Outcomes of applications prolonged-release form of hyaluronic acid in the treatment of patients with advanced knee osteoarthritis

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Abstract

Intra-articular therapy with hyaluronic acid (HA) preparations is a fairly effective method for the treatment of osteoarthritis (OA) of large joints. In recent years, extended-release forms of HA preparations (HAp) requiring a single administration have been rapidly gaining popularity. The aim of our study was to evaluate the results of using a prolonged-release HAp in a volume of 5 ml in patients with knee OA grade III and IV according to the classification of J.H. Kellgren and J.S. Lawrence (K-L).

Materials and methods: During a prospective, randomized, controlled clinical trial, patients in the main group (n = 35) received a single intra-articular injection of HAp with a molecular weight of 3.5 × 106 Da at a concentration of 1.6 % and a volume of 5 ml, while in the comparison group (n = 35), patients received the same HAp in a similar manner, only in a volume of 2 ml. Treatment outcomes were assessed using the visual analogue pain scale (VAS), the Lequesne knee index, and the improved verbal assessment scale (IAS) at 1, 3, and 6 months after the first intra-articular injection.

Results: Overall, patients in the study group rated the treatment efficacy as “good” according to the IAS. In the comparison group, intra-articular therapy was rated as “satisfactory” at 1 month and as “poor” at 3 and 6 months. One month after the start of treatment, the most significant reduction in the level of pain syndrome was achieved according to the VAS and the Lequesne questionnaire in patients of both the main group and the comparison group. Pain was less pronounced with the extended-release HAp. Intra-articular therapy with 5 ml of high-molecular-weight HAp improved algofunctional parameters over 6 months. The duration of the positive effect after intra-articular injection of 2 ml of HAp was 1 month. In patients in this group, pain intensity and knee function were consistent with baseline VAS and Lequesne index scores.

About the authors

Ivan S. Burka

Volgograd State Medical University

Author for correspondence.
Email: dr.ivan.burka@yandex.ru

Assistant of the Department of Traumatology, Orthopedics and Military Field Surgery

Russian Federation, Volgograd

Dmitry A. Malanin

Volgograd State Medical University

Email: malanin67@mail.ru
ORCID iD: 0000-0001-7507-0570

Doctor of Medical Sciences, Professor, Head of the Department of Traumatology, Orthopedics and Military Field Surgery

Russian Federation, Volgograd

Maxim V. Demeshchenko

Volgograd State Medical University

Email: maximus275@yandex.ru

Candidate of Medical Sciences, Associate Professor of the Department of Traumatology, Orthopedics and Military Field Surgery

Russian Federation, Volgograd

Ilya V. Volodin

Volgograd State Medical University

Email: volodin_ili@mail.ru

Assistant of the Department of Traumatology, Orthopedics and Military Field Surgery

Russian Federation, Volgograd

Albert A. Pak

The Clinical Diagnostic Center MEDSI on Krasnaya Presnya

Email: pak.ala@medsigroup.ru

Head of the Surgical Department

Russian Federation, Moscow

Leonid L. Cherezov

Volgograd State Medical University

Email: lchrzv@rambler.ru

Candidate of Medical Sciences, Associate Professor of the Department of Traumatology, Orthopedics and Military Field Surgery

Russian Federation, Volgograd

Aleksander L. Zhulikov

Volgograd State Medical University

Email: julikov60@mail.ru

Candidate of Medical Sciences, Associate Professor of the Department of Traumatology, Orthopedics and Military Field Surgery

Russian Federation, Volgograd

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Copyright (c) 2025 Burka I.S., Malanin D.A., Demeshchenko M.V., Volodin I.V., Pak A.A., Cherezov L.L., Zhulikov A.L.

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