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Accuracy and Outcome of Sonographically Guided Intra-articular Sodium Hyaluronate Injections in Patients With Osteoarthritis of the Hip

Departments of Radiology (M.A.P., A.P.) and Orthopedics (M.O.), Baskent University, Adana Teaching and Medical Research Center, Adana, Turkey.

Address correspondence to Mir Ali Pourbagher, MD, Department of Radiology, Baskent University, Adana Teaching and Medical Research Center, Yuregir, 01250 Adana, Turkey. E-mail: apourbagher{at}hotmail.com

Objective. The aim of this study was to evaluate the accuracy and outcome of sonographically guided intra-articular sodium hyaluronate injections in patients with osteoarthritis of the hip. Methods. The prospective study involved 10 patients who had the diagnosis of unilateral hip osteoarthritis. The mean age of the patients was 63.2 years (range, 27–80 years). Depending on patient body weight, either a 3.5- to 5-MHz convex transducer or a 5- to 12-MHz linear transducer was used to examine each affected joint. Every subject received 3 injections of sodium hyaluronate, 1 per week for 3 consecutive weeks. With real-time sonographic monitoring, each joint was penetrated with a 20-gauge Chiba needle. Contrast medium was injected initially, and proper intra-articular placement was verified with computed tomography before the hyaluronate injection. Each patient’s outcome was assessed on the basis of visual analog scale results and Western Ontario and McMaster Universities osteoarthritis index findings that were recorded before the set of injections and 2, 4, and 6 months after the third injection. Results. Computed tomography confirmed accurate placement in all 30 injections in the study. The visual analog scale and the Western Ontario and McMaster Universities osteoarthritis index scores showed that 80% of the patients had less pain in the joint at 6 months after the last injection. Conclusions. Sonographically guided intra-articular injection of sodium hyaluronate for patients with hip osteoarthritis is easy to perform and is a safe, economical, and well-tolerated form of treatment. In contrast to fluoroscopic or computed tomographic guidance, the sonographic technique exposes neither the patient nor the physician to radiation.

Key Words: hip osteoarthritis • osteoarthritis treatment • sonography • viscosupplementation

Abbreviations: CT, computed tomographic • VAS, visual analog scale • WOMAC, Western Ontario and McMaster Universities osteoarthritis index