TREATMENT OF HIP OSTEOARTHRITIS WITH INTRAARTICULAR INJECTIONS OF HYALURONIC ACID

Abstract

The aim of this paper is to compare the effectiveness on the amelioration of symptoms of hip osteoarthritis (OA) between Nimesulide and intraarticular injection of Hyaluronic acid (HA).

In the Orthopaedic outpatient department of our Hospital we selected 22 patients suffering from hip osteoarthritis as it is defined by the American College of Rheumatology after clinical, radiological and blood examinations. The age range was 62 – 82 years and were all female. They were seperated into two groups.

Group A included 13 patients treated with Nimesulide (NSAID) for a period of 20 days and Group 2 included 10 patients treated with five intraarticular injections of HA in the hip joint, one every week, under ultrasound control. Before treatment initiation we performed clinical examination for active and passive flexion, internal and external rotation of the hip. Pain evaluation was with VAS and Lequense algofunctional index. We repeated the examination and evaluation a month, six months and a year after the end of the treatment.

Following the Helsinki proclamation we did not use placebo group.

The results in group A has shown that 8 patients had considerable amelioration of their symptoms, 3 has a mild amelioration and 2 patients none.

In group B considerable amelioration was observed in all 10 patients. We have noticed that although therapeutic result is usually expected at the end of the treatment, 6 of the patients had improvement after the first 2 intraarticular injections, especially for night pain, and the others just before the end of the treatment.

The duration of the improvement for group A was 15 days in one patient, 30 days in seven and 3 months in three patients.

In group B the duration of improvement was 20 days in one patient, 2 months in two, 6 months in five and 11 months in two patients.

In patients of group B symptoms’ recurrence was not so intense as in the first time. In group A symptoms’ recurrence was at the same level as before treatment initiation. No complication was observed from the intraarticular injections.

In conclusion we could say that treatment with HA is more effective concerning the duration of the symptoms amelioration. There is no risk from gastrointestinal complications.