Open Access Maced J Med Sci. 2022 Jun 22; 10(B):1801-1805. 1801 Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2022 Jun 22; 10(B):1801-1805. https://doi.org/10.3889/oamjms.2022.9640 eISSN: 1857-9655 Category: B - Clinical Sciences Section: Surgery Diagnosis and Management of Osteoarthritis with Hyaluronic Acid Sandër Kola 1 , Irena Kola 2 , Erinda Frroku 1 , Erjona Abazaj 3 * 1 1Department of Imaging, University Hospital Center “Mother Teresa”, Tirana, Albania; 2 Department of Rheumatology, University Hospital Center “Mother Teresa”, Tirana, Albania; 3 National Reference Laboratories, Institute of Public Health, Tirana, Albania Abstract BACKGROUND: Osteoarthritis (OA) of the genu joint is a degenerative disease of the genu joint, which due to functional limitations leads to deterioration of the quality of life of these patients. In many cases, surgical therapy prosthesis of articular surfaces represents the gold standard of treatment for these patients. AIM: In this study, it is proposed to evaluate the effectiveness of hyaluronic acid (HA) injected under the direction of Echo (ultrasound) in the genu articulation accompanied by a rehabilitation program. MATERIALS AND METHODS: Fifteen patients with knee OA were studied. According to the Kellgren-Lawrence radiological classifcation, Grade II-III arthrosis does not qualify for surgical treatment. Patients underwent intra-articular injection with HA, under ultrasound guidance, and after 6 days continued with rehabilitative treatment aimed at combating the patient’s analgesic posture, recovery of muscle traction participating in genu joint movement, decompression maneuvers, and decompaction in monopodial load. Patients were evaluated at the beginning and after 3 months. RESULTS: In the evaluation of patients at the beginning and after 3 months, a reduction in> 60% of the pain was found, and the Western Ontario and McMaster University Osteoarthritis test in 40% of patients after the frst intra- articular injection. No signifcant side effects were observed during infltrative procedures. CONCLUSIONS: This study confrms the effectiveness of the combined treatment of the rehabilitation program and intra-articular therapy under the guidance of Echos, in patients suffering from knee OA, signifcantly reducing pain and recovery of functional capacity. Edited by: Sinisa Stojanoski Citation: Kola S, Kola I, Frroku E, Abazaj E. Diagnosis and Management of Osteoarthritis with Hyaluronic Acid. OpenAccess Maced J Med Sci. 2022 Jun 22; 10(B):1801-1805. https://doi.org/10.3889/oamjms.2022.9640 Keywords: Hyaluronic acid; Osteoarthritis; Radiography; Rehabilitation *Correspondence: Erjona Abazaj, Institute of Public Health, Tirana, Albania. E-mail: abazajerjona@gmail.com Received: 04-Apr-2022 Revised: 23-May-2022 Accepted: 14-Jun-2022 Copyright: © 2022 Sandër Kola, Irena Kola, Erinda Frroku, Erjona Abazaj Funding: This research did not receive any fnancial support Competing Interests: The authors have declared that no competing interests exist Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 International License (CC BY-NC 4.0) Introduction The prevalence of patients with osteoarthritis (OA) is growing rapidly worldwide due to population demographics shifting [1]. Knee OA is a common progressive multifactorial joint disease and is characterized by chronic pain and functional disability [2]. The origin of OA injury starts in the cartilage but also affects other articular structures such as bones, ankle capsules, menisci, ligaments, bursae, and periarticular muscles [3]. It is approximated that 250 million people worldwide suffer from OA, with an increasing trend in prevalence during the last decades, which continues to rise [2]. About one in four people over the age of 55 have persistent knee pain and one in ten of these people have painful disabling knee OA [4], [5]. The most predominant risk factors are aging, obesity, female gender, previous trauma, and repetitive use [1]. The disease increases with increasing longevity and obesity [6], [7]. The increase in obesity has translated into not only increasing knee OA incidence but also the onset at a younger age [8], [9]. The majority of patients have to live with the disease for the rest of their lives, with few being able to receive total joint replacement due to cost and other issues. Obesity is another risk that also increases OA even at a young age, where cases are in advanced stage [4], and need surgery. Optional and traditional treatments for OA include analgesics, AINS, AIS, and lifestyle improvements such as physical therapy, exercise, weight loss, and partial or total arthroplasty for advanced cases. Recent therapies include intra-articular therapy with intra-articular viscous supplementation which involves local injections of hyaluronic acid (HA) that serves as a joint lubricant [10].There are different recommendations related to the use of HA for OA of the knee. Hence, one study conducted by the American College of Rheumatology in 2012, a recommendation that local HA injections use in patients who had an inadequate response to initial therapy [11], but, on the other hand, a study by the American Academy of Orthopaedical Surgeons in 2013, authors of this study were against the use of HA for the treatment of symptomatic patients [12]. Systematic reviews for OA play an important role in establishing and adapting the study-based clinical guidelines. Studies have shown the improvement of methods for medical treatments of OA by creating standardized treatment degrees [13]. Aim of study The research purpose of this study is to evaluate the effectiveness of HA injected (HA) under the direction of Echo (ultrasound) in the genu articulation Since 2002