Viscosupplementation

Intra articular injections of Hyaluronic Acid (HA) are widely used in the treatment of knee osteoarthritis. The initial background for using such i.a injections was to restore a deficient production of HA in osteoarthritic joints. Their clinical efficacy is still controversial. But the majority of studies shown that i.a of HA are more efficient than a placebo for alleviating pain and its duration of action over several months is quite remarkable. HA are injected as one injection per week over 3 weeks or as one shot. Still now, there is no proof in human trials that those i.a injections of HA may preserve the cartilage and slow down the disease progression. HA have also been used in others joints such as shoulder, ankle, CMC of the thumb and hip. Results are promising for the first 3 locations, but disappointing for hip OA.Injections of HA in knee OA should be privileged for knee without concomitant synovial fluid effusion and outside a disease flare. They are part of international recommendations for knee OA management.