The use of intra-articular injections of highly purified, natural-origin polynucleotides and hyaluronic acid may be the preferred treatment option in knee osteoarthritis patients with chronic pain and deteriorating disease.

This randomized, double-blind comparative study was performed to ascertain whether a fixed combination of intra-articular injections of polynucleotides and hyaluronic acid (PNHA) is more effective than hyaluronic acid (HA) alone in improving knee function and joint pain in patients with knee osteoarthritis over 2 years.

Overall, a hundred patients with knee osteoarthritis were considered. The patients were administered with three intraarticular knee injections of either PNHA or HA at the starting and per week for a period of 2 weeks. The Western Ontario and McMaster Universities (WOMAC) and Knee Society Score (KSS) comprised of primary and secondary endpoints assessed at the starting and later after 2 months, 6 months, 1 year and 2 years. The synovial fluid levels were also examined.

Considerable improvements in the KSS scores were observed in both groups. Patients treated with PNHA but not on HA alone had significantly more pain relief. A considerably more decline in the WOMAC pain subscore was noted after a year in PNHA- group patients (Figure 1). 

No major adverse events were reported.

As compared to HA alone, the use of 3 weekly intra-articular injections with polynucleotides along with high molecular weight HA more effectively improves the knee function and provides pain relief in knee osteoarthritis patients.