AMSSM scientific statement concerning viscosupplementation injections for knee osteoarthritis: importance for individual patient outcomes

Osteoarthritis (OA) is a disabling disease that produces severe morbidity reducing physical activity. Our position statement on treatment of knee OA with viscosupplementation injection (hyaluronic acid, HA) versus steroid (intra-articular corticosteroids, IAS) and placebo (intra-articular placebo, I...

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Bibliographic Details
Published in:British journal of sports medicine 2016-01, Vol.50 (2), p.84-92
Main Authors: Trojian, Thomas H, Concoff, Andrew L, Joy, Susan M, Hatzenbuehler, John R, Saulsberry, Whitney J, Coleman, Craig I
Format: Article
Language:English
Subjects:
Age
Arthritis
Bias
Exercise
Female
Humans
Hyaluronic Acid - administration & dosage
Injections, Intra-Articular
Knee
Male
Medical treatment
Medicine
Middle Aged
Morbidity
Osteoarthritis, Knee - therapy
Pain
Randomized Controlled Trials as Topic
Sports medicine
Studies
Ultrasonic imaging
Viscosupplementation - methods
Viscosupplements - administration & dosage
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Summary:Osteoarthritis (OA) is a disabling disease that produces severe morbidity reducing physical activity. Our position statement on treatment of knee OA with viscosupplementation injection (hyaluronic acid, HA) versus steroid (intra-articular corticosteroids, IAS) and placebo (intra-articular placebo, IAP) is based on the evaluation of treatment effect by examining the number of participants within a treatment arm who met the Outcome Measures in Rheumatoid Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) criteria, which is different and more relevant than methods used in other reviews which examined if the average change across the treatment groups were clinically different. We performed a systematic literature search for all relevant articles from 1960 to August 2014 in the MEDLINE, EMBASE and Cochrane CENTRAL. We performed a network meta-analysis (NMA) of the relevant literature to determine if there is a benefit from HA as compared with IAS and IAP. 11 papers met the inclusion criteria from the search strategy. On NMA, those participants receiving HA were 15% and 11% more likely to respond to treatment by OMERACT-OARSI criteria than those receiving IAS or IAP, respectively (p
ISSN:0306-3674
1473-0480
DOI:10.1136/bjsports-2015-095683