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Hyaluronic injections may delay time to arthroplasty in elderly patients with knee OA

Results of a new retrospective observational study showed patients with knee osteoarthritis who were treated with intra-articular hyaluronic acid had a longer time to knee arthroplasty compared with patients who did not receive the injections.

Using the 5% sample of Part B Medicare data between 2007 and 2012, researchers identified 23,008 patients with knee osteoarthritis (OA) who underwent knee arthroplasty (KA). Hyaluronic acid (HA) injections were received by 17,007 of the patients prior to arthroplasty. Investigators stratified patients according to whether they received bioengineered high-molecular weight (HMW) or medium-molecular weight (MMW) HA, or non-bioengineered HMW or low- molecular weight (LMW) HA.

Patients who received HA had a delay to knee arthroplasty by 7.1 months after adjustments for potential confounding factors and propensity scores. Compared with patients who did not receive HA injections, investigators found patients who received bioengineered HMW HA had the longest time to arthroplasty compared with patients who received other formulations, and LMW non-biologic HA was associated with the shortest time to arthroplasty. Other formulations had similar lengths of time to arthroplasty.

I always give the option of hyaluronic acid injection to my patients with knee osteoarthritis. I have found that a majority of my patients are able to get pain relief of up to 1 year from these injections.


Ong K, et al. Paper #310. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

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