Non-operative Management of Osteoarthritis (OA) of the Knee: What Should you be Injecting Now and in the Future? (AANA19)-Hyaluronic Acid_ Science, Controversy, and Current Role-Dr. Jack M. Bert, M.D.

Hyaluronic Acid_ Science, Controversy, and Current Role-Dr. Jack M. Bert, M.D.

Video Transcription

Video Summary

The video discusses the role of hyaluronic acid (HA) visco supplementation in treating knee osteoarthritis (OA). Despite controversial guidelines from the American Academy of Orthopaedic Surgeons (AAOS) recommending against HA use, evidence supports its efficacy, particularly formulations with high molecular weight and cross-linking, which mimic healthy synovial fluid and offer prolonged joint residence time. These injections can reduce pain, improve function, delay total knee arthroplasty by several years, and may slow cartilage degeneration. The AAOS's negative stance is challenged due to flawed studies mixing low- and high-molecular-weight HA and misuse of clinical improvement metrics. Surveys show most orthopedic surgeons continue using HA due to perceived benefits. Recent literature and expert opinions call for a reevaluation of AAOS guidelines. Overall, high molecular weight cross-linked HA safely and effectively manages mild to moderate knee OA symptoms, improves quality of life, and postpones surgery, highlighting an important treatment option amid limited alternatives and concerns over other medications’ side effects.

Asset Caption

Instructional Course Lecture: Non-operative Management of Osteoarthritis (OA) of the Knee: What Should you be Injecting Now and in the Future?

Keywords

hyaluronic acid

knee osteoarthritis

high molecular weight HA

visco supplementation

total knee arthroplasty delay

AAOS guidelines controversy