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Knee Osteoarthritis (OA) is one of the most relevant and debilitating health problems. Obesity represents one of the major risk factor for the early development of OA.
Obesity is suggested to be a major risk factor for the development
of osteoarthritis (OA). The literature reported the intraarticular hyaluronic
acid (HA) viscosupplementation was preferred therapy for OA. In this study,
Papalia R et al. compared the intraarticular injections of hybrid (low
and high molecular weight) hyaluronic acid and revealed better results from
hybrid HA than high molecular weight HA in obese patients.
Knee Osteoarthritis (OA) is one of the most relevant and
debilitating health problems. Obesity represents one of the major risk factor
for the early development of OA. Knee replacement in obese population should be
delayed and eventually avoided. Conservative treatments comprising
intraarticular hyaluronic acid (HA) viscosupplementation should be prefered.
In the present clinical randomized trial, a comparison
between two groups of 24 obese patients were presented, randomized to be
treated with two intraarticular injections of hybrid (low and high molecular
weight) hyaluronic acid (Group A) or two injections of high molecular weight
hyaluronic acid (Group B). Patients were followed-up through to 6 months and
evaluated though IKDC and KOOS scores, the pain was examined with VAS.
All patients reported significant improvement when
compared to baseline value in all the outcome measures. At 3-month follow-up,
IKDC had significantly improved in patients of Group A, compared to Group B
(53.1±1.9 vs 51.4±2.4, p=0.0079) and the same for KOOS (52.1±2.0 vs 50.1±2.9,
p=0.010). Also, the difference in KOOS was persistently significant at 6-month
follow-up (54.7±2.3 vs 51.7±4.9, p=0.014). The VAS reduced significantly more
in Group A at 3 months (3.7±0.5 vs 5.2±0.7, p less than 0.001). In an obese
population, where basal inflammatory pattern increases the symptoms of OA, and
conservative treatment is recommended, HA viscosupplementation improved
function and pain of the knee. The treatment with hybrid HA depicted better
outcomes than high molecular weight HA in obese patients.
Combination of the anti-inflammatory action of low molecular weight
HA on chondrocytes and the biomechanical role of high molecular weight HA might
justify the different results.
J Biol Regul Homeost Agents. 2017 Dec 27;31(4 Suppl 2):103-109.
Hybrid hyaluronic acid versus high molecular weight hyaluronic acid for the treatment of osteoarthritis in obese patients.
Papalia R et al.
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