Evidence map›Paper›PMID 41728202›Full record

ArticleOrthopedic reviews2026

Advances in hyaluronic acid therapy for knee osteoarthritis: monotherapy and combination strategies: an evidenced based review.

Kim Xoa Cao, Ha Nam Anh Tang, Manh Hung Tran

Abstract read
In one paragraph

Article in Orthopedic reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

  1. Article
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  3. Article
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  5. Review
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

3 authors.

Kim Xoa CaoDepartment of Pharmacy, Faculty of Health Sciences Industrial University of Ho Chi Minh City.ORCID https://orcid.org/0009-0007-7664-678X
Ha Nam Anh TangXuong Khop Viet Clinic, Ho Chi Minh City, Vietnam.ORCID https://orcid.org/0000-0001-7791-6437
Manh Hung TranDepartment of Pharmacology, School of Pharmacy University of Medicine and Pharmacy at Ho Chi Minh City.ORCID https://orcid.org/0000-0002-2937-9849

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Knee osteoarthritis (KOA) is a chronic degenerative joint disease that lead to cartilage loss, inflammation, and disability. Intra-articular hyaluronic acid (HA) is widely used for its viscoelastic, anti-inflammatory, and chondroprotective properties; however clinical outcomes remain inconsistent. Recent studies have explored combining HA with biologic or pharmacologic agents, such as platelet-rich plasma (PRP), corticosteroids (CS), fibrinogen, botulinum toxin A, polydeoxyribonucleotide (PDRN), and stem cells, to enhance efficacy through multimodal mechanisms. Despite this, the comparative benefits and safety profiles of these emerging strategies remain unclear. This review aims to evaluate the clinical efficacy of intra-articular HA, used either alone or in combination with adjunctive agents, for the management of KOA. A comprehensive literature search was conducted across PubMed, Embase, the Cochrane Library, and Web of Science, covering the period from January 2010 to April 2025. A total of 70 studies were included, comprising 50 randomized controlled trials (RCTs) and 20 meta-analyses. High-quality evidence supports the modest yet clinically significant efficacy of HA monotherapy, especially in the early to moderate stages of KOA. Outcomes appear to be affected by factors such as molecular weight, crosslinking, and injection protocols. Among combination strategies, the combination of HA and PRP demonstrates the most consistent synergistic benefits across various outcome domains. Short-term improvements are also observed with the combination of HA and CS. Emerging combinations involving fibrinogen, botulinum toxin A, peripheral blood stem cells and polydeoxyribonucleotide show early promise but remain under investigation.

Indexed as

combination therapycorticosteroidsHyaluronic acidknee osteoarthritisplatelet-rich plasmaviscosupplementation

Identifiers

PMID41728202
PMCPMC12922954

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.