The Use of Hyaluronic Acid and Corticosteroid Injections Among Medicare Patients With Knee Osteoarthritis

Abstract Introduction Hyaluronic acid (HA) and corticosteroid (CS) injections are frequently used in the management of osteoarthritis (OA) of the knee, despite a lack of strong evidence supporting their efficacy in the literature. The purpose of this study is to evaluate trends in HA and CS usage in...

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Bibliographic Details
Published in:The Journal of arthroplasty 2016-02, Vol.31 (2), p.351-355
Main Authors: Koenig, Karl M., MD, MS, Ong, Kevin L., PhD, Lau, Edmund C., MS, Vail, Thomas P., MD, Berry, Daniel J., MD, Rubash, Harry E., MD, Kurtz, Steven, PhD, Bozic, Kevin J., MD, MBA
Format: Article
Language:English
Subjects:
corticosteroid injections
Databases, Factual
Female
Glucocorticoids - administration & dosage
Humans
hyaluronic acid
Hyaluronic Acid - administration & dosage
Injections, Intra-Articular
intra-articular injections
Knee Joint
knee osteoarthritis
Male
Medicare
Middle Aged
Orthopedics
osteoarthritis
Osteoarthritis, Knee - drug therapy
United States
Viscosupplements - administration & dosage
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Summary:Abstract Introduction Hyaluronic acid (HA) and corticosteroid (CS) injections are frequently used in the management of osteoarthritis (OA) of the knee, despite a lack of strong evidence supporting their efficacy in the literature. The purpose of this study is to evaluate trends in HA and CS usage in Medicare patients over the past 15 years. Methods The Medicare 5% national sample database was used to identify 581,022 patients (representing an estimated 11.6 million) with a diagnosis of knee OA between 1999 and 2013. Results The percentage of newly diagnosed knee OA patients who received any injection trended from 39% in 1999 to 47% in 2006 and then declined to 37.5% in 2013. However, the mean number of injections per newly diagnosed OA patient nearly doubled from 0.27 to 0.45 for CS and from 0.18 to 0.36 for HA. Among those having both HA and CS injections, 69% had CS as first-line treatment, whereas 31% had HA first. Conclusion The percentage of newly diagnosed knee OA patients receiving injections peaked in 2007 and then decreased steadily through 2013, as did the proportion of patients receiving HA injections as first-line therapy. However, the number of injections per patient has increased significantly over the past 15 years in both groups.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2015.08.024