Acta Chir Orthop Traumatol Cech. 2024; 91(2):109-119 | DOI: 10.55095/achot2024/009

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 EventsOriginal papers

R. PATEL1, 2, 3, G. ORFANOS1, W. GIBSON1, T. BANKS1, G. MCCONAGHIE1, R. BANERJEE1
1 Department of Trauma and Orthopaedics, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom
2 Department of Trauma and Orthopaedics, The Princess Royal Hospital, Telford, United Kingdom
3 Department of Trauma and Orthopaedics, Royal Shrewsbury Hospital, Shrewsbury, United Kingdom

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 & 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.

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

Received: November 28, 2023; Revised: November 28, 2023; Accepted: June 13, 2024; Published: June 12, 2024  Show citation

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PATEL R, ORFANOS G, GIBSON W, BANKS T, MCCONAGHIE G, BANERJEE R. 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. Acta Chir Orthop Traumatol Cech. 2024;91(2):109-119. doi: 10.55095/achot2024/009. PubMed PMID: 38801667.
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