The impact of excluding patients with end-stage knee disease in intra-articular hyaluronic acid trials: A systematic review and meta-analysis
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(22):17 Advances in Therapy. 2018;36:147-61What this means for my practice?
Treatment with IA-HA provides statistically significant pain relief for patients with early-moderate knee OA compared to saline injections. There was also no increase in the risk of treatment-related AEs up to 6 months post injection. IA-HA demonstrated no benefit over saline in the late OA subgroup and was associated with significantly greater treatment-related AEs. Prior studies that demonstrated no significant benefit with IA-HA injections may have confounded their results with the inclusion of a considerable proportion of patients with end-stage knee disease.
Study Summary
Twenty RCT’s that compared intra-articular hyaluronic injections (IA-HA) with saline injections in patients whose osteoarthritis (OA) severity was diagnosed using the K-L grade were included in this meta-analysis. The primary outcome was mean change in pain from baseline to early (4-13 weeks) and late (22-27 weeks) follow-up visits for two subgroups: early-moderate OA and late OA. Safety was also evaluated based on the number of treatment related adverse events.
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