Table 1 Clinical studies evaluating the efficacy of injectable HA in osteoarthritic patients
From: Recent advances in hyaluronic acid based therapy for osteoarthritis
Authors | Years | Study type | Joint | Patient characteristics | HA injection characteristics | Outcome | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Number | Mean age | HA brand | HA molecular weight (kDa) | No. of injections | Comparison group | Follow up (months) | Pain improvement | ||||
HA injections in Hip osteoarthritis | |||||||||||
 Vad [58] | 2003 | Prospective | Hip | 22 | 56.4 | Hylan G-F 20® | 6000 | 3 | None | 12 | VAS pain improved |
 Berg [75] | 2004 | Prospective | Hip | 31 | NA | Durolane® | 90,000 | 1 | None | 3 | Not reported |
 Caglar-Yagci [76] | 2005 | Prospective | Hip | 14 | 65.3 | Hylan G-F 20® | 6000 | 3 | None | 3 | VAS pain improved |
 Tikiz [77] | 2005 | RCT | Hip | 48 | 60.4 | Hylan G-F 20® | 6000 | 3 | Na hyaluronate | 6 | VAS pain improved |
 Qvistgaard [78] | 2006 | RCT | Hip | 88 | 66 | Hyalgan® | 730 | 3 | Saline/prednisolone | 3 | No difference from saline group |
 Gaston [79] | 2007 | Prospective | Hip | 13 | 64 | Suplasyn | NA | 3 | None | 6 | Not reported |
 Rennesson-Rey [80] | 2008 | Prospective | Hip | 55 | NA | Hylan G-F 20® | 6000 | 1 | None | 6 | VAS pain improved |
 Richette et al. [81] | 2009 | RCT | Hip | 85 | 60 | Adant® | 900 | 1 | Saline | 3 | VAS pain improved |
 Migliore et [59] | 2009 | RCT | Hip | 42 | 70 | Hyalubrix® | 3200 | 2 | Mepivacaine | 6 | VAS pain improved |
 Spitzer et al. [82] | 2010 | RCT | Hip | 312 | 59 | Hylan G-F 20® | 6000 | 2 | Prednisolone |  |  |
 Eyigör [83] | 2010 | Prospective | Hip | 21 | 61.3 | Adant® | 900 | 3 | None | 6 | VAS pain improved |
 Atchia et al. [84] | 2011 | RCT | Hip | 57 | 69 | Durolane® | 90,000 | 1 | Saline/prednisolone | 2 | No difference from saline group |
 Battaglia et al. [57] | 2013 | RCT | Hip | 100 | 53 | Hyalubrix® | 3200 | 3 | PRP |  | VAS pain improved |
 Dallari et al. [85] | 2016 | RCT | Hip | 80 | 20–60 | Hyalubrix® | 3200 | 3 | PRP | 12 | WOMAC pain improved |
HA injections in ankle osteoarthritis | |||||||||||
 DeGroot et al. [86] | 2012 | RCT | Ankle | 56 | 54 | Supartz | 620–1170 | 1 | Saline | 3 | VAS pain improved |
 Cohen et al. [87] | 2008 | RCT | Ankle | 28 | 56.2 | Hyalgan® | 500–730 | 5 | Saline | 6 | WOMAC pain improved |
 Salk et al. [88] | 2006 | RCT | Ankle | 17 | 57.8 | Hyalgan® | 500–730 | 5 | Saline | 6 | No difference from saline group |
 Karatosun et al. [89] | 2008 | RCT | Ankle | 30 | 52.1 | Adant® | 900 | 3 | Physical therapy | 12 | VAS pain improved |
 Carpenter [90] | 2008 | Prospective | Ankle | 26 | 57 | Synvisc-one® | 6000 | 3 | Arthroscopy | 13 | Pain improved |
 Sun et al. [91] | 2011 | Prospective | Ankle | 46 | 51.7 | Hyalgan® | 500–730 | 3 | None | 6 | Pain improved |
