Can we also treat hip osteoarthritis with intra-articular injections of hialuronic acid? Clinical results of 2 year experience using ultrasound guided intra-articular injections

Aim. Osteoarthritis (OA) of the hip is the most frequent joint involved after the knee. Its treatment is based on muscular rehabilitation, weight loss and NSAID. NSAID therapy may cause many side effects. The intra-articular injection of hialuronic products hialuronic acid (HA), called viscosupplementation, has broadly been used in knee osteoarthritis. The aim of our study is to evaluate effectiveness and safety of ultrasound guided viscosupplementation in hip osteoarthritis. Methods. Pilot study 1: 19 patients have been treated with HA molecular weight of 500-730 kDa. Effectiveness has been valued through a questionnaire to appraise the mobility and VAS pain. Pilot study 2: 8 patients have been treated with HA molecular weight of 1.000 kDA. Pilot study 3: 12 patients patients have been treated with HA molecular weight up to 7.000 kDa. In the last 2 studies, Lequesne index, VAS pain and NSAID consumption have been evaluated. Results. In pilot study 1 there was a statistical significant reduction in VAS pain and patients judged their motility as improved (42,1%) or much improved (57,8%). In pilot studies 2 and 3 there was a statistical significant reduction in Lequesne index, VAS pain and NSAID consumption. Conclusion. Our data suggest that ultrasound guided administration of hialuronic products is a safe and effective treatment for hip osteoarthritis. Further studies are necessary to determine the benefit duration and the optimal number of intra-articular injections.