Effectiveness of Two Hyaluronic Acids in Osteoarthritis of the Knee

Single-blind Randomised Pragmatic Trial Comparing the Effectiveness of Two Hyaluronic Acid Viscosupplements, DUROLANE® (Single Injection) Versus HYALGAN® (Three Injections) for Symptomatic Tibiofemoral Osteoarthritis of the Knee.

The purpose of this study is to assess whether a single injection hyaluronic acid (HA) product is not inferior to a 3 injection HA product at 24 weeks (6 months), in terms of effectiveness in reducing pain when walking in patients suffering from symptomatic tibiofemoral osteoarthritis of the knee.

non-inferiority study of two HA products commercially availalble

Inclusion Criteria:

• Age ≥ 40 and < 85
• Tibiofemoral osteoarthritis of the knee according to the American College of Rheumatology clinical criteria, in the Kellgren-Lawrence (KL) stages II-III, confirmed by radiology (< 3 months)
• Unilateral symptomatic osteoarthritis of the knee causing pain when walking (WOMAC A1 scale), assessed over the previous 24 hours on a scale of 0 to 10: Pain when walking: ≤ 3 and < 8
• Bilateral osteoarthritis of the knee, if pain in the other knee is < 3 (10-point numerical scale)
• Patient: outpatient, capable of walking 50 metres without a walking stick, crutches or a walker, capable of reading, understanding, signing and dating the patient information sheet
• Patient with social security cover

Exclusion Criteria:

• Osteoarthritis of the knee in Kellgren-Lawrence (KL) stages I and IV
• Bilateral symptomatic osteoarthritis of the knee causing pain when walking (WOMAC A1 scale), assessed on a scale of 0 to 10: Pain when walking > 3, in both knees
• Predominant symptomatic patellofemoral osteoarthritis of the knee
• Congestive manifestation of osteoarthritis of the knee defined according to the Knee Osteoarthritis Flare-Ups Score (KOFUS) criteria
• Last viscosupplementation of the affected knee < 6 months before, last injection of corticosteroids < 2 months before
• Known hypersensitivity to avian proteins and hyaluronic acids;
• History of joint replacement or major surgery in the affected knee in the last six months
• History of arthroscopy or surgery in the affected knee in the last three months
• Symptomatic hip disease on the same side or other side of the body
• Joint replacement or any other surgery planned in the next six months
• History of septic arthritis of the affected knee
• Skin complaint affecting the knee at the injection site
• Haemorrhagic disease contraindicating, in the doctor's opinion, any intra-articular injection
• In order to respect the pragmatic nature of the study:
• Any medical and / or pathological condition that, in the investigator's opinion, makes the subject unsuitable for inclusion
• Any medical and / or pathological condition that, in the investigator's opinion, would be a contraindication for an intra-articular injection
• Any other complaint that, in the investigator's opinion, would impede the assessment of the effectiveness of the affected knee
• Any treatment administered to the patient that may interfere with the interpretation of the study results
• Use of glucocorticosteroids (except inhaled corticosteroids) during the previous month
• Treatment with diacerein, avocado and soya unsaponifiables, glucosamine sulphate or chondroitin sulphate, started in the previous 3 months, or irregular doses over the previous 3 months
• Hard of hearing (not being able to follow a telephone conversation properly)
• Patient without a telephone
• Pregnant women or nursing mothers
• Participation in other clinical studies, within 30 days before inclusion