This prospective cohort study evaluated the long-term efficacy and safety of 5 weekly intra-articular (i.a.) injections of sodium hyaluronate (Hyalgan) in 76 patients (92 knees) with moderate to severe osteoarthritis (OA) of the knee whose pain was not controlled by conventional measures.
Thirteen patients had a repeat treatment course. A total of 72% of patients achieved > 50% improvement (defined by physical examination and assessment of pain using a visual analog scale [VAS]) for 1 year or longer; 9% of patients failed to achieve > 50% improvement for any period of time. The duration of response exceeded 2 years in some patients. Total knee replacement surgery was avoided or significantly delayed in 15 of 19 patients who were considering surgery prior to the injections. Ten of 15 (67%) knees improved after a repeat treatment course. Local adverse events were minor and infrequent.
Intra-articular sodium hyaluronate was an effective and safe treatment for pain in difficult-to-treat patients with moderate to severe OA of the knee.