Common Injections Don’t Help Knee Osteoarthritis More Than Placebo, Large Data Review Finds

State News | By Isabella Cueto

A commonly used treatment for people with knee osteoarthritis is barely more effective than the placebo effect in reducing pain and improving function, a new review of 50 years of data found. Yet despite decades of mounting evidence showing hyaluronic acid injections don’t help most osteoarthritis patients, the shots have become more widely used, costing the American health care system over $300 million each year in Medicare claims alone.

Osteoarthritis is an incurable, chronic condition that occurs as cartilage breaks down in the knees, hips, hands, or other joints, resulting in pain, limited range of motion, and swelling. More than 32 million adults in the United States have osteoarthritis, according to estimates from the Centers for Disease Control and Prevention. Since there is no cure, people with osteoarthritis often manage their condition with exercise, physical therapy, medications, and injected therapies. Since the 1970s, hyaluronic acid has been one of those injectables.

Originally sourced from cartilage in the fleshy, flamboyant-red crown atop a rooster’s head, the treatment has been dubbed the “rooster comb injection,” and thought to offer a gelatinous cushion for worn-down joints. In 2018, it was administered as the first treatment to an estimated one in seven patients with osteoarthritic knee pain, according to a paper published in The BMJ medical journal on Wednesday.

That broad look at the scientific literature concluded that injecting hyaluronic acid — called viscosupplementation — offers such a small reduction in knee osteoarthritis pain and stiffness when compared to placebo shots that it makes no meaningful difference in the lives of patients. Moreover, the shots were also linked to a greater risk of experiencing a wide range of negative side effects, the paper reported.

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