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In osteoarthritis, there is a loss of articular hyaluronic acid activity, likely contributing to pain and stiffness associated with the condition. Hyaluronic acid injections are an FDA-approved treatment for osteoarthritis of the knee, and are sometimes also used for other joints. However, the merits of HA injections are still disputed.
In osteoarthritis, joint injection of glucocorticoids (such as hydrocortisone) leads to short term pain relief that may last between a few weeks and a few months. [5] Injections of hyaluronic acid have not produced improvement compared to placebo for knee arthritis, [6] [7] but did increase risk of further pain. [6]
A 2020 meta-analysis found that intra-articular injection of high molecular weight HA improved both pain and function in people with knee osteoarthritis. [27] Hyaluronic acid has been used to treat dry eye. [28] Hyaluronic acid is a common ingredient in skin care products. Hyaluronic acid is used as a dermal filler in cosmetic surgery. [29]
Ultrasound-guided hip joint injection: A skin mark is made to mark the optimal point of entry for the needle. [111] Use of analgesia, intra-articular cortisone injection and consideration of hyaluronic acids and platelet-rich plasma are recommended for pain relief in people with knee osteoarthritis. [112]
A 2017 review described the evidence as moderate for knee osteoarthritis. [15] A 2016 review found benefit but there was a moderate degree of variability between trials and risk of bias. [16] In 2019, the American College of Rheumatology recommended against prolotherapy for knee osteoarthritis. [17]
A 2011 study reported histologically confirmed hyaline cartilage regrowth in the knee. The successful protocol involved arthroscopic microdrilling/ microfracture surgery followed by postoperative injections of autologous peripheral blood progenitor cells (PBPCs) and hyaluronic acid. [15]