Intra-Articular Hyaluronic Acid as Treatment in Elderly and Middle-Aged Patients with Knee Osteoarthritis

Demet Uçar*, 1, Demirhan Dıraçoğlu2, Türker Süleyman2, Nalan Çapan2
1 Department of Physical Medicine and Rehabilitation, Dicle University Medical Faculty, Diyarbakir, Turkey
2 Department of Physical Medicine and Rehabilitation, Istanbul University Medical Faculty, İstanbul, Turkey

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© Uçar et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Dicle University Medical Faculty, Diyarbakır, Turkey; Tel: 0090 4122488001; Fax: 0090 4122488111; E-mail:



Osteoarthritis is the most common age-related degenerative joint disease. It affects all the joints containing hyaline cartilage. Knee osteoarthritis is the most cumbersome in terms of prevalence and disability. The aim of this study to evaluate the efficacy of intra-articular hyaluronic acid in patients with knee osteoarthritis with regard to joint pain and function, as well as patient satisfaction, assessed at one month and at one year, and by age group.


In this prospective randomised study, 172 patients who were diagnosed knee OA and who received three consecutive intra-articular injections of HA weekly were included. Patients 65 years of age or older were accepted as the “elderly group”, and those under 65 were accepted as the “middle-aged group”. Clinical evaluations of efficacy and safety were conducted at the beginning of the study, one month after the third injection, and one year after the third injection.


In the two groups, the intragroup analysis revealed significant improvements following injection when compared with preinjection values. According to the last followup controls (after 12 months) in the middle-aged group, VAS activity pain, VAS rest pain, WOMAC physical function, and WOMAC pain values were found to be statistically lower when compared with pre-injection values. In the elderly group, no statistically significant differences were found between pre-injection and after 12 months.


We can conclude that intra-articular joint HA injections are effective in both young and old patients with OA with regard to pain and functional status over a short-term period. Further, HA injections in patients younger than 65 years can be planned for a one-year period.

Keywords: : Knee osteoarthritis, hyaluronic acid, knee pain..