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1、ReviewSynthèseIntra-articularhyaluronicacidforthetreatmentofosteoarthritisoftheknee:systematicreviewandmeta-analysisJasminArrich,FranzPiribauer,PhilippMad,DanielaSchmid,KlausKlaushofer,MarcusMüllnerAnabridgedversionofthisarticleappearedintheApr.12,2005,issueofCMAJandisavailableonlineatww
2、w.cmaj.ca/cgi/content/full/172/8/1039/DC1Abstractsteoarthritisaffectsabout10%ofthepopulationover55yearsofage.Ofthose,one-quarterarese-Background:Osteoarthritisofthekneeaffectsupto10%oftheOverelydisabled.1Theconditionischaracterizedbyelderlypopulation.Theconditionisfrequentlytreatedbyin-d
3、egenerationofthearticularcartilageandsubsequentsub-tra-articularinjectionofhyaluronicacid.Weperformedasys-chondralbonechanges.Theunderlyingmechanismsre-tematicreviewandmeta-analysisofrandomizedcontrolledmainunknown,buttheglycosaminoglycan–proteoglycantrialstoassesstheeffectivenessofthist
4、reatment.matrixmayplayamajorrole.2Methods:WesearchedMEDLINE,EMBASE,CINAHL,BIOSISHyaluronicacid,aglycosaminoglycan,iswidelyusedandtheCochraneControlledTrialRegisterfrominceptionforthetreatmentofosteoarthritisoftheknee.AsurveyofuntilApril2004usingacombinationofsearchtermsforknee2generalpra
5、cticesintheUnitedKingdomshowedthatosteoarthritisandhyaluronicacidandafilterforrandomizedabout15%ofpatientswithosteoarthritisreceivedintra-controlledtrials.Weextracteddataonpainatrest,paindur-articulartreatmentwithglucosaminesulfates.3Thecostsingorimmediatelyaftermovement,jointfunctionand
6、ad-verseevents.ofsuchtreatmentaresignificant.Atpresent,1syringeofResults:Twenty-twotrialsthatreportedusablequantitativeinfor-hyaluronicacidcostsatleastCan$130(US$110).ThemationonanyofthepredefinedendpointswereidentifiedandtreatmentofkneeosteoarthritisiscoveredbytheUSincludedinthesystemat
7、icreview.EventhoughpainatrestMedicareprogrambutnotbyprovincialformulariesinmaybeimprovedbyhyaluronicacid,thedataavailablefromCanada.InAustria(whichhas8millioninhabitants)morethesestudiesdidnotallowanappropriateassessmentofthisthan10millioneuros(approximatelyUS$12millionor
