Viscosupplementation with High Molecular Weight Hyaluronic Acid for Hip Osteoarthritis: a Systematic Review and Meta-Analysis of Randomised Control Trials of the Efficacy on Pain, Functional Disability, and the Occurrence of Adverse Events.

IF 0.4 4区 医学 Q4 ORTHOPEDICS
R Patel, G Orfanos, W Gibson, T Banks, G McConaghie, R Banerjee
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Abstract

Purpose of the study: Hip osteoarthritis (OA) has a prevalence of around 6.4% and is the second most commonly affected joint. This review aims to assess the clinical outcomes of intra-articular high molecular weight hyaluronic acid (HMWHA) in the management of hip osteoarthritis.

Material and methods: We conducted a comprehensive search across PubMed, Google Scholar, and the Cochrane Library for randomised trials investigating the effectiveness of high molecular weight hyaluronic acid (HMWHA) in the treatment of hip osteoarthritis. Quality and risk of bias assessments were performed using the Cochrane RoB2 tool. To synthesise the data, we utilised the Standardised Mean Difference (SMD) for assessing pain relief through the Visual Analogue Scale (VAS) and the Lequesne index (LI) for evaluating functional outcomes. Risk Ratio (RR) was calculated to assess the occurrence of complications.

Results: A total of four studies involving HMWHA and control groups were included. The standardised mean difference (SMD) for the Visual Analogue Scale (VAS) (SMD -0.056; 95% CI; -0.351, 0.239; p = 0.709) and the Lequesne index (SMD -0.114; 95% CI; -0.524, 0.296; p = 0.585) were not statistically significant. Analysis for complications demonstrated an overall relative risk ratio (RR) of 0.879 (95% CI; 0.527, 1.466; p = 0.622), and was not statistically significant.

Discussion and conclusions: Intra-articular HMWHA in hip OA can significantly reduce pain and improve functional recovery when compared with the condition before treatment. However, there is no significant difference between HMWHA, or saline, or other therapeutic treatments. Currently, available evidence indicates that intra-articular HMWHA in hip OA would not increase the risk of adverse events.

Key words: hip osteoarthritis, hyaluronic acid, intra-articular, molecular weight, viscosupplementation.

用高分子量透明质酸补充粘液治疗髋关节骨性关节炎:关于疼痛、功能障碍和不良事件发生率疗效的随机对照试验的系统回顾和荟萃分析。
研究目的髋关节骨性关节炎(OA)的发病率约为 6.4%,是第二大最常受影响的关节。本综述旨在评估关节内高分子量透明质酸(HMWHA)治疗髋关节骨性关节炎的临床效果:我们在PubMed、Google Scholar和Cochrane图书馆对调查高分子量透明质酸(HMWHA)治疗髋关节骨性关节炎有效性的随机试验进行了全面检索。使用 Cochrane RoB2 工具进行了质量和偏倚风险评估。为了对数据进行综合,我们使用标准化均值差(SMD)通过视觉模拟量表(VAS)评估疼痛缓解情况,并使用勒克斯指数(LI)评估功能结果。计算风险比(RR)以评估并发症的发生率:结果:共纳入了四项涉及 HMWHA 和对照组的研究。视觉模拟量表(VAS)的标准化平均差(SMD)(SMD -0.056;95% CI;-0.351,0.239;P = 0.709)和勒克斯指数(SMD -0.114;95% CI;-0.524,0.296;P = 0.585)无统计学意义。并发症分析显示,总相对风险比(RR)为 0.879 (95% CI; 0.527, 1.466; p = 0.622),无统计学意义:讨论与结论:与治疗前相比,髋关节 OA 关节内 HMWHA 可明显减轻疼痛并改善功能恢复。然而,HMWHA、生理盐水或其他治疗方法之间并无明显差异。目前,现有证据表明,关节内 HMWHA 治疗髋关节 OA 不会增加不良事件的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.70
自引率
25.00%
发文量
53
期刊介绍: Editorial Board accepts for publication articles, reports from congresses, fellowships, book reviews, reports concerning activities of orthopaedic and other relating specialised societies, reports on anniversaries of outstanding personalities in orthopaedics and announcements of congresses and symposia being prepared. Articles include original papers, case reports and current concepts reviews and recently also instructional lectures.
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