2025 ISAKOS Biennial Congress ePoster
Efficacy of Single Intra-Articular 2% Sodium Hyaluronate Versus Corticosteroid Injection in Isolated Patellofemoral Osteoarthritis: A Double-Blind, Randomized Controlled Trial
Pratchaya Manop, MD, Nonthaburi, Nonthaburi THAILAND
Korawish Mekariya, MD, Khlong Nueng, Pathumthani THAILAND
Bancha Chernchujit, Prof.Dr.med, Bangkok THAILAND
Thammasat University Hospital, Khlong Luang District, Pathum Thani , THAILAND
FDA Status Cleared
Summary
Intra-articular HA and CS injection provide similar pain reduction and functional score improvement at 6-months follow-up, may be an alternative option to CS, with equivalent result but without increasing the risk of chondrotoxicity and cartilage volume loss, especially in isolated PF-OA patients which the tibiofemoral compartment cartilage is relatively preserved.
ePosters will be available shortly before Congress
Abstract
Background
Patellofemoral osteoarthritis (PF-OA) is an unicompartmental arthritis with a hallmark of anterior knee pain disturbing quality of life. Unlike tibiofemoral osteoarthritis, there is still a lack of evidence regarding intra-articular injection for isolated PF-OA patients.
Objective
To compare the efficacy of intra-articular hyaluronic acid (HA) and corticosteroid (CS) injections for pain reduction and improvement in anterior knee function in isolated PF-OA patients
Study Design & Method
This was a prospective, double-blind, randomized, controlled trial. Patients diagnosed with isolated PF-OA from clinical and radiographic features were randomized to receive a single-shot, 2ml intra-articular 2% sodium hyaluronate plus 0.5% mannitol or 2ml solution comprising 1 ml of 40mg triamcinolone acetonide and 1% lidocaine. The primary outcome was pain visual analog scale (VAS) At 6 months, other outcomes were Kujala scores, adverse event and pain during injection procedure.
Result
A total of 60 patients were included. Both groups had significant improvement in VAS and Kujala scores from the first injection to final follow-up (p<0.05). At 6 months no significant between-group difference was found for VAS and Kujala score the mean difference (95% confidence interval [95%CI]) = -4.46 (-11.2, 2.28) (p=0.195) and 2.56 (-4.08, 9.2) (p=0.45). However, in the first week the VAS score was significantly lower in CS group mean difference (95%CI) = 7.67 (0.96, 14.38) (p=0.025). There was no difference in pain during injection and adverse event between groups.
Conclusion
Intra-articular HA and CS injection provide similar pain reduction and functional score improvement at 6-months follow-up, with better pain relief in the first week for the CS group. Intra-articular HA may be an alternative option to CS, with equivalent result but without increasing the risk of chondrotoxicity and cartilage volume loss, especially in isolated PF-OA patients which the tibiofemoral compartment cartilage is relatively preserved.