Search

Study Objective: To assess the efficiency and safety of intraarticular combination therapy with sodium hyaluronate and chondroitin sulfate (Hyalurom СS) in patients with knee osteoarthritis (OS). Materials and Methods. The 6-month study enrolled 79 patients with primary knee OA stage II–III (Kellgren и Lawrence), with pain intensity of at least 40 mm, using a visual analogue scale. Mean age was 60.3 ± 8.7 years; mean body mass index was 29.2 ± 4.7 kg/m2, and duration of disease of 6 (3–10) years. Therapy efficiency and safety were assessed on the basis of pain dynamics, constrained movements, joint functionality, patient health, quality of life, and daily need in non-steroidal anti-inflammatory drugs. Study Results. Initial pain was 62 (55–72) mm. After intraarticular injection of the drug, knee pain was statistically less severe, and in a week, it was 41 (32–51) mm, in a month — 28 (20–42) mm, in 3 months — 22 (14–37) mm, and in 6 months — 20 (14–42) mm (р < 0.0001). The same pattern was identified when the total knee functionality points were determined: 1,125 (899–1540) mm — initial value, 821 (556–1119) mm — in a week, 627 (401–874) mm — in a month, 554 (310–750) mm — in 3 months, and 552 (309–837) mm — in 6 months of follow-up (p < 0.0001). The same pattern was true for the assessment of all components of the index. Pain: 268 (189–312) mm, 161 (91–206) mm, 121 (63–165) mm, 102 (48–163) mm, 91 (48–171) mm, respectively (p < 0.0001); constrained movements: 101 (59–130) mm, 66 (30–92) mm, 51 (24-68) mm, 41 (18-60) mm, 40 (20-61) mm, respectively (p < 0.0001); impaired functionality: 802 (647–1095) mm, 587 (405-798) mm, 457 (277-683) mm, 396 (220-586) mm, 402 (191-638) mm, respectively (p < 0.0001). Statistically significant improvement in the quality of life and overall health condition was noted throughout the entire follow-up period: 0.52 (-0.02–0.59) mm and 0.69 (0.59–0.80) mm, р < 0.0001; 48 (30–60) mm and 72 (60–80) mm, р < 0.0001. The therapy led to reduction in the need for non-steroidal anti-inflammatory drugs: in a week, they were discontinued by 39.2% of patients; in a month — by 72.2% of patients, in 3 months — 73.4%, and in 6 months — 54.4% of patients. When the therapy efficiency was assessed by the patient and physician, “significant improvement” and “improvement” were recorded in a majority of cases. Adverse events associated with increased pain and/or swollen knee were noted in 8 (10.1%) patients. Conclusion. The results show good long-term effect from Hyalurom СS therapy. We recorded statistically significant reduction in pain, less constrained movements, rarer need in non-steroidal anti-inflammatory drugs, improved quality of life and joint functionality. The drug possesses a good safety profile and can be recommended for wide clinical application. Keywords: knee osteoarthritis, hyaluronic acid, chondroitin sulfate.

Objective of the Review: To present the current information on the relations between osteoarthritis (OA) and hyperuricemia (HU). Key Points. Despite the fact that HU is frequently diagnosed in patients with OA, the pathogenic mechanisms of the relationship between these conditions have been studied poorly. Whether HU plays a role in development and progression of OA is still a matter of argument; still, HU can be an aggravating predictor of OA. Higher levels of uric acid are associated with more advanced Rg stages of OA. Conclusion. The article presents evidences of the relationship between uric acid concentration and development/progression and more complicated course of OA. Therefore, it is advisable to lower the uric acid concentration, which is likely to slow down OA progression. Keywords: osteoarthritis, hyperuricemia, uric acid.