Porcine collagen versus hyaluronic acid in patients with knee osteoarthritis

Introduction. Intra-articular hyaluronic acid (HA) injections for knee osteoarthritis represent one of the most effective therapeutic interventions, supported by a substantial body of evidence in the literature (1). In contrast, intra-articular porcine collagen (PC) injections constitute an innovative treatment approach whose efficacy still requires further confirmation through clinical studies (2). The aim of this study was to compare the outcomes of intra-articular HA injections with those of PC injections at 6 months in patients with knee osteoarthritis.Methods. Thirty patients (71 years ± 10.5 SD) affected by knee osteoarthritis and experiencing moderate-to-severe knee pain at Numeric Rating Scale (NRS > 5) were evaluated at the Pain Therapy Unit of the University Hospital Policlinico G.Rodolico-San Marco. Group 1 consisted of 15 patients who received two intra-articular PC injections (one injection per week for two consecutive weeks), whereas Group 2 included 15 patients who underwent the same injection protocol using HA. Treatment efficacy was assessed at baseline (T0), after 1 month (T1), and after 6 months (T2) using the Numeric Rating Scale (NRS) for pain evaluation, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for osteoarthritis-related symptoms and functional impairment, and the 12-Item Short Form Health Survey (SF-12) for quality-of-life assessment.Results. Intra-group analysis demonstrated significant clinical improvement with both treatments up to the 6-month follow-up across all outcome measures considered (P < 0.05). Inter-group analysis revealed a slight difference between the two treatment modalities only at the 6-month follow-up, favouring the group treated with porcine collagen.Conclusions. The results indicate that both interventions are effective in the management of knee osteoarthritis. However, a slight advantage emerged at the 6-month follow-up in favour of the porcine collagen group. Randomized controlled trials involving larger patient populations and longer follow-up periods, as well as cost–benefit analyses, are warranted to fully clarify the efficacy and potential differences between these two treatment approaches in knee osteoarthritis.