Table 4.
Efficacy of hyaluronic acid compared to other types of intra-articular injections.
| Variable | Study | Comparison | Follow-Up | HA Cohort (Mean ± SD) | Comparison Cohort (Mean ± SD) | p-value | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Lequesne Index | Migliore et al.27 | Mepivacaine | 3-months 6-months |
5.15 ± 5.15 3.94 ± 2.58 |
6.53 ± 4.33 6.41 ± 4.14 |
<0.001 <0.05 |
||||
| VAS | Dallari et al.37 | PRP | 2-month 6-month 12-month |
38 44 42 |
23 21 24 |
0.026 0.0005 0.002 |
||||
| Battaglia et al.38 | 1-month 3-months 6-months 12-months |
3.58 3.80 4.04 4.59 |
3.72 3.80 4.29 4.75 |
>0.05 >0.05 >0.05 >0.05 |
||||||
| Di Sante et al.36 | 4-weeks 16-weeks |
5.27 ± 1.6 3.63 ± 2.1 |
4.73 ± 3.4 6.36 ± 2.1 |
N/A 0.0004 |
||||||
| Qvistgaarde et al.44 | Placebo | 2-weeks 4-weeks 3-months |
N/A | 0.13 | ||||||
| Corticosteroid | 0.069 0.14 0.57 |
|||||||||
| Richette et al.40 | Placebo | 3-months | −7.8 ± 24.9a | −9.1 ± 27.4a | >0.05 | |||||
| Migliore et al.27 | Mepivacaine | 3-months 6-months |
4.3 ± 2.58 4.5 ± 1.96 |
4.5 ± 2.63 5.0 ± 2.41 |
<0.05 <0.05 |
|||||
| WOMAC - Pain | Di Sante et al.36 | PRP | 4-weeks 16-weeks |
29.6 ± 13.4 19.9 ± 11.4 |
44.27 ± 28.8 53.47 ± 2.3 |
N/A | ||||
| Richette et al.40 | Placebo | 3-months | −8.6 ± 22.3a | −7.5 ± 24.6a | >0.05 | |||||
| Spitzer et al.51 | Methylprednisolone acetate | 26-weeks | −16.62 ± 2.40a | −13.59 ± 2.38 | 0.8496 | |||||
| Brander et al.49 | Placebo | 4-weeks 8-weeks 12-weeks 16-weeks 20-weeks 26-weeks |
−1.83 ± 0.15† −2.27 ± 0.19† −2.12 ± 0.18† −2.42 ± 0.20† −2.28 ± 0.19† −2.23 ± 0.21† |
−1.95 ± 0.16† −2.36 ± 0.19† −2.44 ± 0.19† −2.32 ± 0.20† −2.20 ± 0.19† −2.30 ± 0.22† |
0.5753 0.7344 0.2140 0.7180 0.7817 0.8352 |
|||||
| Atchia et al.50 | Methylprednisolone acetate | Saline | No-Injection | 1-week 1-month 2-months |
N/A | 0.003‡ | ||||
| WOMAC - Function | Di Sante et al.36 | PRP | 4-weeks 16-weeks |
39.13 ± 17.2 28.39 ± 17.2 |
49.13 ± 29.1 50.80 ± 22.8 |
N/A | ||||
| Richette et al.40 | Placebo | 3-months | −6.7 ± 22.7a | −5.7 ± 19.9a | >0.05 | |||||
| Spitzer et al.51 | Methylprednisolone acetate | 4-weeks 26-weeks |
−18.19 ± 1.79a −13.80 ± 2.32a |
−26.57 ± 1.73a −11.53 ± 2.30a |
0.0005 0.4751 |
|||||
| Brander et al.49 | Placebo | 4-weeks 8-weeks 12-weeks 16-weeks 20-weeks 26-weeks |
−1.81 ± 0.16† −2.14 ± 0.18† −1.94 ± 0.19† −2.27 ± 0.2† −2.05 ± 0.19† −2.09 ± 0.21† |
−1.83 ± 0.16† −2.23 ± 0.19† −2.28 ± 0.19† −2.17 ± 0.20† −2.01 ± 0.20† −2.06 ± 0.17† |
0.9304 0.7226 0.1916 0.7394 0.8658 0.8753 |
|||||
| Atchia et al.50 | Methylprednisolone acetate | Saline | No-Injection | 1-week 1-month 2-months |
N/A | 0.009‡ | ||||
| WOMAC - Total | Dallari et al.37 | PRP | 2-month 6-month 12-month |
59 59 – |
73 72 – |
0.009 0.009 >0.05 |
||||
| Spitzer et al. | Methylprednisolone acetate | 4-weeks 26-weeks |
−18.18 ± 1.75a −14.70 ± 2.32a |
−26.98 ± 1.69a −12.00 ± 2.29a |
0.0002 0.3959 |
|||||
| Richette et al.40 | Placebo | 3-months | −6.2 ± 21.3 | −6.5 ± 20.2 | >0.05 | |||||
| HHS | Dallari et al.37 | PRP | 2-month 6-month 12-month |
N/A | >0.05 >0.05 >0.05 |
|||||
| Battaglia et al.38 | 1-month 3-months 6-months 12-months |
78.02 77.23 75.79 72.55 |
73.72 72.90 70.23 65.73 |
>0.05 >0.05 >0.05 >0.05 |
||||||
| Doria et al.35 | PRP | 6-months 12-months |
75 ± 11.5 78 ± 11.3 |
74 ± 12.3 75 ± 11.4 |
N/A | |||||
| Patient Global Self-Assessment | Brander et al.49 | Placebo | 4-weeks 8-weeks 12-weeks 16-weeks 20-weeks 26-weeks |
−1.68 ± 0.16† −2.16 ± 0.19† −1.84 ± 0.19† −2.28 ± 0.20† −1.97 ± 0.21† −2.07 ± 0.22† |
−1.89 ± 0.17† −2.31 ± 0.20† −2.19 ± 0.19† −2.09 ± 0.21† −1.78 ± 0.21† −2.11 ± 0.23† |
0.3664 0.5852 0.1944 0.5013 0.5143 0.9193 |
||||
| Richette et al.40 | Placebo | 3-months | −7.0 ± 24.9a | −5.4 ± 27.2a | >0.05 | |||||
| Migliore et al.27 | Mepivacaine | 3-months 6-months |
4.5 ± 2.31 4.0 ± 2.06 |
4.7 ± 2.33 4.9 ± 2.01 |
>0.05 >0.05 |
|||||
| Spitzer et al.51 | Methylprednisolone acetate | 4-weeks 26-weeks |
−17.11 ± 1.94a −16.67 ± 2.25a |
−26.10 ± 1.88a −12.71 ± 2.51a |
0.0006 0.2537 |
|||||
a
Values reported as Standard Error of the Mean (SEM). HA: Hyaluronic Acid; PRP: Platelet-Rich Plasma; NS: Normal Saline; UHMW: Ultra High Molecular Weight; HMW: High Molecular Weight; MMW: Medium Molecular Weight; LMW: Low Molecular Weight; THA: total hip arthroplasty; VAS: visual analog scale; HHS: Harris Hip Score; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index; N/A: Information Not Available; KL: Kellgren-Lawrence; SD: standard deviation.