June 07, 2013
1 min read

Revised clinical practice guideline for knee OA no longer recommends HA injections

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The American Academy of Orthopaedic Surgeons recently released a revised version of its clinical practice guideline for the treatment of knee osteoarthritis, which included changes regarding the use of intra-articular hyaluronic acid and acetaminophen.

The original 2009 and revised guidelines by the American Academy of Orthopaedic Surgeons (AAOS) specifically addressed treatments that were less invasive than knee replacement, according to an AAOS press release.

The revised guideline no longer recommends intra-articular hyaluronic acid for symptomatic patients. According to the release, the original guideline review was “inconclusive” for this treatment.


David S. Jevsevar

“Fourteen studies assessed intra-articular hyaluronic acid injections,” David S. Jevsevar, MD, MBA, chair of the Committee on Evidence-Based Quality and Value, which oversees the development of clinical practice guidelines, stated in an AAOS press release. “Although a few individual studies found statistically significant treatment effects, when combined together in a meta-analysis, the evidence did not meet the minimum clinically important improvement thresholds.”

The other change in the revised guideline reduces the recommended daily dosage of acetaminophen from 4,000 mg to 3,000 mg, which reflects an overall change made by the FDA for patients who use this medication.