Intra-Articular Hyaluronic Acid for Viscosupplementation in Osteoarthritis of the Knee: A Review of Clinical Effectiveness and Safety

( Last Updated : June 24, 2019)
Project Line:
Health Technology Review
Project Sub Line:
Summary with Critical Appraisal
Project Number:



  1. What is the clinical effectiveness and safety of intra-articular hyaluronic acid for patients with osteoarthritis of the knee joint?

Key Message

Evidence suggests that there may be differences in the efficacy of intraarticular hyaluronic acid for treatment of knee osteoarthritis with respect to hyaluronic acid products, numbers of injection regimen, and disease severity. Intraarticular hyaluronic acid was found to be more effective with high molecular weight and biological fermented products, with 2-to-4 injection regimens, and in patients with low-to-moderate osteoarthritis. However, studies with direct head-to-head comparison are needed to confirm these findings. Between intraarticular hyaluronic acid and intraarticular corticosteroid, evidence suggests that intraarticular corticosteroid is more effective in the shorter-term (up to 1 or 3 months), while intraarticular hyaluronic acid is more effective in the longer-term (up to 6 or 12 months) in reducing pain and functional improvement in patients with knee osteoarthritis.