Viscosupplementation in patients with severe osteoarthritis of the knee: six month follow-up of a randomized, double-blind clinical trial

Int Orthop. 2017 Nov;41(11):2273-2280. doi: 10.1007/s00264-017-3625-9. Epub 2017 Aug 30.

Abstract

Purpose: To analyze the early outcomes of viscosupplementation in patients with severe knee osteoarthritis.

Method: A randomized, double-blind clinical trial of 143 knees divided into three groups: Group 1 - intra-articular injection of triamcinolone; Group 2 - hylan GF20; and Group 3 - triamcinolone + hylan GF20. Outcomes were evaluated using Lysholm and KSS scores before treatment and after one, three and six months.

Results: Within-group comparisons revealed improvements in Lysholm scores in all groups in the one month evaluation relative to pre-treatment levels (p < 0.01). This improvement was maintained in the third month after treatment (p > 0.05). Scores at six months were significantly lower than those observed in the previous follow-up assessments (p < 0.05), but still higher than pre-treatment levels (p < 0.05). KSS scores also improved after one month relative to pre-treatment levels (p < 0.01). This improvement was still present at three and six months after treatment in the corticosteroid group (p > 0.05). Patients treated with hylan GF20 showed lower scores in the last evaluation relative to month one (p < 0.05). No significant differences were observed between the treatment groups (p > 0.05).

Conclusions: Viscosupplementation increased functional scores in patients with severe osteoarthritis of the knee, especially within three months of injection. However, it was not superior to the use of triamcinolone.

Keywords: Knee; Osteoarthritis; Treatment; Viscosupplementation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Glucocorticoids / therapeutic use
  • Humans
  • Hyaluronic Acid / analogs & derivatives*
  • Hyaluronic Acid / therapeutic use
  • Injections, Intra-Articular
  • Knee Joint / physiopathology
  • Male
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / therapy*
  • Treatment Outcome
  • Triamcinolone / therapeutic use
  • Viscosupplementation / methods*
  • Viscosupplements / therapeutic use*

Substances

  • Glucocorticoids
  • Viscosupplements
  • hylan
  • Triamcinolone
  • Hyaluronic Acid