Ricerc@Sapienza

We read with great interest the study by Priano titled“Early
efficacy of intra-articular HYADD® 4 (Hymovis®) injections
for symptomatic knee osteoarthritis.”
1
The author would like
to explore the efficacy of intra-articular HYADD 4 (Hymovis)
injections for symptomatic knee osteoarthritis. Results from
this study are very interesting and promising from a clinical
aspect; however, we believe that studying patient’sclinical
status with visual analog scale and Western Ontario and
McMaster Universities Arthritis Index scale should be supported by biomechanical information. From this point of
view, to have more data that could influence the clinical
practice, it is important to note the possible action that intraarticular injections of different kinds of hyaluronic acid could
have on walking biomechanics using an objective measurement tool as gait analysis. In our opinion, the work by Priano1
is promising because it investigates the efficacy of a new
formulation of hyaluronic acid. Nowadays, many hyaluronic
acid formulations are approved for clinical use in Europe and
the United States. Furthermore, hyaluronic acid injections’
efficacy has been demonstrated also in hip osteoarthritis.
2
However, even if these formulations differ in their chemical–
physical properties, joint space half-life, rheological properties, and clinical efficacy, there are few studies that investigate hyaluronic acid’s possible action from a biomechanical
point of view.
3,4
From this point of view, we believe that
osteoarthritis management and rehabilitation should be
prescribed after an objective analysis of functional walking
alterations using gait analysis instrumentations. The use
of gait analysis should be desirable during diagnosis and
follow-up. In fact, it is capable to identify different walking
patterns in patient with osteoarthritis of the lower limbs,
whereas the radiology can evaluate the status of the joint’s
structures.