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. 2013 Nov;95(8):545-51.
doi: 10.1308/rcsann.2013.95.8.545.

The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain

D Trigkilidas  1 , A Anand
Affiliations

The effectiveness of hyaluronic acid intra-articular injections in managing osteoarthritic knee pain

D Trigkilidas et al. Ann R Coll Surg Engl. 2013 Nov.

Abstract

Introduction: Knee osteoarthritis (OA) is a common and progressive joint disease. Treatment options for knee OA vary from simple analgesia in mild cases to knee replacement for advanced disease. Knee pain due to moderate OA can be targeted with intra-articular injections. Steroid injections have been used widely in managing acute flare-ups of the disease. In recent years, viscosupplementation has been used as a therapeutic modality for the management of knee OA. The principle of viscosupplementation is based on the physiological properties of the hyaluronic acid (HA) in the synovial joint. Despite a sound principle and promising in vitro studies, clinical studies have been less conclusive on the effectiveness of HA in managing osteoarthritic knee pain. The aim of this systematic review was to assess the effectiveness of HA intra-articular injections in the management of osteoarthritic knee pain.

Methods: A systematic review of the literature was performed using MEDLINE®, Embase™ and CINAHL® (Cumulative Index to Nursing and Allied Health Literature). The databases were searched for randomised controlled trials available on the effectiveness of HA intra-articular injections in managing osteoarthritic knee pain.

Results: The search yielded 188 studies. Of these, 14 met the eligibility criteria and were reviewed in chronological order.

Conclusions: HA intra-articular injections have a modest effect on early to moderate knee OA. The effect peaks at around 6-8 weeks following administration, with a doubtful effect at 6 months.

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Figures

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Figure 1
Flowchart of studies
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References

    1. Osteoarthritis. Centres for Disease Control and Prevention. http://www.cdc.gov/arthritis/basics/osteoarthritis.htm (cited August2013).
    1. NIH Consensus Statement on total knee replacement. NIH Consens State Sci Statements 2003; 20: 1–34. - PubMed
    1. Balazs EA, Denlinger JL. Viscosupplementation: a new concept in the treatment of osteoarthritis. J Rheumatol Suppl 1993; 39: 3–9. - PubMed
    1. Altman RD, Akermark C, Beaulieu AD, Schnitzer T. Efficacy and safety of a single intra-articular injection of non-animal stabilized hyaluronic acid (NASHA) in patients with osteoarthritis of the knee. Osteoarthritis Cartilage 2004; 12: 642–649. - PubMed
    1. Larsen NE, Lombard KM, Parent EG, Balazs EA. Effect of hyalan on cartilage and chondrocyte cultures. J Orthop Res 1992; 10: 23–32. - PubMed

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