Intra-articular hyaluronic acids for osteoarthritis of the knee

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Hyaluronic acids (HAs) are one modality in the arsenal for the treatment of osteoarthritis (OA) of the knee. Non-pharmacologic strategies, such as exercise therapy and weight loss, improve functional capacity and provide pain relief. When patients require adjunct pharmacologic therapy, non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, intra-articular (IA) corticosteroids, duloxetine, HA, topical capsaicin, and, when necessary, opioid medications may be used. Current guidelines recommend caution with use of many of these therapies because of safety concerns, especially in patients with comorbidities. HAs provide pain relief for patients with mild-to-moderate knee OA without adversely affecting patients with comorbidities. With 15 HA preparations available, these agents vary according to origin of derivation, molecular weight, number of injections per series, and duration of effect. This article discusses the various HA preparations.

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