Archives of Orthopaedic and Trauma Surgery

, Volume 131, Issue 12, pp 1677–1685 | Cite as

Intra-articular injection of hyaluronic acid (MW 1,500–2,000 kDa; HyalOne®) in symptomatic osteoarthritis of the hip: a prospective cohort study

  • Migliore AlbertoEmail author
  • Massafra Umberto
  • Bizzi Emanuele
  • Laganà Bruno
  • Germano Valentina
  • Piscitelli Prisco
  • Granata Mauro
  • Tormenta Sandro
Orthopaedic Outcome Assessment



Clinical trials have demonstrated the safety and efficacy of hyaluronic acid-based products for the treatment of hip osteoarthritis, but data from observational studies of normal medical practice are scarce. This study investigated the long-term efficacy and tolerability of ultrasound-guided intra-articular sodium hyaluronate (MW 1,500–2,000 kDa; Hyalone®) injections in daily clinical practice.


In this observational, cohort study of patients with hip osteoarthritis, Hyalone® was administered under the ultrasound guidance, every 6 months, with the possibility of an additional injection at the intervening 3-month intervals on clinical request. Efficacy measurements included the Lequesne algofunctional index, self-reported pain via the visual analogue scale (VAS), the concomitant use of non-steroidal anti-inflammatory drugs (NSAIDs) and safety. The patients were followed up for 18 months after the first intra-articular injection.


Data from 120 patients were collected. During the study, a statistically significant reduction in algofunctional indexes was demonstrated at 3 months after study product injection, while at 12 months 80% of the patients achieved a decrease of at least 30% in symptoms. These results were maintained over time through cyclical and personalized repetition of ultrasound guided injections, at least one injection every 6 months.


The study treatment reduced pain and improved mobility in osteoarthritis of the hip. These results in daily clinical practice demonstrate a beneficial effect and the safety of the study product and suggest adding intra-articular injections of HyalOne® to the armamentarium of conservative management of symptomatic hip osteoarthritis.


Hyaluronic acid Hip Osteoarthritis Intra-articular injection Ultrasound guidance 



American College of Rheumatology


Body mass index


Confidence interval


Hyaluronic acid




Non-steroidal anti-inflammatory drug




Randomised controlled trial


Receiver operating characteristic




Visual analogue scale



Data collection and analysis, the reporting and writing of this study were supported by a grant from Fidia Farmaceutici S.p.A. No equipment or other supplies were provided by Fidia Farmaceutici S.p.A. The authors declare no conflict of interest with respect to the contents of this article.

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Migliore Alberto
    • 1
    Email author
  • Massafra Umberto
    • 1
  • Bizzi Emanuele
    • 1
  • Laganà Bruno
    • 2
  • Germano Valentina
    • 2
  • Piscitelli Prisco
    • 3
  • Granata Mauro
    • 4
  • Tormenta Sandro
    • 5
  1. 1.Operative Unit of RheumatologyS.Pietro Fatebenefratelli HospitalRomeItaly
  2. 2.Operative Unit for Autoimmune DiseasesSapienza UniversityRomeItaly
  3. 3.ISBEM Research CentreBrindisiItaly
  4. 4.Operative Unit of RheumatologySan Filippo Neri HospitalRomeItaly
  5. 5.Department of RadiologyS.Pietro Fatebenefratelli HospitalRomeItaly

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