Yen-Zung Wu1, Hsuan-Ti Huang2,3,4,5, Cheng-Jung Ho1,2,3,4, Chia-Lung Shih6, Chung-Hwan Chen2,3,4,5,7, Tsung-Lin Cheng3,4,8, Ying-Chun Wang2,5, Sung-Yen Lin1,2,3,4. 1. Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung. 2. Departments of Orthopedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung. 3. Orthopaedic Research Center, Kaohsiung Medical University, Kaohsiung. 4. Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung. 5. Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung. 6. Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City. 7. Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung. 8. Department of Physiology, College of Medicine, Kaohsiung Medical University, Kaohsiung.
Abstract
BACKGROUND: This study aimed to compare the efficacy and safety of intra-articular hyaluronic acid (HA) injection with different molecular weights (MWs) for treating hip osteoarthritis (OA). METHODS: A systematic literature search for relevant studies was conducted in 3 electronic databases, including PubMed, BMJ Journals, and Cochrane Library, from inception to April 2020. Extracted outcomes included visual analogue scale (VAS) (1, 3, and 6 months), Lequesne index (3 and 6 months), and adverse effects. HAs were classified into low-molecular-weight (LMW), moderate-molecular-weight (MMW), high-molecular-weight (HMW), and ultra-high-molecular-weight (UHMW) groups. Meta-analysis was performed using Review Manager 5.3. RESULTS: A total of 15 studies with 614 patients were included. Our meta-analysis showed that the HMW HA group had the best improvement in VAS and Lequesne index compared with other HA groups for all the follow-up visits. Moreover, the HMW group demonstrated significantly better improvement than the other groups in VAS at 6-month follow-up and in Lequesne index at 3- and 6-month follow-ups. Analysis for adverse effects revealed low rates of systemic adverse effects (≤0.6%) in all groups and similar rate of local adverse effects (around 10%) among the groups except for UHMW HA group (37.5%). CONCLUSION: Among different MWs of HA for treating hip OA, HMW HA injection demonstrated the best efficacy for up to 6 months after treatment without increased risk of adverse effects. Further studies with more comprehensive data and a higher level of evidence are required to prove our results.
BACKGROUND: This study aimed to compare the efficacy and safety of intra-articular hyaluronic acid (HA) injection with different molecular weights (MWs) for treating hip osteoarthritis (OA). METHODS: A systematic literature search for relevant studies was conducted in 3 electronic databases, including PubMed, BMJ Journals, and Cochrane Library, from inception to April 2020. Extracted outcomes included visual analogue scale (VAS) (1, 3, and 6 months), Lequesne index (3 and 6 months), and adverse effects. HAs were classified into low-molecular-weight (LMW), moderate-molecular-weight (MMW), high-molecular-weight (HMW), and ultra-high-molecular-weight (UHMW) groups. Meta-analysis was performed using Review Manager 5.3. RESULTS: A total of 15 studies with 614 patients were included. Our meta-analysis showed that the HMW HA group had the best improvement in VAS and Lequesne index compared with other HA groups for all the follow-up visits. Moreover, the HMW group demonstrated significantly better improvement than the other groups in VAS at 6-month follow-up and in Lequesne index at 3- and 6-month follow-ups. Analysis for adverse effects revealed low rates of systemic adverse effects (≤0.6%) in all groups and similar rate of local adverse effects (around 10%) among the groups except for UHMW HA group (37.5%). CONCLUSION: Among different MWs of HA for treating hip OA, HMW HA injection demonstrated the best efficacy for up to 6 months after treatment without increased risk of adverse effects. Further studies with more comprehensive data and a higher level of evidence are required to prove our results.
Entities:
Keywords:
hip osteoarthritis; hyaluronic acid; intra-articular; molecular weight; viscosupplementation
Authors: A Migliore; S Tormenta; U Massafra; E Carloni; C Padalino; F Iannessi; A Alimonti; L S Martin Martin; M Granata Journal: Osteoarthritis Cartilage Date: 2005-10-19 Impact factor: 6.576
Authors: P A Band; J Heeter; H-G Wisniewski; V Liublinska; C W Pattanayak; R J Karia; T Stabler; E A Balazs; V B Kraus Journal: Osteoarthritis Cartilage Date: 2014-10-07 Impact factor: 6.576
Authors: A Migliore; S Tormenta; C Valente; U Massafra; L S Martin Martin; E Carmenini; A Bernardini; A Alimonti Journal: Reumatismo Date: 2005 Jan-Mar