CClinicalTrials.gg
CompletedNCT04786613Updated Oct 18, 2022

The Effectiveness of Different Doses of Hyaluronic Acid Injections in Knee Osteoarthritis.

An interventional study of Intra-articular 20 mg, 1.0% Hyaluronic Acid Injection and Intra-articular 32 mg, 1.6% Hyaluronic Acid Injection in Knee Osteoarthritis, sponsored by Istanbul University. Completed at 1 site in Turkey. Open to participants aged 45 Years to 75 Years. Per ClinicalTrials.gov, last updated 2022-10-18.

Sponsored by Istanbul University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
45 Years to 75 Years
Sex
All
01

Study summary

The aim of this prospective, randomized, controlled multi-centre study is to compare the effectiveness and safety of three and five injections of standard linear hyaluronic acid (HA) versus single HA injection in terms of pain intensity and functional status in patients with knee osteoarthritis.

Read the detailed description

Osteoarthritis (OA) is the most common form of chronic joint disease. A treatment option for patients diagnosed with knee osteoarthritis is intra-articular hyaluronic acid therapy. In this prospective, randomized controlled, single blind, interventional study, a total of 90 patients with stage 2-3 knee osteoarthritis according to the kellgren lawrence classification who meet the eligibility criteria will be enrolled in the study. Eligible participants will be randomly assigned to one of the three groups using computer-generated random numbers. In the first group, 2 ml linearly linked 20 mg 1.0% hyaluronic acid injection in 5 sessions, in the second group 2 ml linearly linked 32 mg 1.6% hyaluronic acid injection in 3 sessions and in the third group 2.4 ml linearly linked 48 mg 2.0% hyaluronic acid injection in a single sessions will be applied. Participants are going to evaluate before injection, at the 1-month follow-up, at the 3-month follow-up and 6-month follow-up using the visual analog scale (VAS) scores for pain during activity, at rest, and at night, with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) change in pain, stiffness and physical function score, the change in the Timed Up and Go Test (TUG) time and the change in the patient's daily activities with the numerical global patient assessment scale.

02

Conditions studied

  • Knee Osteoarthritis

Keywords

  • Knee Osteoarthritis
  • Linear Hyaluronic Acid
03

In context

Osteoarthritis

4,398 studies on the registry are indexed under Osteoarthritis; 582 are open to participants now.

This study's enrollment of 100 is above the median of 70 across 3,440 interventional studies indexed under Osteoarthritis.

Browse Osteoarthritis studies →

Lead sponsor

Istanbul University is the lead sponsor of 496 studies on the registry; 79 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 1 (20%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
45 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Unilateral or bilateral symptomatic knee pain for at least three months
  • Presence of Kellgren-Lawrence stage 2-3 osteoarthritis on current anterior-posterior knee radiographs
  • Functional ambulation scale stage 4-5
  • Being able to attend injection and control examinations

Exclusion criteria

Exclusion Criteria:

  • Intra-articular knee injection within the last six months
  • History of severe trauma to the knee within the past six months
  • Concomitant severe meniscus or ligament injury, surgery applied to the knee area
  • Presence of severe effusion, inflammatory joint disease, infection, hematological and oncological disease in the knee.
  • Having a bleeding disorder and / or using warfarin
  • Kellgren-Lawrence stage 1 or stage 4 osteoarthritis on current anterior-posterior knee radiographs
  • Presence of cardiac or systemic disease that may affect exercise
  • The presence of neurological disease and psychiatric disease such as Parkinson's disease, stroke history that may affect balance
  • Body Mass Index ≥35 kg / m²
  • Allergy to hyaluranic acid products
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
100 participants (actual)

Study arms

  • Active comparator
    20 mg, 1.0% hyaluronic acid injection groups

    In the first group, 2 ml linearly linked 20 mg 1.0% hyaluronic acid injection in 5 sessions will be applied.

    Other: Intra-articular 20 mg, 1.0% Hyaluronic Acid Injection

  • Active comparator
    32 mg, 1.6% hyaluronic acid injection groups

    In the second group, 2 ml linearly linked 32 mg 1.6% hyaluronic acid injection in 3 sessions will be applied.

