Intra-Articular Hyaluronic Acid for Osteoarthritis of the Hip or Ankle: A Review of Clinical Effectiveness [Internet]

Excerpt

Osteoarthritis is a disorder caused by damage to articular cartilage, most commonly in older adults. Aging, changes in metabolism, genetic and hormonal factors, biomechanical changes, and inflammation are all associated with the onset and progression of osteoarthritis. Osteoarthritis can cause symptoms such as pain, limitation of movement, various degrees of inflammation, effusion, and disability.^, Between 2010 and 2031, the prevalence of osteoarthritis has been projected to increase from 13.8% to 18.6% in Canada and the direct cost to increase from $2.9 billion to $7.6 billion Canadian dollars (2010 values).

Current treatment options include medications and surgery. Drugs, such as local analgesics, nonsteroidal anti-inflammatory drugs, intra-articular injection of glucocorticoids, can be prescribed to aid with symptom control. Surgery, such as total hip replacement, is often considered a last resort option for osteoarthritis, due to the risks of surgical complications (such as nerve injuries and dislocation). In addition, these treatment options do not aim to delay the pathological progression of osteoarthritis.

Hyaluronic acid supplementation is another option for the treatment of osteoarthritis. Hyaluronic acid constitutes synovial fluid in the joints and increases the viscosity. It functions as shock absorbent within joints and protects cartilage and surrounding soft tissues. Intra-articular injection of hyaluronic acid has been approved by the US Food and Drug Administration in 1999.

Some evidence has suggested that intra-articular injection of hyaluronic acid is effective in relieving pain associated with ankle osteoarthritis and is clinically effective in hip osteoarthritis. Recently there are studies published to demonstrate the effectiveness of the intra-articular injection of hyaluronic acid for patients with osteoarthritis of the hip or ankle.^,, There is a need to update the review on intra-articular injection of hyaluronic acid. This report aims to review the clinical effectiveness of intra-articular injection of hyaluronic acid for osteoarthritis of the hip and ankle.