Abstract

Objectives: To evaluate the results and the safety of intra-articular injection of high molecular weight hyaluronic acid in the treatment of primary knee osteoarthritis in patients with type 2 diabetes. Subjects and methods: Prospective, interventional, longitudinal study on 46 patients with type 2 diabetes (with 68 degenerative knee joints) diagnosed with primary knee osteoarthiritis criteria ACR 2016, X-Ray stage II, III according to Kellgren and Lawrence, type 2 diabetes criteria ADA 2021, 46 patients (68 joints) failed with background treatment (using slow-acting anti-degenerative drugs SYSADOA for more than 3 months anti- inflammatory and pain-relieving oral NSAIDs at therapeutic doses for 7-10 days). The patient was injected one tube intra-articular injection of high molecular weight hyaluronic acid into the damaged knee joint, followed at 4,8, and 12 weeks after injection(T4,T8, T12). Results: All monitoring parameters (VAS score, WOMAC, knee flexion range) of the HA injected knee improved from week 4 and continued until week 12 with p <0.05). The average VAS score decreased from 5.9 ± 1.5 (T0) down 2.1 ± 1.1( T12). WOMAC scores improved across all parameters (pain, stiffness, mobility). The overall WOMAC score decreased from 52±12 (TO) to 27.8±8.1 (T4) and maintained up to 12 weeks after injection (p<0.05). 100% of patients improved knee flexion range. Blood sugar decreased during 3 months of follow-up (p>0.05). There was no case of infection or bleeding in the joints, mainly post-injection pain accounting for 11.8% lasting for 12-24 hours. Conclusions: Intra-articular hyaluronic acid injection therapy is effective in improving symptoms, knee motor function and is safe in patients primary knee osteoarthritis with type 2 diabetes.