Clinical Efficacy and Safety of Two Cycles of Intra-Articular Injection of Porcine Atelocollagen Versus Hyaluronic Acid in Knee Osteoarthritis

(1) <b>Background:</b> 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...

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التفاصيل البيبلوغرافية
الحاوية / القاعدة:Bioengineering
المؤلفون الرئيسيون: Yong In, Keun Young Choi, Man Soo Kim
التنسيق: مقال
اللغة:الإنجليزية
منشور في: MDPI AG 2025-06-01
الموضوعات:
الوصول للمادة أونلاين:https://www.mdpi.com/2306-5354/12/7/710
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author Yong In
Keun Young Choi
Man Soo Kim
author_facet Yong In
Keun Young Choi
Man Soo Kim
author_sort Yong In
collection DOAJ
container_title Bioengineering
description (1) <b>Background:</b> 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) <b>Methods:</b> 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) <b>Results:</b> Significant intragroup improvements in VAS and WOMAC scores were noted after each injection cycle (<i>p</i> < 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%, <i>p</i> = 0.705). (4) <b>Conclusions:</b> 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.
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spelling doaj-art-b9559633207a42cab2cfcc3e5ee2fdd72025-08-20T03:36:13ZengMDPI AGBioengineering2306-53542025-06-0112771010.3390/bioengineering12070710Clinical Efficacy and Safety of Two Cycles of Intra-Articular Injection of Porcine Atelocollagen Versus Hyaluronic Acid in Knee OsteoarthritisYong In0Keun Young Choi1Man Soo Kim2Department 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 KoreaDepartment 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 KoreaDepartment 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(1) <b>Background:</b> 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) <b>Methods:</b> 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) <b>Results:</b> Significant intragroup improvements in VAS and WOMAC scores were noted after each injection cycle (<i>p</i> < 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%, <i>p</i> = 0.705). (4) <b>Conclusions:</b> 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.https://www.mdpi.com/2306-5354/12/7/710knee osteoarthritisintra-articular injectionporcine atelocollagenhyaluronic acidnon-inferiority
spellingShingle Yong In
Keun Young Choi
Man Soo Kim
Clinical Efficacy and Safety of Two Cycles of Intra-Articular Injection of Porcine Atelocollagen Versus Hyaluronic Acid in Knee Osteoarthritis
knee osteoarthritis
intra-articular injection
porcine atelocollagen
hyaluronic acid
non-inferiority
title Clinical Efficacy and Safety of Two Cycles of Intra-Articular Injection of Porcine Atelocollagen Versus Hyaluronic Acid in Knee Osteoarthritis
title_full Clinical Efficacy and Safety of Two Cycles of Intra-Articular Injection of Porcine Atelocollagen Versus Hyaluronic Acid in Knee Osteoarthritis
title_fullStr Clinical Efficacy and Safety of Two Cycles of Intra-Articular Injection of Porcine Atelocollagen Versus Hyaluronic Acid in Knee Osteoarthritis
title_full_unstemmed Clinical Efficacy and Safety of Two Cycles of Intra-Articular Injection of Porcine Atelocollagen Versus Hyaluronic Acid in Knee Osteoarthritis
title_short Clinical Efficacy and Safety of Two Cycles of Intra-Articular Injection of Porcine Atelocollagen Versus Hyaluronic Acid in Knee Osteoarthritis
title_sort clinical efficacy and safety of two cycles of intra articular injection of porcine atelocollagen versus hyaluronic acid in knee osteoarthritis
topic knee osteoarthritis
intra-articular injection
porcine atelocollagen
hyaluronic acid
non-inferiority
url https://www.mdpi.com/2306-5354/12/7/710
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AT keunyoungchoi clinicalefficacyandsafetyoftwocyclesofintraarticularinjectionofporcineatelocollagenversushyaluronicacidinkneeosteoarthritis
AT mansookim clinicalefficacyandsafetyoftwocyclesofintraarticularinjectionofporcineatelocollagenversushyaluronicacidinkneeosteoarthritis