Injection-Based Therapies for the Management of Hip and Knee Osteoarthritis.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

➢ Corticosteroid injections are largely safe, but patients and practitioners should be aware of the small risk of adverse side effects, and their limited duration of efficacy. The timing of injection should be coordinated with potential surgical dates.➢ The routine use of hyaluronic acid injections for osteoarthritis is not recommended, but there are certain subsets of patients, such as those who have undergone other therapies that failed, who may benefit from it.➢ Local anesthetics are frequently used in conjunction with corticosteroids for enhanced pain control; however, caution is needed because of concerns regarding chondrotoxicity. Proper patient selection is crucial, and their overuse for diagnostic purposes is not recommended.➢ There is currently insufficient evidence to support the routine use of prolotherapy, bone marrow aspirate concentrate, stromal vascular fraction, and mesenchymal stromal cell injections.➢ Intra-articular saline solution has been associated with improvements in both patient-reported pain and function scores, and this should be considered in future study designs.

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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