Preliminary Results of a Prospective Trial.

Solène Perruchet, Jean-Charles Balblanc, Charles Rapp,
Charlotte Bourgoin, Cerise Guillochon, Anne Lohse, Thierry Conrozier.



Advanced radiological stage of knee osteoarthritis (OA) is predictive of poor response to viscosupplementation (VS). To date, the impact of x-ray features on the duration of effectiveness (DE) of VS has not been investigated.



To investigate the radiological features associated with DE of VS in patients with knee OA.


Cross-sectional study in patients with knee OA treated with 1 injection of crosslinked hyaluronic acid (HA). The primary outcome was DE, self-assessed by the patients in
weeks of effectiveness. Radiological features (joint space narrowing—JSN topography and
Kellgren-Lawrence [K-L] grade) associated with DE were studied.


Fifty-one patients—33 females (76 knees)—were analyzed.
The average DE was 52.0 (24.7) weeks (range, 13-155 weeks). In the bivariate analysis, DE was 14 weeks longer in those with K-L grades 1 and 2 (62.6 ± 36.4 weeks) than in those with K-L 3 and 4 (48.9 ± 18.6) (P = 0.03). DE was not significantly different according to the involved compartment(s). It was significantly longer in men than in women (60 ± 31.4 vs. 47 ± 16 weeks; P = 0.035). In multivariate analysis, K-L grade (1-2 vs. 3-4) (P = 0.007), male gender (0.02), and older age (0.04) were independently associated with a longer DE.


DE of a single injection of extended-release HA is longer in K-L 1-2 than in K-L 3-4 OA knees, regardless of the JSN topography. However, even the patients with more advanced OA benefited from HANOX-M-XL injection for an average duration barely less than 1 year.


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