Hyaluronic acid injections for knee osteoarthritis. Systematic review of the literature
- PMID: 15000336
- PMCID: PMC2214549
Hyaluronic acid injections for knee osteoarthritis. Systematic review of the literature
Abstract
Objective: To determine whether viscosupplementation with intra-articular hyaluronic acid (HA) injections improves pain and function in patients with osteoarthritis (OA) in their knees.
Data sources: We searched MEDLINE, Pre-MEDLINE, and Cochrane databases using the MeSH headings and key words osteoarthritis (knee) and hyaluronic acid.
Study selection: English-language case series and randomized controlled trials (RCTs) were selected. Studies with biologic, histologic, or arthroscopic outcomes were excluded.
Synthesis: Five case series and 13 RCTs were critically appraised. Data from three case series and three RCTs using injections of high-molecular-weight HA (Synvisc) demonstrated significant improvement in pain, activity levels, and function. The beneficial effect started as early as 12 weeks. Studies using low-molecular-weight HA had conflicting results.
Conclusion: Viscosupplementation with high-molecular-weight HA is an effective treatment for patients with knee OA who have ongoing pain or are unable to tolerate conservative treatment or joint replacement. Viscosupplementation appears to have a slower onset of action than intra-articular steroids, but the effect seems to last longer.
Comment in
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Family physicians and arthritis. Conspiracy of neglect.Can Fam Physician. 2004 Feb;50:205-7, 213-5. Can Fam Physician. 2004. PMID: 15000327 Free PMC article. No abstract available.
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