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Published in: BioDrugs 2/2012

01-04-2012 | Systematic Review

Hyaluronic Acid for the Treatment of Osteoarthritis in all Joints Except the Knee

What is the Current Evidence?

Authors: Dr Sascha Colen, Daniel Haverkamp, Michiel Mulier, Michel P. J. van den Bekerom

Published in: BioDrugs | Issue 2/2012

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Abstract

Background

The use of intra-articular hyaluronic acid (HA) is a well known treatment in patients with knee osteoarthritis (OA). In other joints, less evidence is available about the efficacy of treatment with intra-articular HA. HA is also used intra-articularly in the metatarsophalangeal-1 joint, the ankle, the hip, the sacroiliac joint, the facet joints, the carpometacarpal-1 joint, the shoulder and the temporo-mandibular joint. In this systematic review we include all prospective studies about the effects of intra-articular HA in the above-mentioned joints. Its use in the knee joint, however, will be discussed in a separate article in this journal.

Methods

A systematic review was conducted using databases including MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Clinical Trial Register, and EMBASE.

Results

After performing a solid systematic review using a rigid methodology and trying to pool the outcomes of different studies, we noticed that, compared with baseline, there is statistical evidence for a positive effect of intra-articular HA. However, there is limited evidence HA is superior to placebo and no evidence that intra-articular HA is better than corticosteroids or other conservative therapies.

Conclusion

Our recommendation for future research is that one should focus on adequately powered randomized trials comparing HA treatment with other types of intra-articular or conservative treatment. We think it is useless to further perform and publish (large) non-comparative prospective studies about the use of HA in the treatment of problems caused by OA. It is well perceived that HA exerts positive effects in the treatment of OA, but up to now there is no (strong) evidence available that HA is superior to other treatments of OA such as corticosteroids, physiotherapy or other conservative measures.
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Metadata
Title
Hyaluronic Acid for the Treatment of Osteoarthritis in all Joints Except the Knee
What is the Current Evidence?
Authors
Dr Sascha Colen
Daniel Haverkamp
Michiel Mulier
Michel P. J. van den Bekerom
Publication date
01-04-2012
Publisher
Springer International Publishing
Published in
BioDrugs / Issue 2/2012
Print ISSN: 1173-8804
Electronic ISSN: 1179-190X
DOI
https://doi.org/10.2165/11630830-000000000-00000

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