The Booster Effect of a Single Quarterly Dose of Hyaluronic Acid in Knee Osteoarthritis: Five-Year Results of a Registry-Based Study.
Hyaluronic acid (HA) is a property of joint fluid (synovial fluid) and cartilage cells. HA has a good safety profile associated with limited local and systemic side effects and has no drug interactions, making it a very safe treatment for knee osteoarthritis. Joint HA injection is a well-established treatment for knee osteoarthritis and is produced by bacterial fermentation, and has been used in the treatment of knee osteoarthritis with excellent results on pain reduction as well as functional improvement.
This study looks to evaluate the efficacy of the booster effect of a single injection of HA every three months within a five year period of treatment and follow-up in patients with knee osteoarthritis.
Following the initial treatment dosage, quarterly boosters provided not only the achievement of the maximum effect in pain and joint function between the sixth and the ninth month of treatment but also this effect remained stable and unchanged until the five years of study. This is also constant in all patients, regardless of the initial degree of osteoarthritis. Such significant long-term stable control of pain and improvement of function can be attributed to restoration of the joint fluid maintenance and lubrication of the knee joint. Also, it enhances survival rates of cartilage cells and the production of hyaluronic acid. Furthermore, it inhibits production inflammatory cells, reducing pain. HA also reduces production of damaging cells. In addition to the above, HA also reduces pain through a direct effect on nerves by modulation. It improves functional stability (proprioception) and isokinetic muscle force in patients with knee osteoarthritis.
The use of HA is associated with rare complications and long-term safety, as also confirmed by this study, which allows reducing the use of anti-inflammatory medications and painkillers.
The choice to use this treatment protocol and to record its effects for such a long follow-up was based on the clinical observation and the benefits that the patients themselves reported, one of the most appropriate tools for assessments and effectiveness.
To conclude, it was found that the quarterly joint injection treatments of hyaluronic acid for five years is a safe and effective treatment that reduces pain and improves function in patients with mild to moderate knee osteoarthritis. This is the first evaluation of the use of long-term booster doses of hyaluronic acid injection treatment, thus proposing it as a new therapeutic option in the treatment of knee osteoarthritis. The reason that a quarterly injection of HA may achieve such a good and stable outcome might be that quarterly injection is to "boost" the effect that otherwise would give the joint the potential time of exposure to wear and tear.
Study can be found here
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