Patient-Reported Outcomes Following Intra-articular Hyaluronic Acid for Knee Osteoarthritis

Abstract

Background: Intra-articular hyaluronic acid (IAHA) has been commonly used in the management of knee osteoarthritis (OA). This study sought to assess patient-reported outcomes (PRO) following different formulations of hyaluronic acid injections for patients who have knee OA.

Methods: A retrospective analysis was performed on patients who have knee OA and received IAHA knee injections from October 2018 to May 2022 in sports medicine (SM) and adult reconstructive (AR) clinics. Patients completed PRO measures including the Patient-Reported Outcome Measurement Information System (PROMIS) Mobility, Pain Interference, and Pain Intensity at baseline, 6-week, 6-month, and 12-month follow-up. Univariate and multivariate analyses were used to evaluate changes in PRO measures between baseline and follow-up periods and to evaluate differences between the SM and AR divisions. A total of 995 patients received IAHA for knee OA and completed PRO assessments.

Results: There was no difference in the PROMIS measures based on molecular weight at 6 weeks, 6 months, and 12 months. Except for 6-month Mobility scores between the SM and AR patients (-0.52 ± 5.46 versus 2.03 ± 6.95; P = .02), all other PROMIS scores were similar. Mobility scores at 6 months were significantly different based on Kellgren and Lawrence grade (P = .005), but all other PROMIS scores were similar.

Conclusion: Average change in PROMIS scores were significantly different only for 6-month Mobility scores based on divisions and Kellgren and Lawrence grade but did not achieve minimally clinical important difference at most timepoints. Further studies are needed to investigate whether improvement is observed in specific patient populations.

Keywords: PROMIS; hyaluronic acid; intraarticular injection; knee osteoarthritis; nonsurgical management.