Evaluation of the Effectiveness of Hyaluronic Acid Injections in Treatment of Small Joint Osteoarthritis.

ABSTRACT

BACKGROUND: Osteoarthritis is an incurable, progressive, degenerative and debilitating joint disease, characterized by pain, stiffness and limitation of joint mobility. Treatment is limited to symptom management and includes pharmaco- and physiotherapy, rehabilitation and surgery. OBJECTIVE: To evaluate safety and effectiveness of a selected hyaluronic acid injectable in the treatment of small joint osteoarthritis. MATERIALS AND METHODS: 324 patients (F 190, M 134) aged 19-84 completed the study. Each participant received three, weekly intra-articular hyaluronic acid injections (Suplasyn®, Bioniche Life Sciences Inc, Belleville, Ontario; 700 kDa, 7 ml/7 mg). Morning stiffness and pain intensity (at rest and movement-induced) before and after treatment as well as post-treatment improvement in joint mobility were assessed based on questionnaires filled out by patients and their physicians prior to treatment commencement and at its conclusion. Participants used a Numerical Rating Scale (range 0-10 points) to quantify assessments. Data was analysed with chi-square and Fisher's exact tests and p = 0.05 was accepted as significant. RESULTS: A significant (p <0.001) post-treatment reduction in (1) morning stiffness (median NRS score decrease from 6 to 2 points), (2) pain intensity at rest (median NRS score decrease from 5 to 2 points) and movement induced (median NRS value decrease from 6 to 2 points). Improvement in joint mobility was reported by 97% of patients. Treatment tolerability (safety) was assessed as good to excellent by 25 % and 74% of patients, respectively. No serious adverse reactions were reported. CONCLUSION: Hyaluronic acid injections are a highly effective and safe treatment for symptomatic small joint osteoarthritis.