Turkish Journal of Physical Medicine and Rehabilitation 2012 , Vol 58 , Num 3

The Efficacy of Intra-Articular Injection of Hyaluronic Acid With Supplemental Peroral Vitamin E Following Arthroscopic Debridement in the Treatment of Knee Osteoarthritis: A Prospective, Randomized, Controlled Study

Ahmet Aslan 1 ,Vecihi Kırdemir 2 ,Tolga Atay 2 ,Yakup Barbaros Baykal 2 ,Özgür Aytekin 3 ,Fazıl Cüneyt Aydoğan 4
1 Dr. Münif İslamoğlu Kastamonu Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Kastamonu, Türkiye
2 Süleyman Demirel Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Isparta, Türkiye
3 Çorum Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Çorum, Türkiy
4 Nevşehir Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, Nevşehir, Türkiye
DOI : 10.4274/tftr.36693

Objective: We evaluated clinical results of intra-articular injection of hyaluronic acid and peroral Vitamin E treatment after arthroscopic debridement in patients with knee osteoarthritis who got no cure with medical treatment previously.


Materials and Methods: A total of 44 patients with knee pain, who were diagnosed as having knee osteoarthritis according to the American College of Rheumatology criteria, were included in this study. The subjects were randomly divided into 3 groups after arthroscopic debridement: Group S was given intra-articular Hylan G-F 20 treatment; Group S+E - intraarticular Hylan G-F 20 treatment plus oral vitamin E; and Group C underwent only arthroscopic debridement. Pain, stiffness and functional capacity scores were evaluated preoperatively and 6 and 12 months postoperatively according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).


Results: In all groups, 6- and 12-month postoperative WOMAC scores were lesser than the preoperative ones. The WOMAC scores at 6 and 12 months were statistically lower in the S+E and S groups than in the group C (p<0.05). The S+E group demonstrated better results in terms of improvement in symptoms than the S-group at 6 and 12 months postoperatively (p<0.05).


Conclusion: We believe that arthroscopic debridement is beneficial in suitable knee osteoarthritis cases and vitamin E and intra-articular hyaluronic acid may reduce the symptoms of knee osteoarthritis.

Keywords : Arthroscopic debridement; knee osteoarthritis; hylan G-F 20; intra-articular hyaluronic acid; vitamin E