Evidence map›Paper›PMID 40603830›Full record

SynthesisSports medicine (Auckland, N.Z.)2025

Intra-articular Hyaluronic Acid Injections May Be Beneficial in Patients with Less Advanced Knee Osteoarthritis: A Systematic Review of Randomised Controlled Trials.

Filippo Migliorini, Nicola Maffulli, Francesco Simeone, Naveen Jeyaraman, Swaminathan Ramasubramanian, Madhan Jeyaraman

Abstract readSystematic Review
In one paragraph

Synthesis in Sports medicine (Auckland, N.Z.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Non-Biologic Injections in Sports Medicine.Current reviews in musculoskeletal medicine · 2026
    Review
  5. Article
  6. Article
  7. Repeated (Weekly) Intra-Articular Injections of Sulfated Galactans Attenuate Cartilage Degeneration in a Rat Model of Osteoarthritis.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2026
    Article
  8. Article
  9. Article
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

6 authors.

Filippo MiglioriniDepartment of Trauma and Reconstructive Surgery, University Hospital of Halle, Martin-Luther University Halle-Wittenberg, Ernst-Grube-Street 40, 06097, Halle (Saale), Germany. filippo.migliorini@uk-halle.de.ORCID 0000-0001-7220-1221
Nicola MaffulliDepartment of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University La Sapienza, 00185, Rome, Italy.
Francesco SimeoneDepartment of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Via Lorenz Böhler 5, 39100, Bolzano, Italy.
Naveen JeyaramanDepartment of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, 600077, India.
Swaminathan RamasubramanianDepartment of Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai, Tamil Nadu, 600002, India.
Madhan JeyaramanDepartment of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, 600077, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKnee osteoarthritis is a degenerative joint disease that impairs quality of life. Hyaluronic acid (HA) injections are used to restore synovial fluid viscosity and improve joint function.

objectivesThe present systematic review investigated the prognostic factors influencing the effect of intra-articular HA injections for knee osteoarthritis (OA). The endpoint of interest was whether patient characteristics and molecular weight of the HA influence patient-reported outcome measures (PROMs) at different follow-ups.

methodsThis study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. All randomised controlled trials (RCTs) investigating the efficacy of intra-articular HA injections in the knee were accessed. Data concerning the visual analogue scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Lequesne scales were collected at baseline and the last follow-up. OA was scored using the Kellgren-Lawrence (KL) classification. The endpoint of interest was whether patient characteristics and the molecular weight of HA influence clinical outcomes.

resultsThe study included 71 RCTs and data from 10,590 patients; 67% (7082 of 10,570) were women. The mean age of the patients was 61.8 ± 5.1 years, and the mean body mass index (BMI) was 27.8 ± 2.3 kg/m

conclusionsHA injections lead to an initial worsening of symptoms; however, patients with early stage osteoarthritis, particularly older women, may experience significant long-term improvements. Further research should standardise treatment protocols and investigate the role of HA molecular weight in optimising outcomes.

Indexed as

Hyaluronic AcidOsteoarthritis, KneeViscosupplementsFemaleHumansInjections, Intra-ArticularMolecular WeightPatient Reported Outcome MeasuresRandomized Controlled Trials as TopicHyaluronic AcidViscosupplements

Identifiers

PMID40603830
PMCPMC12460378

What OpenQuestion holds

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Registered trials

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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.