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Hyaluronic acid injections helps preserve knee cartilage, study finds
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HOLLYWOOD, FL. — Six-month intra-articular injections of hylan G-F 20 (Synvisc) administered without regard to symptoms can have a beneficial effect on knee cartilage preservation, according to a study presented here.
Stephen Hall, MD, presented the findings of his team’s single-blind, parallel control group pilot clinical trial at the 2010 Annual Meeting of the Arthroscopy Association of North America.
“The aim of the study was to determine the effect of repeated Synvisc injections on the progression of cartilage damage using quantitative MRI measures over a 2-year period in patients with symptomatic osteoarthritis,” Hall said.
Intervention and control
In the study, 78 patients with symptomatic knee osteoarthritis were assigned to either an intervention group (39 patients) or a control group (39 patients). Intervention group patients received four courses of intra-articular hylan G-F 20 injections at 6-month intervals.
Magnetic resonance imaging (MRI) was used to image the target knees at baseline, 6, 12 and 24 months. Tibial cartilage volume, tibiofemoral cartilage defects and bone marrow lesions were assessed at baseline and follow-up.
“The two outcome measures we looked at were cartilage volume and cartilage defects,” Hall said. “What we are doing with the cartilage volume is measuring the total cartilage volume purely on the tibial side of the joint.”
A trend of reduced loss
In all, Hall reported, 55 patients completed their 2-year follow-up. Those 55 patients demonstrated a “significantly reduced annual percentage rate of medial, lateral and total tibial cartilage loss in the intervention group,” as compared to the control group.
Furthermore, Hall said, the intervention group showed a significant reduction in the increase of cartilage defect score in the medial and total tibiofemoral compartments.
“We can see at 12 months there is a trend to a reduced loss of cartilage from the Synvisc-treated group, which reaches statistical significance at 2 years,” Hall said. “At which point, the treated group … had essentially no loss of cartilage, whereas the observational group had the expected 2.5-3% annual loss of cartilage.”
Promising results
Hall said that after 2 years, the control group continued to lose cartilage while the intervention group showed no significant loss. Though he stressed that further evaluation is needed in larger trials, the results thus far were deemed promising.
“We believe these studies demonstrate that Synvisc injections given repeatedly are associated with reduced loss of cartilage volume [and] reduced progression of cartilage defects,” Hall concluded.
- Reference:
Hall S, Wang Y, Hanna F, et al. Effects of HYLAN G-F 20 [Synvisc] supplementation on cartilage preservation in osteoarthritis of the knee: A two-year, single-blind clinical trial. Paper SS-A. Presented at the 29th Annual Meeting of the Arthroscopy Association of North America. May 20-23, 2010. Hollywood, Florida.
