Q&A

Hyaluronic acid minimally effective for knee osteoarthritis

J Fam Pract. 2004 April;53(4):261-268
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  • CLINICAL QUESTION: Is intra-articular hyaluronic acid effective in the treatment of knee osteoarthritis?
  • STUDY DESIGN: Meta-analysis (randomized controlled trials)
  • SETTING: Various (meta-analysis)
  • SYNOPSIS: Intra-articular hyaluronic acid for knee osteoarthritis is an expensive therapy that has been widely used since US Food and Drug Administration approval in 1997. The efficacy of this procedure remains, however, controversial.
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BOTTOM LINE

Intra-articular hyaluronic acid (Provisc, Synvisc, Suplasyn) is minimally, if at all, more effective than placebo in the treatment of knee osteoarthritis. The evidence of publication bias against negative trials in this meta-analysis suggests that any overall positive effect is overestimated. The highest-molecular-weight hyaluronic acid (Synvisc) may be more effective than lower-molecular-weight hyaluronic acid. (LOE=1a–)

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