In the ongoing quest to manage knee osteoarthritis (OA), hyaluronic acid injections, known as intra-articular hyaluronic acid (IAAH), have emerged as a promising treatment option. Experts have highlighted the benefits of IAAH, particularly its favorable benefit/risk ratio and its potential efficacy over nonsteroidal anti-inflammatory drugs (NSAIDs). This treatment is suitable for most patients with symptomatic knee OA, regardless of age, and is notably devoid of drug interactions. However, it is crucial to understand the specific conditions under which IAAH injections are recommended.
IAAH injections are well-suited for frail populations and those facing moderate to severe obesity, with a body mass index (BMI) ranging from 30 to 40. Furthermore, patients with mild to moderate femorotibial or patellofemoral OA, as well as those with advanced radiographic cases, may find IAAH injections beneficial. Viscosupplementation, the process of injecting hyaluronic acid into the knee joint, is also a viable option for individuals with type 1 or type 2 diabetes, gout, or metabolic syndrome.
Despite these advantages, IAAH injections are not advised for all scenarios. They are not recommended for patients experiencing large synovial effusions exceeding 20 mL, acute flare-ups of knee OA, or those suffering from inflammatory knee pain. In such cases, alternatives like NSAIDs, ice application, or intra-articular steroids may offer more appropriate relief.
"Rather than challenging the effectiveness of IAHA in the general population, we must distinguish the good, bad, and poor indications and identify the characteristics of patients which can influence the response to this treatment." – EUROVISCO group
The EUROVISCO group underscores the importance of understanding patient-specific factors when considering IAAH treatment. The group's insights suggest that while IAAH could be highly effective for many, it is essential to tailor the treatment approach to individual patient profiles.
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