PMID- 29618143
OWN - NLM
STAT- MEDLINE
DCOM- 20190521
LR  - 20190521
IS  - 1938-2480 (Electronic)
IS  - 1538-8506 (Linking)
VI  - 32
IP  - 3
DP  - 2019 Mar
TI  - Efficacy and Safety of Hylan versus Hyaluronic Acid in the Treatment of Knee 
      Osteoarthritis.
PG  - 259-268
LID - 10.1055/s-0038-1641142 [doi]
AB  - The purpose of this study was to use meta-analytic approach to compare the 
      efficacy and safety of intraarticular hylan and hyaluronic acid (HA) for knee 
      osteoarthritis (OA) treatment. We searched PubMed, Embase, and the Cochrane 
      databases through July 2017 to identify Level I randomized controlled trials 
      (RCTs) that evaluated clinical efficacy and safety of hylan compared with HA for 
      knee OA. The primary outcomes were Visual Analogue Scale (VAS) for pain and 
      Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, and 
      WOMAC function scores. In each study and for the outcome measures (VAS for pain, 
      WOMAC pain, function and stiffness scores, and Lequesne score), we calculated the 
      treatment effect from the difference between the preintervention and 
      postintervention changes in the hylan and HA groups. Twenty-one RCTs involving 
      3,058 patients were included. Pooled analysis suggested that compared with HA, 
      hylan was associated with similar pain relief and function improvement in 
      patients with knee OA (VAS for pain: mean difference [MD], -3.04; 95% confidence 
      interval [CI], -9.13 to 3.04; p = 0.33; I (2) = 76%. WOMAC pain score: MD, 0.23; 
      95% CI, -0.25 to 0.70; p = 0.35; I (2) = 0%. WOMAC function score: MD, -0.47; 95% 
      CI, -6.81 to 5.88; p = 0.88; I (2) = 84%). No significant difference was found 
      comparing the patients with treatment-related adverse events. The relationship 
      was robust in sensitivity analysis and consistent in most of the subgroup 
      analyses. As to the primary outcomes (WOMAC pain, function scores, VAS for pain), 
      the difference between hylan and HA did not reach the previously reported minimum 
      clinically important difference (MCID) values (-13.4 for VAS for pain, -2.0 for 
      WOMAC pain score, -7.7 for WOMAC function score). Our meta-analysis showed that 
      there were no statistically and clinically significant differences in pain relief 
      and function improvement between hylan and HA injections for knee OA treatment. 
      In view of its higher costs, we discourage the use of hylan in patients with knee 
      OA in clinical practice. The level of evidence is I, meta-analysis of Level I 
      studies.
CI  - Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
FAU - Dai, Wen-Li
AU  - Dai WL
AD  - Department of Orthopedic Surgery, Southern Medical University, Nanfang Hospital, 
      Guangzhou, China.
FAU - Lin, Ze-Ming
AU  - Lin ZM
AD  - Department of Orthopedic Surgery, Southern Medical University, Nanfang Hospital, 
      Guangzhou, China.
FAU - Guo, Dong-Hong
AU  - Guo DH
AD  - Department of Orthopedic Surgery, Southern Medical University, Nanfang Hospital, 
      Guangzhou, China.
FAU - Shi, Zhan-Jun
AU  - Shi ZJ
AD  - Department of Orthopedic Surgery, Southern Medical University, Nanfang Hospital, 
      Guangzhou, China.
FAU - Wang, Jian
AU  - Wang J
AD  - Department of Orthopedic Surgery, Southern Medical University, Nanfang Hospital, 
      Guangzhou, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20180404
PL  - Germany
TA  - J Knee Surg
JT  - The journal of knee surgery
JID - 101137599
RN  - 0 (Viscosupplements)
RN  - 125935-84-4 (hylan)
RN  - 9004-61-9 (Hyaluronic Acid)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Hyaluronic Acid/*analogs & derivatives/*therapeutic use
MH  - Injections, Intra-Articular
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis, Knee/*drug therapy/physiopathology
MH  - Pain Management
MH  - Pain Measurement
MH  - Treatment Outcome
MH  - Viscosupplements/*therapeutic use
MH  - Visual Analog Scale
COIS- None.
EDAT- 2018/04/05 06:00
MHDA- 2019/05/22 06:00
CRDT- 2018/04/05 06:00
PHST- 2018/04/05 06:00 [pubmed]
PHST- 2019/05/22 06:00 [medline]
PHST- 2018/04/05 06:00 [entrez]
AID - 10.1055/s-0038-1641142 [doi]
PST - ppublish
SO  - J Knee Surg. 2019 Mar;32(3):259-268. doi: 10.1055/s-0038-1641142. Epub 2018 Apr 
      4.