There have been multiple studies in the recent orthopedic literature evaluating the effectiveness of hyaluronic acid in the treatment of patients with mild to moderate osteoarthritis of the knee. While studies that have had industry sponsorship have typically had a more favorable outcome, other studies without industry funding have concluded that hyaluronic acid is no more effective than either cortisone or placebo. Because of the conflicting data, most orthopedic surgeons will attempt to use an intraarticular cortisone injection first to see if they can gain an adequate response with decreased inflammation and pain. If oral anti-inflammatories and intraarticular cortisone injections fail, then in patients with mild to moderate osteoarthritis hyaluronic acid is certainly a viable option with the realization there is a substantial increased cost associated with the use of this drug, therefore a less expensive option should be tried first.
—William P. Barrett, MD