Comparison of Two Hyaluronic Acid Preparations for the Treatment of Rizoar throsis

Abstract

Osteoarthritis of the trapeziometacarpal joint (TOA) or rizoar throsis is a pathology particularly prevalent in post-menopausal women. It can be symptomatic, with associated pain, or asymptomatic, and in this latter case it is diagnosed by radiographical examination. TOA, when symptomatic, strongly affects quality of life. The treatment of TOA involves both pharmacological and non-pharmacological treatment (including local application of heat, ultrasound and splints). The major treatments,recommended by the European League Against Rheumatism consists of corticosteroids for pain control and hyaluronic acid (HA) for amelioration of functional capacity. The present study aimed at comparing the efficacy and tolerance of intra articular injections of two HA preparations, high-low molecular weight HA (HL) (Sinovial® HL) and high molecular weight HA (HMW) (Sinovial® Mini), in patients with TOA. The observational and retrospective study involved overall 125 subjects, ageing from 45 to 85 years, who had clinical symptoms of TOA lasting at least 6 months. The patients received HL (66 subjects) or HMW (59 subjects) in two injections at baseline and after 15 days. The subjects were followed for 6 months, and the outcome measurements included pain control (through VAS scale) functional hand capacity, using the Duruoz Hand Index (DHI) and the change of the duration of morning stiffness, using the Italian version of the Health Assessment Questionnaire (HAQ). HL was found superior to HMW in all the three parameters examined, with a quicker and stronger pain relief, recovery of hand function as well as in self-assessment by the subjects. Both treatments were associated with very modest side effects.