[Viscosupplementation with High Molecular Weight Hyaluronic Acid for Hip Osteoarthritis: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials].

Abstract

Objective: To evaluate the efficacy and safety of high molecular weight hyaluronic acid (HMWHA) versus other therapies for hip osteoarthritis (OA) management.

Methods: The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) comparing HMWHA versus other therapies (corticosteroids, platelet-rich plasma, saline, or low molecular weight hyaluronic acid) for hip OA treatment were included. Mean differences (MDs) or standardized mean differences (SMDs) were calculated for continuous outcomes with 95% confidence intervals (CIs).

Results: Four RCTs were included, involving 823 patients with hip OA, of whom 408 (49.5%) were treated with HMWHA. The mean age of the patients was 60.1 (±10.21) years. No significant differences were observed between groups for pain (SMD -0.30 points; 95% CI -1.60 to 0.99), Lequesne index (MD 1.30 points; 95% CI -8.83 to 11.44), WOMAC total (MD -9.26 points; 95% CI -51.33 to 32.56), WOMAC stiffness (MD -0.93 points; 95% CI -12.30 to 10.45), WOMAC physical function (MD -0.15 points; 95% CI -7.24 to 7.60), and patient global self-assessment (MD -1.95 points; 95% CI -27.49 to 23.59).

Conclusion: No significant differences were observed between HMWHA and other treatments regarding pain relief and functional recovery in patients with hip OA. However, further high-quality RCTs are needed to evaluate the HMWHA in the treatment of hip OA.