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Expert Review

Solving Osteoarthritis Pain Control: Current Status of Hyaluronic Acid Knee Injections

Osteoarthritis 2014

Chapter 1: Osteoarthritis of the Knee: Addressing a Growing Epidemic

Pankaj Dhawan, MD, FRCSC
Physical Medicine and Rehabilitation, Vancouver, British Columbia

Osteoarthritis (OA) of the knee is a common orthopedic complaint, affecting about one in six adult Canadians.(1) A chronic and progressive inflammatory condition, OA is painful, restricts activity, and impairs quality of life. Due to its chronicity, it is essential to consider the long-term safety and tolerability of therapeutic options in the context of extended symptom control. Strategies to slow the pace of joint deterioration are being pursued, but the current focus of intervention is on symptom control. Traditionally, such simple analgesics as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) have been the first-line option, but their efficacy is limited and there are safety concerns with chronic use. For localized joint injections, hyaluronic acid (HA), which is a component of normal joint physiology, has safety advantages over corticosteroids, particularly when repeated treatments are anticipated. The durability of the effect of hyaluronic acid is also an advantage relative to other options. The success of any therapy is likely to be increased with non-pharmacologic support, particularly exercise to strengthen joints. 

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