Hyaluronic Acid Injections Are Associated with Delay of Total Knee Replacement Surgery in Patients with Knee Osteoarthritis: Evidence from a Large U.S. Health Claims Database. A retrospective claims analysis

Hyaluronic Acid Injections Are Associated with Delay of Total Knee Replacement Surgery in Patients with Knee Osteoarthritis.

Article specifications

This review article was published in 2015 in PLOS ONE (IF 2015:2.806) by American orthopedics. In this study researchers retrospectively evaluated records in an administrative claims database of ~79 million patients, to identify all patients with knee OA who received TKR during a 6-year period. Only patients with continuous plan enrollment from diagnosis until TKR were included, so that complete medical records were available. OA diagnosis was the index event and we evaluated time-to-TKR as a function of the number of HA injections. The database included 182,022 patients with knee OA who had TKR; 50,349 (27.7%) of these patients were classified as HA Users, receiving _1 courses of HA prior to TKR, while 131,673 patients (72.3%) were HA Non-users prior to TKR, receiving no HA.

Results

The results of the study showed that HA injection is associated with a significant delay in TKR. Patients who received no HA had a median time-to-TKR of ~0.3 years; with one course of HA, the median time to TKR was >1.0 year (p < 0.0001); patients who received _5 courses delayed TKR by 3.6 years (p < 0.0001). The dose-response relationship between numbers of HA courses and time-to-TKR suggests that there is clinical benefit from HAs.