Evidence map›Paper›PMID 34109828›Full record

SynthesisCartilage2021

Molecular Weight of Hyaluronic Acid Has Major Influence on Its Efficacy and Safety for Viscosupplementation in Hip Osteoarthritis: A Systematic Review and Meta-Analysis.

Yen-Zung Wu, Hsuan-Ti Huang, Cheng-Jung Ho, Chia-Lung Shih, Chung-Hwan Chen, Tsung-Lin Cheng, Ying-Chun Wang, Sung-Yen Lin

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cartilage, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 4 pooled it
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Intra-articular hyaluronic acid injections for hip osteoarthritis: a level I systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Yen-Zung WuDepartment of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.ORCID 0000-0002-0559-785X
Hsuan-Ti HuangDepartments of Orthopedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung.
Cheng-Jung HoDepartment of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.
Chia-Lung ShihClinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City.
Chung-Hwan ChenDepartments of Orthopedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung.ORCID 0000-0001-8941-4792
Tsung-Lin ChengOrthopaedic Research Center, Kaohsiung Medical University, Kaohsiung.
Ying-Chun WangDepartments of Orthopedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung.
Sung-Yen LinDepartment of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.
Kaohsiung Medical University · TWChia-Yi Christian Hospital · TWNational Sun Yat-sen University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to compare the efficacy and safety of intra-articular hyaluronic acid (HA) injection with different molecular weights (MWs) for treating hip osteoarthritis (OA).

methodsA systematic literature search for relevant studies was conducted in 3 electronic databases, including PubMed, BMJ Journals, and Cochrane Library, from inception to April 2020. Extracted outcomes included visual analogue scale (VAS) (1, 3, and 6 months), Lequesne index (3 and 6 months), and adverse effects. HAs were classified into low-molecular-weight (LMW), moderate-molecular-weight (MMW), high-molecular-weight (HMW), and ultra-high-molecular-weight (UHMW) groups. Meta-analysis was performed using Review Manager 5.3.

resultsA total of 15 studies with 614 patients were included. Our meta-analysis showed that the HMW HA group had the best improvement in VAS and Lequesne index compared with other HA groups for all the follow-up visits. Moreover, the HMW group demonstrated significantly better improvement than the other groups in VAS at 6-month follow-up and in Lequesne index at 3- and 6-month follow-ups. Analysis for adverse effects revealed low rates of systemic adverse effects (≤0.6%) in all groups and similar rate of local adverse effects (around 10%) among the groups except for UHMW HA group (37.5%).

conclusionAmong different MWs of HA for treating hip OA, HMW HA injection demonstrated the best efficacy for up to 6 months after treatment without increased risk of adverse effects. Further studies with more comprehensive data and a higher level of evidence are required to prove our results.

Indexed as

AgedFemaleHumansHyaluronic AcidMaleMiddle AgedMolecular WeightOsteoarthritis, HipTreatment OutcomeViscosupplementationHyaluronic Acidhip osteoarthritishyaluronic acidintra-articularmolecular weightviscosupplementation

Identifiers

PMID34109828
PMCPMC8808882
OpenAlexW3168780368

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.