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Patients with knee osteoarthritis often are treated with viscosupplementation (intra-articular injections of hyaluronic acid [HA]). HA injections are expensive, and their efficacy is controversial. In this meta-analysis, researchers identified randomized trials of viscosupplementation that had at least 4 weeks of follow-up and at least 30 patients per treatment group; trials were included if either the WOMAC osteoarthritis index or a visual analog pain scale was used to assess outcomes. The minimum important differences for pain and function are 8 points on the 100-point WOMAC scale, and 20 mm on a 100-mm visual analog scale.
Nineteen trials met inclusion criteria. In double-blind, sham-controlled trials, HA reduced mean pain scores and func…