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Int. J. Mol. Sci. 2017, 18(3), 658; doi:10.3390/ijms18030658

Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid

Department of Orthopedic Surgery and Traumatology, Virgen de la Victoria University Hospital, Málaga E-29010, Spain
Department of Orthopedic Surgery and Traumatology, Hospital Regional Universitario Carlos Haya, Malaga, Málaga E-29010, Spain
Department of Orthopedic Surgery and Traumatology, Hospital Quirónsalud Málaga, Málaga E-29004, Spain
Department of Health Sciences, University of Jaén, Jaén E-23071, Spain
Biopathology and Regenerative Medicine Institute (IBIMER), Centre for Biomedical Research, University of Granada, Granada E-18071, Spain
Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada E-18016, Spain
Biosanitary Institute of Granada (ibs. GRANADA), University Hospitals of Granada-University of Granada, Granada, Granada E-18016, Spain
Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga E-29010, Spain
Author to whom correspondence should be addressed.
Received: 3 February 2017 / Revised: 27 February 2017 / Accepted: 15 March 2017 / Published: 17 March 2017
(This article belongs to the Special Issue Musculoskeletal Diseases Therapy)
View Full-Text   |   Download PDF [247 KB, uploaded 21 March 2017]


Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA) in a single injection with standard preparations of hyaluronic acid (HA) in five injections in osteoarthritis (OA) of the knee. Fifty-four patients with knee osteoarthritis (Kellgren–Lawrence Grade II and III) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane®) and Group II with HA (Go-ON®). Patient’s evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA. View Full-Text
Keywords: knee osteoarthritis; hyaluronic acid; Stabilized hyaluronic acid (NASHA) knee osteoarthritis; hyaluronic acid; Stabilized hyaluronic acid (NASHA)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Estades-Rubio, F.J.; Reyes-Martín, A.; Morales-Marcos, V.; García-Piriz, M.; García-Vera, J.J.; Perán, M.; Marchal, J.A.; Montañez-Heredia, E. Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid. Int. J. Mol. Sci. 2017, 18, 658.

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