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.
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.
Authors: L S Lohmander; N Dalén; G Englund; M Hämäläinen; E M Jensen; K Karlsson; M Odensten; L Ryd; I Sernbo; O Suomalainen; A Tegnander Journal: Ann Rheum Dis Date: 1996-07 Impact factor: 19.103
Authors: P Ravaud; L Moulinier; B Giraudeau; X Ayral; C Guerin; E Noel; P Thomas; B Fautrel; B Mazieres; M Dougados Journal: Arthritis Rheum Date: 1999-03
Authors: Nefyn H Williams; Elvis Amoakwa; Kim Burton; Maggie Hendry; Ruth Lewis; Jeremy Jones; Paul Bennett; Richard D Neal; Glynne Andrew; Clare Wilkinson Journal: Br J Gen Pract Date: 2010-02 Impact factor: 5.386
Authors: W Zhang; M Doherty; B F Leeb; L Alekseeva; N K Arden; J W Bijlsma; F Dinçer; K Dziedzic; H J Häuselmann; G Herrero-Beaumont; P Kaklamanis; S Lohmander; E Maheu; E Martín-Mola; K Pavelka; L Punzi; S Reiter; J Sautner; J Smolen; G Verbruggen; I Zimmermann-Górska Journal: Ann Rheum Dis Date: 2006-10-17 Impact factor: 19.103