Comparison of two hyaluronan drugs in patients with advanced osteoarthritis of the knee. A prospective, randomized, double-blind study with long term follow-up

V. Karatosun¹, B. Unver², Z. Gocen², A. Sen²

Department of Orthopaedic Surgery¹ and School of Physical Therapy², Dokuz Eylul University Hospital, Balcova, Izmir, Turkey

ABSTRACT
Objectives
To compare the long-term effects of high and low molecular weight hyaluronic acid (HA) applications in severe (Kellgren Lawrence stage III) osteoarthritis (OA) of the knee.

Methods
In a prospective clinical trial 184 knees (92 patients) with radiographic Kellgren Lawrence stage III OA were randomized to receive either 3 intra-articular high molecular weight HA (Hylan G-F 20) injections or 3 low molecular weight HA (Orthovisc) injections at one-week intervals. Patients were evaluated by the Hospital for Special Surgery (HSS) Knee Score and were followed-up for 12 months.

Results
The total HSS score in high molecular weight HA patients improved from 71.8 ± 11.6 to 86.7 ± 11.6 and in low molecular weight HA patients from 66.7 ± 11.0 to 86.6 ± 9.1 at the end of the trial (p < 0.01). There were no statistically significant differences between the groups and both had improved in all parameters at the latest follow-up (p = 0.000).

Conclusions
Three intra-articular injections at intervals of 1 week of both HA preparations resulted in a pronounced reduction in pain and improved function as measured by the HSS score during a period of 52 weeks, without complications.

Key words
Advanced osteoarthritis, knee, high molecular weight hyaluronic acid, low molecular weight hyaluronic acid.

Please address correspondence to: Prof. Vasfi Karatosun, MD, Erzene Mah. 116/16 Sokak No:8/12 Bornova TR-35050, Izmir, Turkey.
E-mail: vasfi.karatosun@deu.edu.tr

Clin Exp Rheumatol 2005; 23: 213-218.
© CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2005.