 Luciani et al. [92] | 2008 | Prospective | Ankle | 21 | 45 | Synvisc-one® | 6000 | 3 | None | 18 | VAS pain improved |
 Witteveen et al. [93] | 2008 | Prospective | Ankle | 55 | 55 | Synvisc-one® | 6000 | 1 | None | 3 | VAS pain improved |
 Sun et al. [94] | 2006 | Prospective | Ankle | 75 | 50.2 | Artz | 620–1200 | 5 | None | 6 | Pain improved |
HA injections in knee osteoarthritis | |||||||||||
 Grecomoro [95] | 1987 | RCT | Knee | 34 | 65 | Hyalgan® | 500–730 | 3 | Placebo | 1.5 | VAS pain improved |
 Puhl [96] | 1993 | RCT | Knee | 209 | 61 | Supartz | 600–1200 | 5 | 0.25 mg hyaluronate/2.5 ml | 2 | VAS pain improved |
 Henderson [97] | 1994 | RCT | Knee | 91 | 66 | Hyalgan® | 500–750 | 5 | Placebo | 0 | No superior effect compared to placebo group (in mean joint space width (JSW) of the medial compartment) |
 Adams [98] | 1995 | RCT | Knee | 102 | 61 | Hylan G-F 20® | 6000 | 3 | NSAIDs/Arthrocentesis | 2 | WOMAC pain improved |
 Lohmander [99] | 1996 | RCT | Knee | 240 | 58 | Artzal ™ | 1000 | 5 | Placebo | 6 | VAS pain improved |
 Altman [44] | 1998 | RCT | Knee | 495 | 64 | Hyalgan® | 500–730 | 5 | Placebo/NSAIDs | 3 | WOMAC pain improved |
 Huskisson [53] | 1999 | RCT | Knee | 100 | 65 | Hyalgan® | 500–750 | 5 | Placebo | 3 | VAS pain improved |
 Brandt [48] | 2001 | RCT | Knee | 226 | 66 | Orthovisc® | 1000–2900 | 3 | Placebo | 3 | VAS pain improved |
 Bunyaratavej [100] | 2001 | RCT | Knee | 49 | 59 | Hyalgan® | 500–730 | 4 | Placebo | 1.6 | VAS pain improved |
 Jubb [101] | 2003 | RCT | Knee | 408 | 64 | Hyalgan® | 500–730 | 3 | Placebo | 3.5 | No superior effect compared to placebo group (in mean joint space width (JSW) of the medial compartment) |
 Altman [44] | 2004 | RCT | Knee | 347 | 63 | Durolane | 1000 | 1 | Placebo | 3 | No superior effect compared to placebo group |
 Chevalier [102] | 2010 | RCT | Knee | 235 | 63.6 | Synvisc-one® | 6000 | 1 | Placebo | 6.5 | WOMAC pain improved |
 Huang [55] | 2011 | RCT | Knee | 100 | 65.9 | Hyalgan® | 500–730 | 5 | Placebo | 6.25 | WOMAC pain improved |
 Lundsgaard [45] | 2008 | RCT | Knee | 84 | 68.8 | Hyalgan® | 500–730 | 4 | Placebo | 6.5 | No superior effect compared to placebo group |
 Neustadt [50] | 2005 | RCT | Knee | 115 | 58.4 | Orthovisc® | 1000–2900 | 4 | Arthrocenteses | 5.5 | WOMAC pain improved |
 Çubukçu [51] | 2004 | RCT | Knee | 30 | 52.6 | Hylan G-F 20® | 6000 | 8 | Placebo | 2 | WOMAC pain improved |
 Day [49] | 2003 | RCT | Knee | 116 | 62 | Artz™ | 620–1200 | 5 | Placebo | 4.5 | WOMAC pain improved |
 Petrella [52] | 2006 | RCT | Knee | 51 | 63.9 | HA sodium salt | NA | 6 | Placebo | 3 | VAS pain improved |
 Petrella [103] | 2002 | RCT | Knee | 54 | 65.5 | Suplasyn® | NA | 3 | Placebo | 1 | VAS pain improved |
 Strand et al. [104] | 2012 | RCT | Knee | 249 | 60 | Gel-One | NA | 1 | Placebo | 3 | WOMAC pain improved |
 Sun [40] | 2017 | RCT | Knee | 132 | 62.7 | HYA-JOINT Plus | NA | 1 | Synvisc-One | 6 | VAS pain improved |