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Are intra-articular injections of Hylan G-F 20 efficacious in painful osteoarthritis of the knee? A systematic review and meta-analysis

AIM: To systematically review evidence and perform a meta-analysis of the efficacy of intra-articular (IA) injections of Hylan G-F 20 for the treatment of painful osteoarthritis (OA) of the knee.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Efficacy and safety of viscosupplementation with Hylan G-F 20 for the treament of knee osteoarthritis: a systematic review

This review assessed intra-articular injections of Hylan G-F 20 for the treatment of knee osteoarthritis. The available evidence suggested that Hylan G-F 20 injections decreased pain and improved knee function in the short term. The authors' conclusions are supported by the data presented, but differences between included studies, suggest they should be viewed with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Functional improvement with hylan G-F 20 in patients with knee osteoarthritis

The review concluded that hylan G-F 20 (intra-articular hyaluronic acid derivative) relieved pain and improved function in patients with osteoarthritis of the knee. The review's numerous methodological limitations suggest that the authors' conclusions should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Hylan versus hyaluronic acid for osteoarthritis of the knee: a systematic review and meta-analysis

This review found that hylan appears unlikely to be more effective than hyaluronic acid for treating pain associated with osteoarthritis of the knee, and that it is associated with an increased risk of local adverse events. The review was well-conducted and the authors' conclusions seem likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Joint corticosteroid injection for knee osteoarthritis

We searched the literature until 3 February 2015 for studies of the effects on pain, function, quality of life, and safety of intra‐articular (injected into the joint) corticosteroids compared with sham injection or no treatment in people with knee osteoarthritis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Systematic Review for Effectiveness of Hyaluronic Acid in the Treatment of Severe Degenerative Joint Disease (DJD) of the Knee [Internet]

The Coverage and Analysis Group at the Centers for Medicare and Medicaid Services (CMS) requested from The Technology Assessment Program (TAP) at the Agency for Healthcare Research and Quality (AHRQ), a review of the evidence that intraarticular injections of hyaluronic acid (HA) in individuals with degenerative joint disease (osteoarthritis [HA]) of the knee improve function and quality of life (QoL) and that they delay or prevent the need for total knee replacement (TKR), specifically for individuals age 65 and over.. AHRQ assigned this report to the following Evidence-based Practice Center: RAND Southern California Evidence –based Practice Center (Contract Number: HHSA290201200006I).

Technology Assessment Report - Agency for Healthcare Research and Quality (US).

Version: July 23, 2015
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Viscosupplementation for the treatment of osteoarthritis of the knee

Osteoarthritis (OA) is the most common form of chronic arthritis worldwide. Hyaluronan and hylan (HA) products provide opportunity to treat OA in individual knee joints. To evaluate the efficacy, effectiveness and safety of HA products, in knee OA, we have conducted a systematic review using Cochrane methodology. The analyses support the contention that the HA class of products is superior to placebo. There is considerable between‐product, between‐variable and time‐dependent variability in the clinical response. The clinical effect for some products against placebo on some variables at some time points is in the moderate to large effect size range. In general, sample size restrictions preclude any definitive comment on the safety of the HA class of products, however, within the constraints of the trial designs employed, no major safety issues were detected. The analyses suggest that viscosupplements are comparable in efficacy to systemic forms of active intervention, with more local reactions but fewer systemic adverse events, and that HA products have more prolonged effects than IA corticosteroids. Overall, the aforementioned analyses support the use of the HA class of products in the treatment of knee OA.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Osteoarthritis: Care and Management in Adults

Osteoarthritis refers to a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life. It is the most common form of arthritis, and one of the leading causes of pain and disability worldwide. The most commonly affected peripheral joints are the knees, hips and small hand joints. Although pain, reduced function and effects on a person’s ability to carry out their day-to-day activities can be important consequences of osteoarthritis, pain in itself is of course a complex biopsychosocial issue, related in part to person expectations and self-efficacy, and associated with changes in mood, sleep and coping abilities. There is often a poor link between changes on an X-ray and symptoms: minimal changes can be associated with a lot of pain and modest structural changes to joints oftencan occur without with minimal accompanying symptoms. Contrary to popular belief, osteoarthritis is not caused by ageing and does not necessarily deteriorate. There are a number of management and treatment options (both pharmacological and non-pharmacological), which this guideline addresses and which offer effective interventions for control of symptoms and improving function.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: February 2014
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Depression: The Treatment and Management of Depression in Adults (Updated Edition)

This clinical guideline on depression is an updated edition of the previous guidance (published in 2004). It was commissioned by NICE and developed by the National Collaborating Centre for Mental Health, and sets out clear, evidence- and consensus-based recommendations for healthcare staff on how to treat and manage depression in adults.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2010
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Hyaluronic acid injections relieve knee pain

This review assessed intra-articular hyaluronic acid for treating pain from knee osteoarthritis. The authors concluded that intra-articular hyaluronic acid has a modest early effect on pain but not at 15 to 22 weeks. The authors' conclusions appear to reflect the evidence presented, but differences between the studies and other review limitations mean that the reliability of these conclusions is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

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