Vol. 10, Issue 4 (2024)

Efficacy of intra-articular hyaluronic acid with sorbitol injection for pain relief in primary osteoarthritis knee 

Author(s):

Dr. Anku Athokpam, Dr. Veeranna HD, Dr. Kiran Kalaiah, Dr. Prashanth Reddy and Dr. Sunil Kiran

Abstract:

Background: Osteoarthritis (OA) is a degenerative disease characterized by progressive articular destruction that causes pain, deformity, joint stiffness and functional impairment. Pain management and reduction in functional limitation are the main goals of the current pharmacologic and non-pharmacologic OA therapy strategies. The most often prescribed pharmacologic therapy are intra-articular (IA) corticosteroid injections and non-steroidal anti-inflammatory medications (NSAIDs). These treatments have drawbacks because IA corticosteroid injections offer temporary, effective relief and NSAIDs can have major side effects. Another therapy option for knee OA discomfort is an intraarticular injection (IA) of hyaluronic acid (HA). HA reduces articular cartilage deterioration by acting as a lubricant and shock absorber to shield the joint structures and articular cartilage from compressive and shear pressures. Sorbitol helps shield sodium hyaluronate from deterioration and reduces tissue damage brought on by inflammation. The purpose of this study was to advance our understanding on the application of intra-articular injection of hyaluronic acid with sorbitol in patients with osteoarthritis of the knee and to support practicing clinicians in selecting the most suitable patients for intra-articular hyaluronic acid with sorbitol. 
Materials and Methods: This prospective observational study was conducted at Sri Siddhartha Medical College Hospital and Research Centre, Tumakuru between June 2022 to May 2024. A total of 33 Patients who were clinically diagnosed to be suffering from Osteoarthritis, fulfilling the inclusion & exclusion criteria were chosen as final study participants. Patients given single dose of intra-articular injection of Hyaluronic Acid with Sorbitol {Hylasto S, 2ml (HA 2% 40mg; Sorbitol 4% 80mg)}. Follow up done at the end of 1st, 3rd and 6th month post procedure. The patients were evaluated primarily by assessing pain relief by Visual analogue scale and functional assessment by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Annexure] at the end of 1st, 3rd and 6th month. 
Results: Maximum subjects were in age range of 51-70yrs. There were 51.5% in grade3 group and 48.5% in grade2 of Kellgren and Lawrence grade of OA. More subjects were having symptoms of 6 months duration followed by 8 & 9months duration in 21.2% each, 7-month duration in 12.1%, 10-month duration in 9.1%- and 12-month duration in 6.1%. Improvement in pain noticed in VAS score and follow up shows highly statistically changes (p<0.05). 
Conclusion: Use of IAHA with Sorbitol in our study provided quick and clinically significant improvements in symptoms related to knee OA in patients who experienced failure or intolerance of previous analgesic and anti-inflammatory treatments. Present study findings could be helpful in improving the treatment for OA, especially when TKR needs to be delayed. The demonstrated efficacy of products supports their use as a therapeutic option in early knee OA, as mentioned in the recent recommendations of the scientific community.
 

Pages: 170-179  |  342 Views  132 Downloads

How to cite this article:
Dr. Anku Athokpam, Dr. Veeranna HD, Dr. Kiran Kalaiah, Dr. Prashanth Reddy and Dr. Sunil Kiran. Efficacy of intra-articular hyaluronic acid with sorbitol injection for pain relief in primary osteoarthritis knee . Int. J. Orthop. Sci. 2024;10(4):170-179. DOI: 10.22271/ortho.2024.v10.i4c.3638