Hyaluronan for knee XXXX : an updated meta-analysis of trials with low risk of bias.

@entity1 @entity158 @entity571 @entity7334
BACKGROUND: The effectiveness of @entity7334 ( @entity7334 ) injection for knee @entity571 (KOA) is debated. OBJECTIVES: To evaluate the effect of @entity7334 for @entity1 with KOA by analysing data from trials of @entity7334 versus placebo with low risk of bias, to provide the highest level of evidence. METHODS: A systematic review and meta-analysis was conducted. Randomised controlled trials (RCTs) with a low risk of bias (adequate randomisation and concealment and double-blind design) that investigated @entity7334 versus placebo (saline solution) injection were eligible. The primary efficacy measure was @entity158 intensity and secondary outcome function at 3   months. The treatment effect was summarised with the standardised mean difference (SMD) calculated from differences in means of @entity158 and function measures between treatment and control groups at 3   months. Trials were pooled by a random-effects model with DerSimonian and Laird weights. Statistical heterogeneity was explored by a visual exploration of forest plots and the I(2) statistic. RESULTS: A total of eight RCTs (2 199 randomised @entity1 ) met our inclusion criteria. @entity7334 significantly reduced the @entity158 intensity (SMD=-0.21, 95% CI (95% CI) -0.32 to -0.10) and improved function (SMD=-0.12, 95% CI -0.22 to -0.02). Trials showed no heterogeneity. CONCLUSIONS: This meta-analysis of high-quality trials of @entity7334 versus placebo shows that @entity7334 provides a moderate but real benefit for @entity1 with KOA.
