Migliorini Filippo, Maffulli Nicola, Schäfer Luise, Kubach Joshua, Betsch Marcel, Pasurka Mario
Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100 Bolzano, Italy.
Department of Life Sciences, Health, and Health Professions, Link Campus University, 00165 Rome, Italy.
Pharmaceuticals (Basel). 2024 Nov 20;17(11):1557. doi: 10.3390/ph17111557.
The present meta-analysis investigated the efficacy of intra-articular hyaluronic acid (HA) injections for knee osteoarthritis. The outcomes of interest were the visual analogue scale (VAS) and Western Ontario McMaster Osteo-Arthritis Index (WOMAC) scores. This study was conducted according to the 2020 PRISMA statement. All the randomised controlled trials (RCTs) comparing the efficacy of intra-articular HA injections versus placebo injections for knee osteoarthritis were accessed in September 2024. Data from 3851 patients were collected. In total, 64% (2467 of 3851 patients) were women, and the mean age of the patients was 63.5 ± 4.9 years. At baseline, good comparability was found for the mean age, BMI, percentage of women, and patient-reported outcome measures (PROMs). Studies which reported data from two to four weeks of follow-up evidenced a lower value of the subscales pain ( < 0.0001) and stiffness ( = 0.01) of the WOMAC score. No difference was observed in VAS at rest ( = 0.4), VAS at exercise ( = 0.1), and subscale function ( = 0.4) of the WOMAC score. Studies which reported data from five to eight weeks of follow-up evidenced lower VAS at rest in favour of the HA group ( = 0.01). No difference in the other PROMs of interest was observed: VAS at exercise ( = 0.1), and the subscales pain ( = 0.3), function ( = 0.4), and stiffness ( = 0.4) of the WOMAC score. The current level I of evidence suggests that intra-articular HA injections in the knee might reduce pain in the short term.
本荟萃分析研究了关节腔内注射透明质酸（HA）治疗膝关节骨关节炎的疗效。感兴趣的结果指标是视觉模拟量表（VAS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分。本研究按照2020年PRISMA声明进行。2024年9月检索了所有比较关节腔内注射HA与安慰剂注射治疗膝关节骨关节炎疗效的随机对照试验（RCT）。收集了3851例患者的数据。其中，64%（3851例患者中的2467例）为女性，患者的平均年龄为63.5±4.9岁。在基线时，发现平均年龄、体重指数、女性百分比和患者报告结局指标（PROMs）具有良好的可比性。报告随访2至4周数据的研究表明，WOMAC评分的疼痛子量表（<0.0001）和僵硬子量表（=0.01）的值较低。在静息时的VAS（=0.4）、运动时的VAS（=0.1）和WOMAC评分的功能子量表（=0.4）方面未观察到差异。报告随访5至8周数据的研究表明，静息时VAS较低，有利于HA组（=0.01）。在其他感兴趣的PROMs方面未观察到差异：运动时的VAS（=0.1）以及WOMAC评分的疼痛子量表（=0.3）、功能子量表（=0.4）和僵硬子量表（=其0.4）。目前的证据等级I表明，膝关节腔内注射HA可能在短期内减轻疼痛。
