| Summary: | 碩士 === 中山醫學大學 === 醫學研究所 === 95 === This study was to determine whether hyaluronan （hyaluronic acid, HA） products with different molecular weight （MW） have significant differences in the treatment of early osteoarthritic （OA） knees. There were 41 patients with primary symptomatic OA of both knees, prospectively collected between October 2005 and December 2006 at our outpatient clinic. This study applied HA products with two different MW: sodium hyaluronate, Artz® （MW = 0.6-1.2 kDA） and Hylan G-F 20, Synvisc® （MW = 6 kDA）. Artz® injection was applied once a week for five consecutive weeks and Synvisc® intraarticular injection was applied once a week for three consecutive weeks. Based on the questionnaire, we compared the efficacy monthly for half a year to assess which HA product had better degrees of improvement. We also calculated and compared the total cost effectiveness.
There were no significant differences in long term clinical efficacy between the two HA products, but the Synvisc® showed significant benefit in short term symptoms relief. However, patients paid fewer in Synvisc® intraarticular injections than in Artz® intraarticular injections.
Some studies suggest that products with high MW have better therapeutic effects than those with low MW, whereas other studies show no significant differences between them. In our study, higher MW HA possessed a greater symptom-relieving effect than lower MW HA in short term follow-up; however, there were no significant differences between them in long term results. Synvisc® treatment resulted in better short term pain relief and a reasonable cost-effectiveness ratio for patients with early knee OA.
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