The pain of osteoarthritis (OA) can be crippling. The usual treatments are anti-inflammatory drugs and physical therapy. Sometimes steroid injections can ease pain, at least for awhile. But, in general, none of these treatments works very well for very long. The idea is to manage the pain of OA as long as possible. Doctors are always looking for new treatments that can help patients better manage the pain of OA. Joint replacement is put off until the pain is severe and activities are very limited.
Hylan injections are a newer treatment for OA. Hylan is a synthetic type of hyaluronic acid (HA). HA is naturally found in the fluid inside joints. No one understands exactly how HA works, but it seems to lubricate the joint, protect the cartilage, and maybe even slow the process of OA. Hylan injections have shown promise in easing the pain of knee OA. It has not been tested much in other joints. These authors tested hylan injections in hip joints with OA.
The injections were tested in 25 hips. None of the patients was getting good relief with standard treatments. Most of the patients had mild to moderate OA, and a few had severe OA. They all got a joint-rinse with saline (called lavage) in the fist week. They got one hylan injection a week for the next three weeks. All the patients also did a four- to six-week program of hip exercises.
One year later, most patients still had less pain. The authors considered success to be at least 50 percent less pain and a patient rating of the treatment as good or excellent. For patients with mild or moderate OA, the success rate was just over 90 percent. For patients with severe OA, the success rate was 50 percent.
This study suggests that hylan, together with an exercise program, can ease the pain of mild to moderate hip OA. More studies are needed to support this finding. But patients with hip OA–and their doctors–will be glad to have another possible tool to use against pain.