HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Watterson, J. R. Articles by Esdaile, J. M. Search for Related Content PubMed PubMed Citation Articles by Watterson, J. R. Articles by Esdaile, J. M.

Viscosupplementation: Therapeutic Mechanisms and Clinical Potential in Osteoarthritis of the Knee

Dr. Watterson is Rheumatology Fellow, University of British Columbia, Vancouver. Dr. Esdaile is Professor of Medicine, University of British Columbia, and Scientific Director, Arthritis Research Centre of Canada, Vancouver.

Reprint requests: Dr. Esdaile, Scientific Director, Arthritis Research Centre of Canada, 895 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1L7.

Viscosupplementation by means of intra-articular injections of hyaluronic acid has been used to treat osteoarthritis of the knee. The proposed mechanisms of action result from the physical properties of hyaluronic acid, as well as from its anti-inflammatory, anabolic, local analgesic, and chrondroprotective effects. Adverse reactions from hyaluronic acid injections into the knee occurred in 8.3% of the 336 patients treated in one study, but at a rate of less than 3% per injection. Reactions were almost always local and generally resolved over 1 to 2 days. Hyaluronic acid injections were approved by the US Food and Drug Administration as a medical device; thus, the level of efficacy demonstrated is less than might have been required for approval as a drug. Several studies have failed to show statistically significant benefit compared with placebo. Furthermore, the treatment is relatively expensive; the cost of the drug for a series of injections is more than $500 per knee. Therefore, widespread use of these agents should be limited until more convincing data on their efficacy are available from well-designed clinical trials.

This article has been cited by other articles:

				E. J. Strauss, J. A. Hart, M. D. Miller, R. D. Altman, and J. E. Rosen Hyaluronic Acid Viscosupplementation and Osteoarthritis: Current Uses and Future Directions Am. J. Sports Med., August 1, 2009; 37(8): 1636 - 1644. [Abstract] [Full Text] [PDF]

				E. Silverstein, R. Leger, and K. P. Shea The Use of Intra-articular Hylan G-F 20 in the Treatment of Symptomatic Osteoarthritis of the Shoulder: A Preliminary Study Am. J. Sports Med., June 1, 2007; 35(6): 979 - 985. [Abstract] [Full Text] [PDF]

				G. D Deyle, S. C Allison, R. L Matekel, M. G Ryder, J. M Stang, D. D Gohdes, J. P Hutton, N. E Henderson, and M. B Garber Physical Therapy Treatment Effectiveness for Osteoarthritis of the Knee: A Randomized Comparison of Supervised Clinical Exercise and Manual Therapy Procedures Versus a Home Exercise Program Physical Therapy, December 1, 2005; 85(12): 1301 - 1317. [Abstract] [Full Text] [PDF]

				M. A. Pourbagher, M. Ozalay, and A. Pourbagher Accuracy and Outcome of Sonographically Guided Intra-articular Sodium Hyaluronate Injections in Patients With Osteoarthritis of the Hip J. Ultrasound Med., October 1, 2005; 24(10): 1391 - 1395. [Abstract] [Full Text] [PDF]

				S. Morshed, G. R. Huffman, and M. D. Ries Septic Arthritis of the Hip and Intrapelvic Abscess Following Intra-Articular Injection of Hylan G-F 20. A Case Report J. Bone Joint Surg. Am., April 1, 2004; 86(4): 823 - 826. [Full Text] [PDF]

				C.-T. Wang, J. Lin, C.-J. Chang, Y.-T. Lin, and S.-M. Hou Therapeutic Effects of Hyaluronic Acid on Osteoarthritis of the Knee. A Meta-Analysis of Randomized Controlled Trials J. Bone Joint Surg. Am., March 1, 2004; 86(3): 538 - 545. [Abstract] [Full Text] [PDF]

				M. Ulrich-Vinther, M. D. Maloney, E. M. Schwarz, R. Rosier, and R. J. O'Keefe Articular Cartilage Biology J. Am. Acad. Ortho. Surg., November 1, 2003; 11(6): 421 - 430. [Abstract] [Full Text] [PDF]

				R. Iorio and W. L. Healy Unicompartmental Arthritis of the Knee J. Bone Joint Surg. Am., July 3, 2003; 85(7): 1351 - 1364. [Full Text] [PDF]

				A. L. Chen, P. Desai, E. M. Adler, and P. E. Di Cesare Granulomatous Inflammation After Hylan G-F 20 Viscosupplementation of the Knee : A Report of Six Cases J. Bone Joint Surg. Am., July 9, 2002; 84(7): 1142 - 1147. [Abstract] [Full Text] [PDF]