumatologia, Bollate, Italy.
6
IRCCS Policlinico San Donato, San Donato Milanese, Italy.

Abstract

BACKGROUND:

Viscosupplementation with hyaluronic acid (HA) is increasingly used for the treatment of hip osteoarthritis (OA). The purpose of this study was to compare the efficacy of intra-articular injections of an ultra-high molecular weight viscosupplement (UHMW-HA, Fermathron S) with a medium molecular weight hyaluronan (MMW-HA, Hyalubrix 60) in hip OA.

METHODS:

Fifty-four patients with hip OA grade 3 on the Kellgren/Lawrence scale were randomized. All infiltrations were performed under ultrasound guidance. Evaluation was performed preoperatively and at 1, 3, 6 and 12 months after infiltration. Patients were clinically evaluated using Lequesne index, VAS and WOMAC score.

RESULTS:

Fifty patients, including 27 in the MMW-HA group and 23 in the UHMW-HA group, completed the follow-up. No significant difference was found between the two groups in terms of VAS, WOMAC or Lequesne index preoperatively or at 1, 3, 6 and 12 months after viscosupplementation. A stratified analysis was performed to study the development over time of Lequesne index of patients aged ≤ 55 years, > 55 and, ≤ 70 years and > 70 years and Lequesne index was different between the three age-stratified subgroups only in the MMW-HA group. The subgroup of older patients showed a higher Lequesne index than the subgroups of younger patients (p < 0.05).

CONCLUSIONS:

UHMW-HA is a safe and effective treatment for hip osteoarthritis. A single dose of UHMW-HA was as effective as two doses of MMW-HA resulting in similar reductions of pain and disability.

STUDY DESIGN:

Multicenter, independent, prospective, randomized controlled trial with level of evidence 1.

KEYWORDS:

Biology of cartilage; Hip osteoarthritis; Hyaluronic acid; Randomized clinical trial; Regenerative medicine

PMID:
29164399
DOI:
10.1007/s00590-017-2083-9
[Indexed for MEDLINE]

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