Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Osteoarthritis

Hyaluronic acid is not effective in symptomatic hip OA

Nature Reviews Rheumatology volume 5, pages 359–360 (2009)Cite this article

Consistent with evidence from trials in osteoarthritis of the knee, the results of a randomized controlled trial demonstrate that, for symptomatic hip osteoarthritis, a single intra-articular injection of hyaluronic acid is no better than placebo at alleviating pain.

Viscosupplementation, which involves the injection of a solution containing sodium hyaluronate or its derivatives into the patient's joint, is purported to restore the viscoelasticity of the synovial fluid by supplementing native or endogenous hyaluronic acid (HA). Until recently, there was a dearth of controlled trials assessing the efficacy of HA for hip osteoarthritis (OA).1 Following recent publications,2,3 however, we now have greater confidence that HA is not efficacious in symptomatic hip OA, despite evidence from uncontrolled trials that suggested otherwise.

This is a preview of subscription content

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

Buy

All prices are NET prices.

References

  1. van den Bekerom, M. P., Lamme, B., Sermon, A. & Mulier, M. What is the evidence for viscosupplementation in the treatment of patients with hip osteoarthritis? Systematic review of the literature. Arch. Orthop. Trauma Surg. 128, 815–823 (2008).

    Article  Google Scholar 

  2. Richette, P. et al. Effect of hyaluronic acid in symptomatic hip osteoarthritis: a multicenter, randomized, placebo-controlled trial. Arthritis Rheum. 60, 824–830 (2009).

    CAS  Article  Google Scholar 

  3. Qvistgaard, E., Christensen, R., Torp-Pedersen, S. & Bliddal, H. Intra-articular treatment of hip osteoarthritis: a randomized trial of hyaluronic acid, corticosteroid, and isotonic saline. Osteoarthritis Cartilage 14, 163–170 (2006).

    CAS  Article  Google Scholar 

  4. Rennesson-Rey, B. et al. Does joint effusion influence the clinical response to a single Hylan GF-20 injection for hip osteoarthritis? Joint Bone Spine 75, 182–188 (2008).

    Article  Google Scholar 

  5. Campbell, J., Bellamy, N. & Gee, T. Differences between systematic reviews/meta-analyses of hyaluronic acid/hyaluronan/hylan in osteoarthritis of the knee. Osteoarthritis Cartilage 15, 1424–1436 (2007).

    CAS  Article  Google Scholar 

  6. Lo, G. H., LaValley, M., McAlindon, T. & Felson, D. T. Intra-articular hyaluronic acid in treatment of knee osteoarthritis: a meta-analysis. JAMA 290, 3115–3121 (2003).

    CAS  Article  Google Scholar 

  7. Dagenais, S., Garbedian, S. & Wai, E. K. Systematic review of the prevalence of radiographic primary hip osteoarthritis. Clin. Orthop. Relat. Res. 467, 623–637 (2009).

    Article  Google Scholar 

  8. Fortin, P. R. et al. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 42, 1722–1728 (1999).

    CAS  Article  Google Scholar 

  9. Zhang, W. et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 16, 137–162 (2008).

    CAS  Article  Google Scholar 

  10. Lambert, R. G. et al. Steroid injection for osteoarthritis of the hip: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 56, 2278–2287 (2007).

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

  1. Division of Research, New England Baptist Hospital, Boston, MA, USA

    David J. Hunter

Authors
  1. David J. Hunter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David J. Hunter.

Ethics declarations

Competing interests

The author has received grant/research support from AstraZeneca, DonJoy, Eli Lilly, Pfizer and Stryker, and has acted as a patent holder on behalf of DonJoy.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hunter, D. Hyaluronic acid is not effective in symptomatic hip OA. Nat Rev Rheumatol 5, 359–360 (2009). https://doi.org/10.1038/nrrheum.2009.119

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrrheum.2009.119

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing