Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Orthopaedic Surgery


Dr. Nancy Reid



Objective: The objective of this article is to review how efficient intraarticular hyaluronic acid (HA) injections of the knee joints are to prevent the need for total knee replacement (TKR) in patients with knee osteoarthritis (OA).

Method: PubMed Central search was performed with search terms knee osteoarthritis, hyaluronic acid, imaging, and total knee replacement. Pertinent articles were obtained and applied towards this clinical review.

Results: Hyaluronic acid injections with image guidance of the effected knee joint may allow for relief of six months or longer. This will delay the need for the TKR. Treatment will vary with longevity based on degree of OA and patient’s response to treatment. Treatment may vary with dosing quantity of HA injections.

Conclusion: In practice, many patients obtain relief with HA injections of the knees. It is permissible to include corticosteroid injections as well if the patient is in pain. Total knee replacements are permanent and may not result in the expected relief. With this considered, it is medically appropriate to begin conservative care first. With HA injections, patients may obtain long-term relief. If OA is found early in the disease progression, the HA injections may be more efficacious. The HA injections will treat and help with the OA of the effected knee. While it may work with severe arthritis, it may not work as long in duration, or it may not have a strong impact of relief and joint functionality. In conclusion, intraarticular HA injections of the knee joints will provide significant relief and will prolong the need for a TKR in the majority of patients with OA.

Keywords: Knee osteoarthritis, Hyaluronic acid, Imaging, Total knee replacement.


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