In Yong, Choi Keun Young, Kim Man Soo
Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea.
Bioengineering (Basel). 2025 Jun 29;12(7):710. doi: 10.3390/bioengineering12070710.
(1) Knee osteoarthritis (KOA) induces pain, stiffness, and impaired mobility, particularly in aging populations. Despite providing symptom relief, the long-term efficacy of intra-articular hyaluronic acid (HA) injections remains unclear. With its longer intra-articular residence time and potential chondroprotective effects, porcine-derived atelocollagen is an alternative to HA. We aimed to compare the safety and efficacy of collagen versus HA injections in symptomatic KOA. (2) This retrospective observational study included 40 patients with KOA who received either two cycles of collagen or HA injections at 6-month intervals. Clinical outcomes were assessed using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and 6 months after the first and second injections (Cycle 1 and Cycle 2, respectively). Patient satisfaction and adverse events were recorded. Non-inferiority analysis was conducted for VAS and WOMAC score changes. (3) Significant intragroup improvements in VAS and WOMAC scores were noted after each injection cycle ( < 0.05), albeit without significant between-group differences, non-inferiority of collagen to HA based on predefined margins, and comparable patient-reported satisfaction (>85% reported improvement after each cycle), with similar incidence of mild adverse events (collagen: 20%, HA: 25%, = 0.705). (4) Intra-articular collagen injections were clinically non-inferior to HA in reducing pain and improving function in patients with KOA across two treatment cycles. Given its favorable safety profile and potential structural benefits, collagen may serve as a viable alternative injectable therapy for the non-surgical management of KOA.
(1) 膝关节骨关节炎（KOA）会引发疼痛、僵硬以及活动能力受损，在老年人群中尤为常见。尽管关节腔内注射透明质酸（HA）能缓解症状，但其长期疗效仍不明确。猪源去端胶原蛋白在关节腔内停留时间更长且具有潜在的软骨保护作用，是HA的一种替代物。我们旨在比较胶原蛋白注射与HA注射对有症状KOA的安全性和疗效。(2) 这项回顾性观察研究纳入了40例KOA患者，他们每隔6个月接受两个周期的胶原蛋白或HA注射。在基线以及首次和第二次注射后6个月（分别为第1周期和第2周期），使用视觉模拟量表（VAS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估临床结局。记录患者满意度和不良事件。对VAS和WOMAC评分变化进行非劣效性分析。(3) 每个注射周期后，VAS和WOMAC评分在组内均有显著改善（<0.05），尽管组间无显著差异，基于预设界值胶原蛋白不劣于HA，且患者报告的满意度相当（每个周期后>85%报告有改善），轻度不良事件发生率相似（胶原蛋白：20%，HA：25%，P = 0.705）。(4) 在两个治疗周期中，关节腔内注射胶原蛋白在减轻KOA患者疼痛和改善功能方面临床效果不劣于HA。鉴于其良好的安全性和潜在的结构益处，胶原蛋白可作为KOA非手术治疗的一种可行的替代注射疗法。
