Long-term efficacy and safety of intra-articular sodium hyaluronate (Hyalgan) in patients with osteoarthritis of the knee.

OBJECTIVE: 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.
RESULTS: 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.
CONCLUSION: 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.