The Theraputic Effect Of Sodium Hyaluronate Of Different Molecular Weights On Knee Osteoarthritis

Objective:To assess the clinical effects and physical characteristics changes of nano-particles in knee joint synovial fluid before and after treatment with intra-joint injection of sodium hyaluronate of different molecular weights to treat knee osteoarthritis(KOA),in order to find a better therapy for KOA treatment.Methods:521 KOA cases that match to the criteria and had had regular follow up in our orthopedic department between March year 2005 to December year 2006 were randomly divided into group A,B and C.The patients in group A were treated with 900,000 units of sodium hyaluronate of low molecular weight(ARTZ(?)Dispo);The patients in group B were treated with 1800,000 units of sodium hyaluronate of high molecular weight(Sofast);The patients in group C were treated with oral glucosamine hydrochloride capsules.Lysholm scoring standard was used to calculate the conditions of clinical symptoms relieving before and after treatment,and evaluate the effects and related influence factors.Furthermore,knee joint synovial fluid of the patients in three groups was obtained to analyse physical characteristics changes of nano-particles in the synovial fluid before and after treatmet.Results:There was no significant difference in age,sex ratio,duration of osteoarthritis and Lysholm score in patients from Group A,B and C.ARTZ(?) Dispo,Sofast and glucosamine hydrochloride all relieved clinical symptoms of KOA, and the therapeutic efficiency of ARTZ(?) Dispo(group A) was better than that of Sofast(group B) and glucosamine hydrochloride(group C).Lysholm score in groupA,B and C was 91±4,82±4 and 71±4 one month after treatment;92±4,84±3 and 73±3 three months after treatment;95±3,86±4 and 76±4 six months after treatment,respectively,Lysholm scors in three groups were higher after treatment than before treatmen,and Lysholm score in group A was markedly higher than group B and C(P＜0.05).One month after treatment,the effective rate in group A,B and C was 95.3%,82.7%and 70.4%;Three months after treatment,the effective rate in group A,B and C was 97.1%,83.2%and 75.1%;six months after treatment, the effective rate in group A,B and C was 97.1%,81.6%and 84.0%,respectively,the effective rate was higher in group A than group B and C.The nano-particle size in knee joint synovial fluid was reduced after treatment in all three groups,with most significantly decreas in group A[sodium hyaluronate(ARTZ(?) Dispo) group].Conclusion:Sodium hyaluronate can effectively treat KOA with no severe side effect, and treatment with sodium hyaluronate of low molecular weight can reach a better clinical effect earlier than sodium hyaluronate of high molecular weight and glucosamine hydrochloride.The nano-particle size of synovial fluid is significantly correlated with the development of KOA,and it can reflect the severity of KOA.