medwireNews: Findings from a systematic review and meta-analysis indicate that viscosupplementation does not significantly improve pain and physical function in people with knee osteoarthritis, but increases the risk for serious adverse events.
Bruno da Costa (University of Toronto, Ontario, Canada) and co-authors analyzed data from 25 placebo-controlled trials including a total of 9423 patients, finding that viscosupplementation – defined as intra-articular injection with any hyaluronic acid preparation or a hyaluronic acid derivative – achieved a “small, non-clinically relevant” decrease in pain intensity.
Specifically, the pooled standardized mean difference (SMD) for viscosupplementation versus placebo was –0.08, and the lower bound of the 95% confidence interval excluded the minimal clinically important difference. These findings corresponded to a reduction in pain intensity of 2 mm on a 100 mm visual analog scale with viscosupplementation relative to placebo.
Similarly, viscosupplementation resulted in a small improvement in physical function when compared with placebo, with an SMD of –0.11 that did not meet the threshold for clinical importance.
Despite the lack of benefits with viscosupplementation, the study authors found that the procedure was associated with a significant 1.49-fold increased risk for serious adverse events relative to placebo, at rates of 3.7% versus 2.5%.
“Our findings do not support the broad use of viscosupplementation for the treatment of knee osteoarthritis,” concludes the team in The BMJ.
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