Are Clinicians Following the Recommendation Against Hyaluronic Acid Injections for Knee Osteoarthritis?

In a 2013 guideline, the American Academy of Orthopedic Surgeons reviewed the evidence on efficacy of hyaluronic acid (HA) injections for knee osteoarthritis and concluded, “We cannot recommend using HA for patients with symptomatic osteoarthritis of the knee. Strength of Recommendation: Strong” (J Am Acad Orthop Surg 2013; 21:571). To examine whether clinicians have paid attention to this recommendation, researchers reviewed U.S. Medicare claims for HA injections.

The overall number of clinicians who provided these injections annually (≈11,000 providers) stayed relatively constant during the 7-year period from 2012 to 2018. However, the number of injections per provider increased modestly (from 101 to 108 per provider annually). The number …