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Hyaluronic acid, not so effective against knee osteoarthritis

There is little interest in injecting hyaluronic acid in knee osteoarthritis patients, according to a large study published Thursday, July 6, confirming growing doubts about the interest of this pain-reducing treatment. This work “does not advocate the widespread use of viscoupling for the treatment of knee osteoarthritis”summarize the research authors have published British Medical Journal (BMJ).

Knee osteoarthritis is one of the most common rheumatisms. Patients experience deterioration of the cartilage in the knee joint, which leads to pain and difficulties in daily life, including walking. This condition is very common. According to a 2020 report cited by the study’s authors, it affects more than 500 million people worldwide. In France, Social Security estimates that osteoarthritis of the knee affects almost a third of people between the ages of 65 and 75.

For several decades, one of the mainstays of treatment has been injecting hyaluronic acid into the affected joints, a jelly-like substance that promotes good lubrication. But the real effectiveness of this treatment, called visco-supplementation, is becoming more and more doubtful, which, in particular, forced the French social security to stop its reimbursement a few years ago, despite the opposition of laboratories specializing in these procedures. hyaluronic acid as well as patient associations.

A BMJ study goes in this direction. This is a meta-analysis that compiles a number of previous works, several dozen here, and therefore provides a good overview of the state of knowledge. True, the authors admit that visco-filling contributes “slight reduction in knee osteoarthritis pain.” but the effect is too small to be considered to make a real clinical difference.

Especially since, at the same time, injection of hyaluronic acid is not harmless. “Visco supplementation is associated with higher incidence of serious side effects compared to placebo”, the authors note. The latter, even if they cannot exclude the possible benefit of visco-supplementation for specific categories of patients, therefore call for it to no longer be a systematic procedure for the treatment of knee osteoarthritis.

Source: Le Figaro

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