Hyaluronic Acid Injections For Treatment Research Articles

Efficacy of Hyaluronic Acid Injections in the Treatment of Osteoarthritis of the Knee

Background: Hyaluronic acid injections for treatment of osteoarthritis of the knee are a widely used yet highly controversial therapy. Many societal guidelines recommend against the use of such injections. Objective: This review aims to investigate efficacy of intra-articular hyaluronic acid injections for treatment of osteoarthritis of the knee. Conclusion: There are many factors impacting the efficacy of intra-articular hyaluronic acid injections. This can include source of hyaluronic acid, dosing regimen, molecular weight of the product, and patient characteristics. Overall, hyaluronic acid injections can be effective in reducing pain and improving physical function in patients with osteoarthritis of the knee. These injections may also prolong time between diagnosis and arthroplasty. Adverse events after injection are rare and can be product-related. Radiologic findings and severity of disease can be predictive of successful treatment outcomes. More consistent research will be necessary to overturn societal guideline recommendations to support treatment with intra-articular hyaluronic acid products.

A comparative study of 60 patients to compare the efficacy of P-PRP (Pure-platelet rich plasma) v/s hyaluronic acid injection in treatment of osteoarthritis of knee

Objective: To compare efficacy of PRP v/s hyalonuric acid administration in cases of osteoarthritis of knee. Method: Analysis of two goups of 30 patients each who were administered PRP and Hyalonuric acid respectively. Results: Result was analysed in terms of VAS and WOMAC scores, with PRP showing better results all together. Conclusion: Local administration of PRP gives better long term outcome.

Outcome of hyaluronic acid injection in treatment of symptomatic osteoarthritis of the knee

Outcome of hyaluronic acid injection in treatment of symptomatic osteoarthritis of the knee

A study assessing intra-articular PRP vs PRP with HMW HA vs PRP with LMW HA in early knee osteoarthritis

ObjectiveWe aim to study the effects of platelet rich plasma (PRP) and hyaluronic acid injections in treatment of early Osteoarthritis (OA). We assess which form of HA is most beneficial and whether combining PRP and HA have a better clinical outcome. DesignData: Cases diagnosed with early knee OA in the department of Orthopedic's, K. S. Hegde Medical Academy.Sample Size: Total 51 patients divided into 3 groups•Group 1: PRP group•Group 2: PRP with LMW HA•Group 3: PRP with HMW HAInclusion criteria•Pain or swelling of knee >4 months•Kellgren Lawrence 0-III on X-rayExclusion criteria•Kellgren-Lawrence >grade 3•Rheumatoid arthritis•Haematological diseases•Severe cardiovascular diseases•Infections•Diabetes Mellitus•Patients in therapy with anticoagulants or anti aggregants Study MethodPatients selected based on inclusion criteria and using block randomisation divided into a group. Pre injection visual analogue score (VAS) and International knee documentation committee score (IKDC) proforma are done. The decided injection is then performed and the patient followed up at 6 weeks and 6 months. StatisticsPaired T testOne way Anova and Posthoc testP=0.05 significant ResultsAll groups showed statistically significant decrease in VAS score and increase in IKDC scores with P<0.05. LMW+ PRP injection showed the greatest difference in IKDC and VAS scores though this difference was not statistically significant. ConclusionAll injections are a beneficial form of treatment. LMW HA + PRP is the most beneficial injection all though not statistically significant.

Hyaluronic Acid Injections for Treatment of Advanced Osteoarthritis of the Knee: Utilization and Cost in a National Population Sample.

The prevalence of knee osteoarthritis is increasing in the aging U.S. The efficacy and cost-effectiveness of the use of hyaluronic acid (HA) injections for the treatment of knee osteoarthritis are debated. In this study, we assessed the utilization and costs of HA injections in the 12 months preceding total knee arthroplasty (TKA) and evaluated the usage of HA injections in end-stage knee osteoarthritis management in relation to other treatments. MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases (Truven Health Analytics) were reviewed to identify patients who underwent TKA from 2005 to 2012. The utilization of patient-specific osteoarthritis-related health care (including medications, corticosteroid injections, HA injections, imaging, and office visits) and payment information were analyzed for the 12 months preceding TKA. A total of 244,059 patients met the inclusion criteria. Of those, 35,935 (14.7%) had ≥1 HA injection in the 12 months preceding TKA. HA injections were responsible for 16.4% of all knee osteoarthritis-related payments, trailing only imaging studies (18.2%), and HA injections accounted for 25.2% of treatment-specific payments, a rate that was higher than that of any other treatment. Patients receiving HA injections were significantly more likely to receive additional knee osteoarthritis-related treatments compared with patients who did not receive HA injections. Despite numerous studies questioning the efficacy and cost-effectiveness of HA injections for osteoarthritis of the knee, HA injections are still utilized for a substantial percentage of patients. Given the paucity of data supporting the effectiveness of HA injections and the current cost-conscious health-care climate, decreasing their use among patients with end-stage knee osteoarthritis may represent a substantial cost reduction that likely does not adversely impact the quality of care.

Appropriate Use Criteria for Hyaluronic Acid in the Treatment of Knee Osteoarthritis in the United States.

Objective:A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria.Methods:The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy. This workgroup utilized the results of a systematic review of evidence, expert clinical opinion, and current evidence-based clinical practice guidelines to develop appropriateness criteria for the use of intra-articular HA for knee OA in 17 real-world clinical scenarios.Results:The workgroup scored the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as appropriate (7-9), uncertain (4-6), or inappropriate (1-3). Six scenarios were scored as appropriate, 10 scenarios were scored as uncertain, and 1 scenario was scored as inappropriate.Conclusion:This article can assist clinicians in shared decision-making by providing best practices in considering HA injections for knee OA treatment. Moreover, this AUC article can aid payers and policy makers in determining reimbursement and preauthorization policies and more appropriately managing health care resources. It is clear that further research is still necessary—particularly in patient populations differentiated by OA severity—that may benefit the greatest from the use of HA injections for the treatment of knee OA.