Comparison of the effects of intraarticular hyaluronic acid and antiinflammatory drug treatments on the surgical intervention rates in patients with gonarthrosis

Authors: MURAT KORKMAZ, YALÇIN ERDOĞAN, AYLİN OKUR, AYŞE YEŞİM GÖÇMEN, İLHAN GÜNAYDIN

Abstract: The aim of this study was to compare the frequencies of surgical interventions between patients receiving intraarticular hyaluronic acid (IAHA) injection and those receiving only oral antiinflammatory drug treatment at the end of a 1-year follow-up period. Materials and methods: A total of 705 patients diagnosed with knee osteoarthritis (OA) between 2007 and 2009 were included in this study. Their records were investigated retrospectively. We divided 218 of the patients into 3 groups according to the Kellgren–Lawrence criteria, and they received sodium hyaluronate once a week for 3 weeks. Another 487 patients with gonarthrosis served as group 2 and were treated with nonsteroidal oral antiinflammatory drugs and exercises. The surgical rates between the IAHA groups and the control groups were compared. The groups with the 2 different treatment modalities were compared according to the surgical operation rates at the end of a 1-year period. Results: While 9 of the 68 IAHA-treated patients with grade 2 OA had a surgical intervention within the year, 22 of the 172 patients with grade 2 OA in group 2 were operated on (13.2% versus 12.8%, P = 0.927). A surgical intervention was performed in 7 of the 78 IAHA-treated patients with grade 3 OA at the end of 1 year, and in 18 of the 164 patients with grade 3 OA (group 2) (8.9% versus 10.9%, P = 0.629). Of the 51 IAHA-treated patients with grade 4 OA, 4 underwent a surgical intervention within the year, whereas 22 of the 151 patients in group 2 were operated on (7.8% versus 14.6%, P = 0.222). Conclusion: Although there was no statistically significant difference between the groups, a lower percentage of IAHA-treated patients with grade 4 OA underwent surgical interventions. At the end of 1 year, the rates of surgical operations between the patients receiving IAHA and antiinflammatory treatment in the other 2 groups (knee grades 2 and 3 OA) showed no statistically significant difference.

Keywords: Hyaluronic acid, intraarticular injections, osteoarthritis, knee surgery

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