TY - JOUR
T1 - Expert consensus on hyaluronic acid injections for knee osteoarthritis
T2 - a patient-centered approach
AU - Fuggle, Nicholas
AU - Rannou, François
AU - Maheu, Emmanuel
AU - Migliore, Alberto
AU - Al-Daghri, Nasser
AU - Alokail, Majed
AU - Ammann, Patrick
AU - Berenbaum, Francis
AU - Botto-van Bemden, Angie
AU - Brandi, Maria Luisa
AU - Burlet, Nansa
AU - Chapurlat, Roland
AU - Cooper, Cyrus
AU - Dennison, Elaine
AU - Harvey, Nicholas C.
AU - Im, Gun Il
AU - Kurth, Andreas
AU - Matijevic, Radmila
AU - Messina, Daniel
AU - Faure, Jordi Monfort
AU - Radermecker, Régis P.
AU - Schmidmaier, Ralf
AU - Silverman, Stuart
AU - Wegrzyn, Julien
AU - Zakraoui, Leith
AU - Rizzoli, René
AU - Reginster, Jean Yves
AU - Bruyère, Olivier
AU - Mobasheri, Ali
N1 - Publisher Copyright:
© The Author(s) 2026.
PY - 2026/12
Y1 - 2026/12
N2 - Hyaluronic acid (HA) is a linear polysaccharide which occurs naturally as a constituent of synovial fluid. The HA concentration in the joint decreases inexorably during the progression of knee osteoarthritis (OA) and so, for nearly five decades, HA has been trialled and used in the treatment of knee OA. There are strong data from clinical trials, meta-analyses and umbrella reviews to support the use of intra-articular hyaluronic acid (IAHA) in the treatment of patients with knee OA, though not in patients with acute, active OA experiencing a flare. The majority of the literature suggests that IAHA has a positive safety profile despite a few meta-analyses suggesting an increased risk of serious adverse effects. Further qualitative analysis integrating patient preferences for multi-modal and/or non-surgical management is required in order to further explore these findings. IAHA has been combined with a number of additional agents, including mannitol, sorbitol, chondroitin sulphate, tranexamic acid, polynucleotides and hybrid IAHA formulations. These show variable performance beyond the baseline effect of their constituents. It is crucial to consider the patient’s preference when considering treatments for knee OA. Specific to IAHA, patients seek minimally invasive, lower-risk, and non-steroidal options with at least moderate efficacy and advantageous safety profiles.
AB - Hyaluronic acid (HA) is a linear polysaccharide which occurs naturally as a constituent of synovial fluid. The HA concentration in the joint decreases inexorably during the progression of knee osteoarthritis (OA) and so, for nearly five decades, HA has been trialled and used in the treatment of knee OA. There are strong data from clinical trials, meta-analyses and umbrella reviews to support the use of intra-articular hyaluronic acid (IAHA) in the treatment of patients with knee OA, though not in patients with acute, active OA experiencing a flare. The majority of the literature suggests that IAHA has a positive safety profile despite a few meta-analyses suggesting an increased risk of serious adverse effects. Further qualitative analysis integrating patient preferences for multi-modal and/or non-surgical management is required in order to further explore these findings. IAHA has been combined with a number of additional agents, including mannitol, sorbitol, chondroitin sulphate, tranexamic acid, polynucleotides and hybrid IAHA formulations. These show variable performance beyond the baseline effect of their constituents. It is crucial to consider the patient’s preference when considering treatments for knee OA. Specific to IAHA, patients seek minimally invasive, lower-risk, and non-steroidal options with at least moderate efficacy and advantageous safety profiles.
KW - Hyaluronic Acid
KW - IAHA
KW - Injection
KW - Knee
KW - Osteoarthritis
UR - https://www.scopus.com/pages/publications/105035453269
U2 - 10.1007/s40520-026-03366-8
DO - 10.1007/s40520-026-03366-8
M3 - Article
C2 - 41920453
AN - SCOPUS:105035453269
SN - 1594-0667
VL - 38
JO - Aging Clinical and Experimental Research
JF - Aging Clinical and Experimental Research
IS - 1
M1 - 110
ER -