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Higher OMERACT-OARSI response rate following IA-HA injection vs steroid or placebo
①
Synopsis: 11 randomized controlled trials were included in this traditional meta-analysis and network meta-analysis comparing the efficacy of intra-articular injections of hyaluronic acid (IA-HA), corticosteroids (IA-CS), and placebo (IA-P) in the treatment of patients with mild-moderate knee osteoarthritis.The primary end point was the treatment response rate according to the Outcome Measures in Rheumatoid Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) criteria, and the secondary end points included standard mean differences in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, function, and stiffness scores.All data came between 8 and 26 weeks post-injection time points.Network meta-analysis demonstrated significance in favour of IA-HA over both IA-CS and IA-P regarding OMERACT-OARSI response rate and WOMAC function scores, and, additionally, significance in favour of IA-HA over IA-P in WOMAC pain scores.No significant difference between treatments was observed in network meta-analysis of WOMAC stiffness scores. Based on the... Read More »
Author verified Level 1 Meta Analysis
11%
Network meta-analysis evaluating injection treatments for plantar fasciopathy
①
Synopsis: 22 randomized controlled trials were included in this network meta-analysis, that included over 10 injectable treatments, to evaluate comparative efficacy for the management of plantar faciopathy.The primary outcome of this study was pain relief.At 0-2 month follow-up, micronized dehydrated human amniotic/chorionic membrane was the most likely treatment to be effective for pain relief.At 2-6 months, botulinum toxin A was the treatment most likely to be effective for pain relief, while a treatment most likely to be effective beyond 12 months could not be identified from the limited amount of evidence available at this time point.The lack of trials available was a limiting factor of this network meta-analysis, exemplified by the lack of studies reporting data on micronized dehydrated human amniotic/chorionic membrane beyond 2 months. Further trials are... Read More »
Level 1 Meta Analysis
8%
Autologous whole blood vs. corticosteroids for epicondylopathy and plantar fasciopathy
①
Synopsis: The present study is a meta-analysis evaluating the efficacy of autologous whole blood (AWB) therapy versus corticosteroid injections in the treatment of epicondylopathy and plantar fasciopathy (PF).The primary outcome was pain relief at 2-6, 8-13, and 24-26 weeks.The authors included a total of 9 RCTs, and found statistically significant results in favour of corticosteroids at 2-6 weeks for patients with plantar fasciopathy, and in favour of AWB as early as 8 weeks up to 24 weeks for individuals with epicondylopathy. Read More »
Author verified Level 1 Meta Analysis
3%
Knee OA: NASHA intra-articular hyaluronic acid vs. methylprednisolone acetate
①
Synopsis: 442 patients suffering from unilateral knee pain were randomized to evaluate the safety and efficacy of 26 weeks of a single-injection of intra-articular non-animal stabilized hyaluronic acid (NASHA) compared to methylprednisolone acetate (MPA).Following 26 weeks of blinded evaluation, patients were offered a second injection with NASHA and were followed for an additional 26 weeks.The evidence presented in this study demonstrated that NASHA gel produced a non-inferior response rate in comparison to MPA.WOMAC pain, physical function, and stiffness evaluations favored NASHA over MPA during the blinded phase from 12 to 26 weeks.Sustained improvements were apparent in WOMAC outcomes irrespective of initial treatment in response to open-labeled extension with NASHA. No serious device-related... Read More »
Author verified Level 1 RCT
3%
Intra-articular hyaluronic acid provides longer pain relief as compared to corticosteroid
①
Synopsis: 7 randomized controlled trials (RCTs) were included in this meta-analysis comparing the effect of intra-articular hyaluronic acid (HA) injections and corticosteroids (CS) for the treatment of knee osteoarthritis (OA).Visual analog scale (VAS), Lequesne index, Knee Society Clinical Rating System (KSS), maximum flexion, and adverse events of treatments were measured.Analysis revealed that VAS scores between the two groups at one month were similar, but at 3 and 6 months, hyaluronic acid injections provided greater pain relief. The other measured... Read More »
Level 1 Meta Analysis
3%
Adjunct periarticular lidocaine-corticosteroid injection to IAHA improves pain in knee OA
②
Synopsis: 77 patients with symptomatic, Kellgren-Lawrence grade II-IV knee osteoarthritis were randomized to intraarticular hyaluronic acid (IAHA) injections with or without an additional, single periarticular lidocaine-corticosteroid injection (PALCI) at the beginning of treatment.The purpose of this study was to determine if the addition of PALCI to IAHA had a significant effect on pain after 1, 3, 6, 12, 26 and 52 weeks.Visual analog pain scores demonstrated significantly lower pain scores in the IAHA+PALCI group compared to the IAHA group at 1 and 3 weeks, while no significant differences between groups at 6, 12, 26 or 52 weeks. A significant within-group... Read More »
Level 2 RCT
2%
Efficacy of conservative treatments for thumb base osteoarthritis
②
Synopsis: 25 randomized controlled trials were included in this systematic review.The purpose of this study was to evaluate the efficacy of non-surgical treatments currently available for thumb base osteoarthritis.Treatments were assessed for impact on outcomes including thumb pain and function.The results of the included studies indicated that intra-articular hyaluronate injections reduced pain over long periods of time (1 year), whereas steroid intra-articular injections and leech therapy reduced pain over shorter periods of time. Orthoses were found... Read More »
Author verified Level 2 Meta Analysis
1%
Similar, modest effect on pain & function with hyaluronic acid & corticosteroid injection
②
Synopsis: 100 patients were randomized to evaluate the comparative efficacy of hyaluronic acid and corticosteroid injections in the treatment of knee osteoarthritis.Follow-up was conducted over 6 months.Results indicated that there was no difference between groups in terms of pain relief and improvement in function.Men appeared to have a better response than women to both treatments. Read More »
Level 2 RCT
1%
Knee OA - The therapeutic trajectory of corticosteroids and hyaluronic acid
①
Synopsis: 7 randomized controlled trials (RCTs) were included in this systematic review and meta-analysis comparing conservative treatment methods of intra-articular hyaluronic acid injections and corticosteroid injections.Pain scores were pooled at 2, 4, 8, 12, and 26 weeks post-injection.At early follow-up (2 weeks), treatment with corticosteroid injections resulted in lower pain when compared to treatment with hyaluronic acid injections.From 4-8 weeks, treatment displayed similar efficacy.At 12 weeks and 26 weeks, hyaluronic acid injections demonstrated significantly lower pain scores compared to corticosteroid injections. Read More »
Level 1 Meta Analysis
1%
Hyaluronic acid more effective versus methylprednisolone in the long term for knee OA
②
Synopsis: 99 patients with knee osteoarthritis (OA) were randomized to treatment with either hyaluronic acid (HA) or methylprednisolone acetate (MP) and followed up for 180 days.The purpose of this study was to determine the clinical efficacy and the structural effects of the two intra-articular injections.MP showed lower pain scores compared to HA initially following injection up to 35 days, although the differences between groups at 180 days post-injection were not significant. Second-look arthroscopy in... Read More »
Level 2 RCT