Efficacy of hyaluronic acid after knee arthroscopy: A systematic review and meta-analysis

Abstract

OBJECTIVE: To investigate the effect of hyaluronic acid on functional recovery and pain control in patients following knee arthroscopy. DESIGN: A systematic review and meta-analysis was conducted to explore the efficacy of hyaluronic acid following knee arthroscopy. SUBJECTS AND METHODS: Randomized controlled trials (RCTs) assessing the effect of hyaluronic acid in knee arthroscopy were included. A meta-analysis was performed using the random-effect model. RESULTS: Six RCTs involving 310 patients were included in the meta-analysis. Overall, compared with control intervention following knee arthroscopy, hyaluronic acid treatment was found to significantly increase Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores (mean difference 11.43; 95% confidence intervals (95% CI) 1.39-21.47; p = 0.03), but had no impact on pain scores at 2 weeks (mean difference -0.16; 95% CI -0.81-0.49; p = 0.63), pain scores at 6 weeks (mean difference 0.01; 95% CI -0.86-0.89; p = 0.98), pain scores at 12 weeks (mean difference -0.51; 95% CI -1.56-0.53; p = 0.34). In addition, pain on motion was significantly reduced after knee arthroscopy (risk ratio (RR) 0.22; 95% CI 0.06-0.79; p = 0.02). CONCLUSION: Compared with control intervention after knee arthroscopy, hyaluronic acid treatment was found to significantly improve WOMAC score and decrease pain on motion, but had no substantial influence on pain scores at 2, 6 and 12 weeks after knee arthroscopy.