Knee Surg Relat Res 2019 Mar; 31(1): 44-53
Intra-articular Recombinant Human Growth Hormone Injection Compared with Hyaluronic Acid and Placebo for an Osteoarthritis Model of New Zealand Rabbits
Andri Maruli Tua Lubis, MD, PhD1, Erick Wonggokusuma, MD2, and Aldo Fransiskus Marsetio, MD1
1Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia and Department of Orthopaedic and Traumatology, Cipto Mangunkusumo Hospital, Jakarta; 2Department of General Orthopaedic, Siloam Hospital Kebon Jeruk, Jakarta, Indonesia
Correspondence to: Aldo Fransiskus Marsetio, MD Department of Orthopaedic and Traumatology, Cipto Mangunkusumo General Hospital, Jl. Diponegoro No. 71, Senen, Jakarta 10430, Indonesia Tel: +62-21-3155996, Fax: +62-21-3929655 E-mail:
Received: October 22, 2018; Revised: November 6, 2018; Accepted: November 17, 2018; Published online: March 1, 2019.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Up to now, there is no feasible solution for stopping or reversing the degenerative process of osteoarthritis (OA). Our study evaluated the effect of intra-articular injection of growth hormone (GH) in OA-induced rabbit knees compared to hyaluronic acid (HA) and placebo.
Materials and Methods: A total of 21 male, skeletally mature, New Zealand rabbits received an intra-articular type II collagenase injection for OA induction. Two weeks later, the rabbits were randomized into three groups based on the weekly intra-articular injection to be received: GH, HA, and saline. Injections were done for three consecutive weeks. Evaluation was done at 8 weeks after treatment, clinically using the lameness period, macroscopically using the Yoshimi score and microscopically using the Mankin score.
Results: The shortest period of lameness was found in the GH group (15.9±2.12 days), compared to the HA group (19.4±1.72 days) and placebo group (25.0±2.94 days). There was a statistically significant difference in macroscopic scoring between groups (p=0.001) in favor of the GH group. There was also significant difference in the microscopic score between groups (p=0.001) also in favor of the GH group.
Conclusions: Intra-articular injection of GH showed better clinical, macroscopic and microscopic results as compared to HA and placebo.
Keywords: Knee, Osteoarthritis, Growth hormone, Hyaluronic acid


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