変形性膝関節症に対する高分子ヒアルロン酸製剤の有効性

―分子量の違いによる臨床効果の検討―

抄録

The currently available hyaluronan products used in conservative therapy for osteoarthritis of the knee have two different average molecular weights of 900, 000 and 1, 900, 000. The purpose of the study was to determine how the effects of these two hyaluronan products differ in improving joint function. We investigated thirty knee joints of 25 patients who were diagnosed with osteoarthritis, which were treated with the 900, 000-AMW hyaluronan product (15 knees of 13 patients) or the 1, 900, 000-AMW hyaluronan product (15 knees of 12 patients) . The assessment variables were: 1) pain in walking, 2) pain in descending and ascending stairs, and 3) total score based on the Japanese Orthopedics Association's Knee Osteoarthritis Therapeutic Response Rating Scale (JOA score) . In addition, for subjective evaluation of pain-relieving effect based on the visual analog scale (VAS), three parameters were selected: 1) pain at rest, 2) pain on movement, and 3) pain during sleep. The 1, 900, 000-AMW hyaluronan product was proved to be superior in efficacy in respect of all three JOA scores and the pain at rest and pain on movement in the VAS assessment. The high molecular weight hyaluronan product improves joint function as well as ADL and pain from an induction phase of conservative treatment.