Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis

Rutjes AW, Jüni P, da Costa BR, et al. · Annals of Internal Medicine

Overall pain effect size -0.37, but the 18 large blinded trials (5,094 patients) showed a clinically irrelevant -0.11, and unpublished trials -0.03 — the apparent benefit lives in small, unblinded, published trials. Serious adverse events were increased (RR 1.41).

Population

89 trials, 12,667 adults with knee OA

Intervention

Intra-articular hyaluronic acid (viscosupplementation)

Comparator

Sham or non-intervention

Limitations

Trial heterogeneity across HA products; conclusions driven by sensitivity analyses of trial size and blinding.