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AB0093 EFFECTIVENESS AND SAFETY OF PRILOCAINE IN COMBINATION WITH HYALURONIC ACID IN KNEE OSTEOARTHRITIS: AN OPEN-LABEL STUDY

Background Knee osteoarthritis (OA) is a degenerative progressive, debilitating and painful joint disease. Apart from surgery, treatment of OA includes pharmacotherapy and non-medical treatment such as physical therapy, exercise and local applications. Local hyaluronic acid, steroids and local anesthetics provide symptomatic relief and delay surgery. Objectives The present study aimed to assess the effectiveness and safety local prilocaine + hyaluronic acid combination in patients with painful knee osteoarthritis radiologically classified as having grade 2 and 3 OA. Methods A total of 64 patients with knee OA diagnosed as per the American College of Rheumatology (ACR) criteria were enrolled in the study. Of these patients, 42 had grade 2 and others had grade 3 disease. A single injection of the combination product was administered to all patients. The combination product contained 1 mg hyaluronic acid, 14 mg cross-linked hyaluronic acid, 6.9 mg sodium chloride and 3 mg prilocaine hydrochloride in a 2 ml solution. The combination was injected into a single joint in the painful knee through the anteromedial aspect of the joint. Assessments were performed before the treatment and at 4 and 12 weeks post-treatment by the same physician. The study was designed as an open-label, observational study. The patients were assessed using the Lysholm Knee Scoring Scale. Patient scores were categorized as poor (0-64), fair (65-83), good (84-90) or excellent (91-100). Pain and functional measures were evaluated by this scale. Results There was a female (n=58) predominance in the study sample. The mean age of the patients was 56.4 ± 15.3 years. As rated by the Lysholm Knee Scoring Scale, the number of patients with poor scores was 50 before treatment which decreased to 40 at 4 weeks and 30 at 12 weeks post-treatment. There were 4 patients which scored good before treatment and the number of patients with good scores rose to 6 at 4 weeks and 16 at 12 weeks. These findings were statistically significant (p<0.05). None of the patients received any additional medication and all continued their daily activities. A home exercise program was followed by the patients throughout the study. Global evaluation of the study physician rated 40 patients in good or excellent condition, whereas 34 patients self-rated themselves in good or excellent condition. Six patients had local symptoms including swelling, pain and redness which were of mild-to-moderate intensity. These symptoms resolved in 1-3 days with simple interventions. Conclusion Local hyaluronic acid injections may represent an alternative to systemic medications in the treatment of knee osteoarthritis and they can provide long-term relief with minimal adverse effects when combined with local anesthetics without the need for additional drugs or treatments. Disclosure of Interests None declared