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Article

Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta‑analysis

  • Authors:
    • Fang Wang
    • Xijing He
  • View Affiliations / Copyright

    Affiliations: Orthopedics Department, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
  • Pages: 493-500
    |
    Published online on: December 15, 2014
       https://doi.org/10.3892/etm.2014.2131
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Abstract

The aim of the present study was to evaluate the therapeutic effect of intra‑articular hyaluronic acid (HA) in comparison to corticosteroids (CS) for knee osteoarthritis (OA). The data sources included PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and hand searched reviews. Randomized controlled trials that reported the effects of intra‑articular HA and CS in the treatment of knee OA were selected based on specific inclusion criteria. A meta‑analysis was performed for the visual analog scale (VAS), Lequesne index, Knee Society Clinical Rating System (KSS), maximum flexion and adverse events of knee OA. Sensitivity analysis was also conducted to avoid bias. The seven eligible trials included 583 participants and the majority of the trials were of high quality. After one month, the mean difference in the VAS was 1.66 [95% confidence interval (CI); ‑0.90, 4.23), indicating equal efficacy for HA and CS. However, after three months, the mean difference was ‑12.58 (95% CI; ‑17.76, ‑7.40), while after six months, the difference was ‑9.01 (95% CI; ‑12.62, ‑5.40), favoring HA. For the additional indicators, including the Lequesne index, the KSS, maximum flexion and adverse events, no statistically significant differences were observed between the two treatment approaches for knee OA. Therefore, the results of the meta‑analysis highlight a therapeutic trajectory for intra‑articular HA in knee OA pain, as compared with CS, over six months post‑intervention. After one month, the two approaches exhibited equal efficacy; however, in the long term, HA was found to have an enhanced effect. No statistically significant difference was observed in the adverse events caused by the two interventions. Further investigation and understanding into the trend observed in the present study may aid clinicians in the treatment of knee OA.
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Copy and paste a formatted citation
Spandidos Publications style
Wang F and He X: Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta‑analysis. Exp Ther Med 9: 493-500, 2015.
APA
Wang, F., & He, X. (2015). Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta‑analysis. Experimental and Therapeutic Medicine, 9, 493-500. https://doi.org/10.3892/etm.2014.2131
MLA
Wang, F., He, X."Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta‑analysis". Experimental and Therapeutic Medicine 9.2 (2015): 493-500.
Chicago
Wang, F., He, X."Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta‑analysis". Experimental and Therapeutic Medicine 9, no. 2 (2015): 493-500. https://doi.org/10.3892/etm.2014.2131
Copy and paste a formatted citation
x
Spandidos Publications style
Wang F and He X: Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta‑analysis. Exp Ther Med 9: 493-500, 2015.
APA
Wang, F., & He, X. (2015). Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta‑analysis. Experimental and Therapeutic Medicine, 9, 493-500. https://doi.org/10.3892/etm.2014.2131
MLA
Wang, F., He, X."Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta‑analysis". Experimental and Therapeutic Medicine 9.2 (2015): 493-500.
Chicago
Wang, F., He, X."Intra-articular hyaluronic acid and corticosteroids in the treatment of knee osteoarthritis: A meta‑analysis". Experimental and Therapeutic Medicine 9, no. 2 (2015): 493-500. https://doi.org/10.3892/etm.2014.2131
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