{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:16:58Z","timestamp":1790669818933,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,5,18]],"date-time":"2015-05-18T00:00:00Z","timestamp":1431907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,5,18]],"date-time":"2015-05-18T00:00:00Z","timestamp":1431907200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2015,5,18]],"date-time":"2015-05-18T00:00:00Z","timestamp":1431907200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","arthroscopyjournal.org","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To conduct a systematic review of overlapping meta\u2010analyses comparing treatment of knee osteoarthritis (OA) with intra\u2010articular viscosupplementation (intra\u2010articular hyaluronic acid [IA\u2010HA]) versus oral nonsteroidal anti\u2010inflammatory drugs (NSAIDs), intra\u2010articular corticosteroids (IA\u2010corticosteroids), intra\u2010articular platelet\u2010rich plasma (IA\u2010PRP), or intra\u2010articular placebo (IA\u2010placebo) to determine which meta\u2010analyses provide the best current evidence and identify potential causes of discordance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Literature searches were performed for meta\u2010analyses examining use of IA\u2010HA versus NSAIDs, IA\u2010corticosteroids, IA\u2010PRP, or IA\u2010placebo. Clinical data were extracted, and meta\u2010analysis quality was assessed. The Jadad algorithm was applied to determine which meta\u2010analyses provided the highest level of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen meta\u2010analyses met the eligibility criteria and ranged in quality from Level I to IV evidence. In studies reporting patient numbers, there were a total of 20,049 patients: 13,698 receiving IA\u2010HA, 355 receiving NSAIDs, 294 receiving IA\u2010corticosteroids, and 5,702 receiving IA\u2010placebo. Ten studies examined the effects of IA\u2010HA versus IA\u2010placebo; of these, 5 found that IA\u2010HA improved pain and 4 found that IA\u2010HA improved function. No clinically relevant differences in the efficacy of IA\u2010HA versus NSAIDs regarding pain and function were found. Regarding IA\u2010HA versus IA\u2010PRP, IA\u2010HA improved knee function at 2 and 6 months after injection but the effects were less robust than those of IA\u2010PRP. Regarding IA\u2010HA versus IA\u2010corticosteroids, the positive effects of IA\u2010HA were greater at 5 to 13 weeks and persisted for up to 26 weeks. After application of the Jadad algorithm, 2 concordant high\u2010quality meta\u2010analyses were selected and both showed that IA\u2010HA provided clinically relevant improvements in pain and function compared with IA\u2010placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This systematic review of overlapping meta\u2010analyses comparing IA\u2010HA with other nonoperative treatment modalities for knee OA shows that the current highest level of evidence suggests that IA\u2010HA is a viable option for knee OA. Its use results in improvements in knee pain and function that can persist for up to 26 weeks. IA\u2010HA has a good safety profile, and its use should be considered in patients with early knee OA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, systematic review of Level I to IV studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2015.03.030","type":"journal-article","created":{"date-parts":[[2015,5,19]],"date-time":"2015-05-19T18:27:00Z","timestamp":1432060020000},"page":"2036","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":134,"title":["Is Local Viscosupplementation Injection Clinically Superior to Other Therapies in the Treatment of\u00a0Osteoarthritis of the Knee: A Systematic Review of\u00a0Overlapping Meta\u2010analyses"],"prefix":"10.1002","volume":"31","author":[{"given":"Kirk A.","family":"Campbell","sequence":"first","affiliation":[{"name":"Midwest Orthopaedics at Rush Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon J.","family":"Erickson","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan M.","family":"Saltzman","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine Department of Orthopaedic Surgery The University of Texas Health Science Center at Houston Houston Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Bernard R.","family":"Bach","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Cole","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil N.","family":"Verma","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,18]]},"reference":[{"key":"e_1_2_3_2_2","first-page":"10","article-title":"Symptom onset, diagnosis and management of osteoarthritis","volume":"25","author":"MacDonald K.V.","year":"2014","journal-title":"Health Rep"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.2174\/1874325001408010255"},{"key":"e_1_2_3_4_2","first-page":"278","article-title":"Viscosupplementation 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