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Medicina dello Sport 2020 March;73(1):127-39

DOI: 10.23736/S0025-7826.20.03648-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English, Italian

Evaluation of the efficacy of intra-articular injective treatment with reticular hyaluronic acid (Mo.Re. Technology) in amateur athletes with over-use gonarthrosis

Andrea BERNETTI ¹, Massimiliano MANGONE ¹, Teresa PAOLUCCI ², Valter SANTILLI ¹, Simone VERNA ¹, Francesco AGOSTINI ¹ ✉, Marco PAOLONI ¹

¹ Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy; ² Unit of Physical Medicine and Rehabilitation, Department of Medical Science and Oral Biotechnology, G. D’Annunzio University of Chieti-Pescara, Chieti, Italy

BACKGROUND: Osteoarthritis (OA) is a chronic inflammatory and progressive disease characterized by cartilage degeneration, joint pain, functional disability and quality of life alterations. It is the most widespread form of arthropathy in the world population. Intra-articular hyaluronic acid (HA), which has long been successfully used in clinical practice, has proved to be able to improve symptoms, joint mobility and quality of life, slowing down the progression of joint degeneration. At present there are no known studies in the literature that have demonstrated the efficacy of intra-articular HA injection in over-use gonarthrosis related to sports activity. The aim of our study was therefore to analyze the efficacy of the intra-articular mobile reticulum HA, 24 mg/3 mL, in amateur athletes with low to moderate over-use gonarthrosis, using specific scales assessment for pain, functionality, joint stiffness and the impact of these in daily life.
METHODS: Amateur athletes (aged between 30 and 70 years) of both sexes with radiographic diagnosis of gonarthrosis (II-III Kellgren-Lawrence scale) were recruited. Patients underwent 2 knee intra-articular injections with HYADD®4-G, 2 weeks apart. Patients were evaluated using pain scales (VAS) and disability related to gonarthrosis (KOOS; WOMAC), at baseline (T0), after 1 month (T1), 3 months (T2) and 6 months (T3) since the last injection.
RESULTS: Thirty amateur athletes were recruited. The results of the VAS Scale showed a statistically significant reduction in pain between T1 and T2 and between T2 and T3 (P value <0.007). In the KOOS Scale, for the pain item, there were statistically significant differences between T0 and T1, between T1 and T2 and between T2 and T3 (P-value <0.001). With regard to items related to symptomatology, sports and recreational activities and quality of life, there was a statistically significant improvement between T0 and T2 (P-value: <0.047; <0.034; <0.04 respectively). The results of the WOMAC scale were not statistically significant.
CONCLUSIONS: Based on our experience, intra-articular HA injections, thanks to the innovation of the mobile reticulum, is certainly an effective and safe method in athlete management with low-moderate over-use gonarthrosis. Further studies, with the recruitment of a greater number of patients, longer-term follow-up and a comparison with a control group, are necessary in order to further define the efficacy in the treatment of athletes with over- use.

KEY WORDS: Osteoarthritis, knee; Hyaluronic acid; Injections; Rehabilitation