Date of Award
12-2017
Degree Type
Selective Evidence-Based Medicine Review
Degree Name
Master of Science in Health Sciences - Physician Assistant
Department
Physician Assistant Studies
Department Chair
John Cavenagh, MBA, PhD, PA-C
Recommended Citation
Hood, Jordan S., "Are Hylan Injections More Effective In Reducing Stiffness In Primary Knee Osteoarthritis Compared To Hyaluronic Acid Derivative Injections?" (2017). PCOM Physician Assistant Studies Student Scholarship. 385.
https://digitalcommons.pcom.edu/pa_systematic_reviews/385
Comments
Objective: The objective of this selective EBM review is to determine whether or not hylan injections are more effective in reducing stiffness in primary knee osteoarthritis compared to hyaluronic acid derivative injections.
Study Design: Review of three published, English language randomized controlled trials published in 2007, 2008 and 2011.
Date Sources: Three randomized control trials were found using PubMed. These studies compared the efficacy and safety of hylan injections and hyaluronic acid derivative injections for reducing stiffness in primary knee osteoarthritis.
Outcome(s) Measured: The efficacy and tolerability of hylan injections for the treatment of stiffness in patients with knee osteoarthritis. The clinical outcome was measured using the Western Ontario McMaster University Osteoarthritis Index (WOMAC). The incidence of serious adverse events including septic arthritis, anaphylactic shock, pain, effusion, erythema and injection site hematoma. Adverse events were patient reported with investigator documentation.
Results: Juni (2007)8 found that patients given hylan injections compared to hyaluronic acid derivative injections showed equal efficacy in improving clinical performance in reducing the WOMAC subscores including the stiffness subscore. Raman (2008)9 found improvement in the WOMAC stiffness subscale for both hylan and hyaluronic acid derivative injections, but no statistical difference observed between the two injections. Pavelka (2011)10 found both preparations equally effective in reducing the WOMAC stiffness subscale with no significant difference between the hylan and hyaluronic acid derivative injection treatment groups.
Conclusions: Results from the three randomized controlled studies demonstrate that both hylan and hyaluronic acid derivative injections show equal efficacy in reducing stiffness in primary knee osteoarthritis.