Quantitative analysis of the efficacy and associated factors of intra-articular hyaluronic acid with respect to osteoarthritis symptoms: A systematic review of randomized trials and model-based meta-analysis
Pooled result · WOMAC pain effect sizeResult — go to the resultWOMAC pain ES (contrast between meta-analyses) 1.9 95% CI 1.2–5.2Authors' conclusion
The quantitative model suggested that HA interventions were statistically more effective than placebo, with participants receiving HA+ CS or PRP experiencing the best efficacy.
Study context
- Population
- Participants with symptomatic or radiographic osteoarthritis (OA)
- Participants
- 24,101 participants168 studies
- Comparison
- Intra-articular hyaluronic acid (HA) treatments vs placebo
- Outcome
- WOMAC pain effect size
Methodological detailspharmacodynamic Bateman function model, covariate model, Embase, MEDLINE (PubMed) and Cochrane CENTRAL searched from inception to March 13, 2023
- Pharmacodynamic Bateman function model
- Covariate model
- Embase, MEDLINE (PubMed) and Cochrane CENTRAL searched from inception to March 13, 2023
Pooled result
As reported in the abstract
WOMAC pain ES (contrast between meta-analyses)
1.9
95% CI 1.2–5.2
By group
HA + CS
4.4
95% CI 3.0 to 5.7
WOMAC pain ES
HA + platelet-rich plasma (PRP)
4.0
95% CI 2.7 to 5.3
WOMAC pain ES
Further pooled results
Time course of HA treatment effect
- HA treatment effects plateaued at ≈2 months
Subgroups benefiting more
- Younger (age < 65), overweight (BMI ≥ 25) knee OA patients with more severe baseline symptoms and lower Kellgren-Lawrence (KL) grade (≤ 2) could benefit more
Original publication
Quantitative analysis of the efficacy and associated factors of intra-articular hyaluronic acid with respect to osteoarthritis symptoms: A systematic review of randomized trials and model-based meta-analysis. Osteoarthritis Cartilage. Published 11 April 2025. doi:10.
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