    Other: Intra-articular 32 mg, 1.6% Hyaluronic Acid Injection

  • Active comparator
    48 mg, 2.0% hyaluronic acid injection groups

    In the third group 2.4 ml linearly linked 48 mg 2.0% hyaluronic acid injection in a single sessions will be applied.

    Other: Intra-articular 48 mg, 2.0% Hyaluronic Acid Injection

Interventions

  • OtherIntra-articular 20 mg, 1.0% Hyaluronic Acid Injection

    Intra-articular 2 ml linearly linked 20 mg 1.0% hyaluronic acid injection in 5 sessions will be applied. As a home exercise program, hamstring and quadriceps stretching, quadriceps isometric strengthening, short arc terminal extension exercises will be given at least three days a week with 3 sets of 10 repetitions.

  • OtherIntra-articular 32 mg, 1.6% Hyaluronic Acid Injection

    Intra-articular 2 ml linearly linked 32 mg 1.6% hyaluronic acid injection in 3 sessions will be applied. As a home exercise program, hamstring and quadriceps stretching, quadriceps isometric strengthening, short arc terminal extension exercises will be given at least three days a week with 3 sets of 10 repetitions.

  • OtherIntra-articular 48 mg, 2.0% Hyaluronic Acid Injection

    Intra-articular 2,4 ml linearly linked 48 mg 2.0% hyaluronic acid injection in single session will be applied. As a home exercise program, hamstring and quadriceps stretching, quadriceps isometric strengthening, short arc terminal extension exercises will be given at least three days a week with 3 sets of 10 repetitions.

06

What researchers measure

Primary outcomes

  1. Change from baseline activity pain score at 1-months, 3-months and 6-months

    Visual Analogue Scale-Activity pain (0-10 point). Higher scores mean a worse outcome

    Time frame: Baseline, 1-month, 3-month, 6-month

Secondary outcomes

  1. Change from baseline rest pain score at 1-months, 3-months and 6-months

    Visual Analogue Scale-Rest pain (0-10 point). Higher scores mean a worse outcome

    Time frame: Baseline, 1-month, 3-month, 6-month

  2. Change from baseline night pain score at 1-months, 3-months and 6-months

    Visual Analogue Scale-Night pain (0-10 point). Higher scores mean a worse outcome

    Time frame: Baseline, 1-month, 3-month, 6-month

  3. Change from baseline pain, stiffness and physical function at 1-months, 3-months and 6-months

    Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) measures knee pain, stiffness, and physical function. The scores for each subscale are summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function. The sum of the scores for the three subscales gives a total WOMAC score. High scores are associated with more pain, stiffness, and poor function, while low scores indicate well-being.

    Time frame: Baseline, 1-month, 3-month, 6-month

  4. Change from baseline functional balance at 1-months, 3-months and 6-months

    The Timed Up and Go test requires the person to stand up from a standard chair in which they are sitting, walk 3 m at a comfortable speed to the marked place on the floor, turn around, walk backwards to the starting point and return to the sitting position in the chair. The time taken for the person to complete the test is measured in seconds. The timing of the test is related to the function.

    Time frame: Baseline, 1-month, 3-month, 6-month

07

Study locations

1 site
  • Istanbul University Istanbul Faculty of Medicine, Department of Physical Medicine and Rehabilitation
    Istanbul, Fatih 34034, Turkey
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 18, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04786613
Lead sponsor
Istanbul University
Responsible party
Selim Sezikli (MD, Sub-Investigator, Istanbul University) — Principal investigator
First posted
Mar 8, 2021
Start date
Mar 10, 2021
Primary completion
Oct 7, 2021
Completion
Nov 7, 2021
Last update
Oct 18, 2022

Study contacts

Demirhan Diracoglu, Prof.
principal investigator · Istanbul University Istanbul Faculty of Medicine, Department of Physical Medicine and Rehabilitation

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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