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      Effectiveness of intra-articular injections of sodium hyaluronate-chondroitin sulfate in knee osteoarthritis: a multicenter prospective study

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          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).

          Materials and 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).

          Conclusion

          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.

          Level of evidence

          IV.

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          Most cited references21

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          Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines.

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            The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): a review of its utility and measurement properties.

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              The effects of specific medical conditions on the functional limitations of elders in the Framingham Study.

              The purpose of this study was to identify associations between specific medical conditions in the elderly and limitations in functional tasks; to compare risks of disability across medical conditions, controlling for age, sex, and comorbidity; and to determine the proportion of disability attributable to each condition. The subjects were 709 noninstitutionalized men and 1060 women of the Framingham Study cohort (mean age 73.7 +/- 6.3 years). Ten medical conditions were identified for study: knee osteoarthritis, hip fracture, diabetes, stroke, heart disease, intermittent claudication, congestive heart failure, chronic obstructive pulmonary disease, depressive symptomatology, and cognitive impairment. Adjusted odds ratios were calculated for dependence on human assistance in seven functional activities. Stroke was significantly associated with functional limitations in all seven tasks; depressive symptomatology and hip fracture were associated with limitations in five tasks; and knee osteoarthritis, heart disease, congestive heart failure, and chronic obstructive pulmonary disease, were associated with limitations in four tasks each. In general, stroke, depressive symptomatology, hip fracture, knee osteoarthritis, and heart disease account for more physical disability in noninstitutionalized elderly men and women than other diseases.
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                Author and article information

                Contributors
                +39-3472992578 , rivgio@libero.it
                Journal
                J Orthop Traumatol
                J Orthop Traumatol
                Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology
                Springer International Publishing (Cham )
                1590-9921
                1590-9999
                14 November 2015
                14 November 2015
                March 2016
                : 17
                : 1
                : 27-33
                Affiliations
                [ ]Department of Orthopedic Trauma, SS Annunziata Hospital, Savigliano, CN Italy
                [ ]Sant’Anna Clinic, Casale Monferrato, AL Italy
                [ ]Eporediese Hospital, Ivrea, TO Italy
                [ ]La Vialarda Clinic, Biella, Italy
                [ ]Sestri Ponente Hospital, Genova, Italy
                [ ]Department of Orthopedics and Traumatology, IRCCS A.O.U. San Martino-IST, Genova, Italy
                [ ]Department of Orthopedics and Traumatology, AO CTO Hospital, Turin, Italy
                [ ]Santa Rita Clinic, Vercelli, Italy
                [ ]Via Servais 200 A 16, Turin, Italy
                Article
                388
                10.1007/s10195-015-0388-1
                4805636
                26577936
                ad76fb4c-bd3b-4ecb-bda7-b0ff4a393dff
                © The Author(s) 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 16 September 2015
                : 28 October 2015
                Categories
                Original Article
                Custom metadata
                © The Author(s) 2016

                Orthopedics
                knee osteoarthritis,intra-articular injection,sodium hyaluronate,chondroitin sulfate

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