Viscosupplementation Provides Minimal Relief for Knee Osteoarthritis Pain

Viscosupplementation provides a marginally small reduction in knee osteoarthritis pain but increases the risk of adverse side effects compared with placebo, according to a systematic review published in the BMJ.

The objective of the study was to determine the effectiveness and safety of viscosupplementation vs placebo or no intervention in the treatment of knee osteoarthritis. The study involved data from 21,163 randomly selected participants through 169 trials. The authors obtained information from the Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases as well as unpublished trials.

The review concluded that the reduction in pain intensity from the use of viscosupplementation was clinically minimal (SMD −0.08, 95% confidence interval −0.15 to −0.02). However, viscosupplementation was associated with a statistically significant higher risk of serious adverse events than placebo (relative risk 1.49, 95% confidence interval 1.12 to 1.98)

“We found that viscosupplementation was significantly associated with a small reduction in pain intensity compared with placebo, but the difference was less than the minimal clinically important between group difference,” the authors wrote. “We also found that viscosupplementation is associated with a higher incidence of serious adverse events compared with placebo.”

—Priyam Vora

Reference:

Pereira T, Jüni P, Saadat P, et al. Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis. BMJ. 2022;378 doi: https://doi.org/10.1136/bmj-2022-069722