Email updates

Keep up to date with the latest news and content from BMC Research Notes and BioMed Central.

Open Access Short Report

Intra-articular use of a medical device composed of hyaluronic acid and chondroitin sulfate (Structovial CS): effects on clinical, ultrasonographic and biological parameters

Yves Henrotin1*, Jean-Philippe Hauzeur2, Pierre Bruel3 and Thierry Appelboom2

Author Affiliations

1 Physical Therapy and Rehabilitation Department, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Bone and Cartilage Research Unit, University of Liège Institute of Pathology, level 5, CHU Sart-Tilman, 4000, Liège, Belgium

2 Department of Rheumatology, Erasme Hospital, University of Brussels, 808 Route de Lennik, 1070, Brussels, Belgium

3 Laboratoires Pierre Fabre, 29 Avenue du Sidobre, 81 106, Castres Cedex, France

For all author emails, please log on.

BMC Research Notes 2012, 5:407  doi:10.1186/1756-0500-5-407

Published: 4 August 2012



This pilot open noncontrolled study was designed to assess the efficacy of intra-articular injections of a solution combining hyaluronic acid (HA) and chondroitin sulphate (CS) in the treatment of outpatients affected by knee osteoarthrosis.


Thirty patients with knee OA have been included. The primary objective was to assess clinical efficacy as measured by pain and Lequesne’s index. Secondary objectives were to assess potential effect of the treatment on ultrasound parameters, safety and biomarkers of cartilage metabolism and joint inflammation. After a selection visit (V1), the study treatment was administered 3 times on a weekly basis (V2, V3, V4). Follow-up was planned 6 (V5) and 12 weeks (V6) after the first intra-articular injection. Efficacy results showed a reduction in mean pain at V3 and V6 and in functional impairment, the most marked changes being measured at the two follow-up visits (V5 and V6). Although statistical significance was not achieved due to small sample size, a clear tendency towards improvement was detectable for ultrasound assessments as well as biomarkers. Except for a mild injection site hematoma for which the drug causal relationship could not be excluded, no adverse effect of clinical relevance was recorded during the study.


Although this pilot study was performed according to an open design only, the ultrasound as well as biomarkers changes strongly suggest a non-placebo effect. These preliminary results call now for a randomized controlled study to confirm the clinical relevance of the observed results.

Trial registration


Chondroitin sulphate; Hyaluronic acid; Knee osteoarthritis; Clinical trial; Osteoarthritis treatment; Ultrasonography; Biomarkers