Hyaluronic Acid Research
38 peer-reviewed studies · Evidence score: 8/10
Long-term effectiveness of intra-articular injectables in patients with knee osteoarthritis: a systematic review and Bayesian network meta-analysis
Gupta N et al. • Journal of orthopaedic surgery and research (2025)
These findings emphasize the sustained efficacy of PRP, particularly when combined with HA, in providing superior long-term pain relief and functional improvement in knee OA compared to other intra-articular injectables, highlighting its potential as a preferred treatment modality.
- These findings emphasize the sustained efficacy of PRP, particularly when combined with HA, in providing superior long-term pain relief and functional improvement in knee OA compared to other intra-articular injectables, highlighting its potential as a preferred treatment modality.
- Published in Journal of orthopaedic surgery and research (2025)
- Further research warranted to confirm findings
Platelet-Rich Plasma, Bone Marrow Aspirate Concentrate, and Hyaluronic Acid Injections Outperform Corticosteroids in Pain and Function Scores at a Minimum of 6 Months as Intra-Articular Injections for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis
Jawanda H et al. • Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (2024)
At a minimum 6-month follow-up, PRP demonstrated significantly improved pain and function for patients with knee osteoarthritis compared with placebo.
- The most studied intra-articular injection was HA (40.9%), followed by placebo (26.2%), PRP (21.5%), CS (8.8%), and then BMAC (2.5%).
- HA and PRP both led to a significant improvement in pain compared with placebo.
- HA, PRP, and BMAC all led to a significant improvement in function scores when compared with placebo.
Effects and safety of hyaluronic acid gel on intrauterine adhesion and fertility after intrauterine surgery: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials
Luo Y et al. • American journal of obstetrics and gynecology (2024)
Hyaluronic acid can safely and effectively reduce the incidence of intrauterine adhesions and may improve fertility outcomes.
- The analysis revealed that hyaluronic acid reduced the incidence of intrauterine adhesion (risk ratio, 0.53; 95% confidence interval, 0.42-0.67; I2=48%) and improve pregnancy rates (risk ratio, 1.24; 95% confidence interval, 1.02-1.50; I2=0%).
- The protective effect was statistically significant after a follow-up of 6 to 12 weeks.
- Hyaluronic acid can safely and effectively reduce the incidence of intrauterine adhesions and may improve fertility outcomes.
Efficacy and safety of corticosteroids, hyaluronic acid, and PRP and combination therapy for knee osteoarthritis: a systematic review and network meta-analysis
Qiao X et al. • BMC musculoskeletal disorders (2023)
The current study found that PRP and PRP + HA were the most successful in improving function and alleviating pain after 3, 6, and 12 months of follow-up.
- The current study found that PRP and PRP + HA were the most successful in improving function and alleviating pain after 3, 6, and 12 months of follow-up.
- CSC, HA, PRP, and combination therapy did not result in an increase in the incidence of treatment-related side events as compared to placebo.
- Further research warranted to confirm findings
The Role of Hyaluronic Acid for Soft Tissue Indications: A Systematic Review and Meta-Analysis
Khan M et al. • Sports health (2023)
This systematic review and meta-analysis support HA's efficacy in the treatment of a variety of soft tissue indications.
- The pooled treatment effect of HA across most soft indications against placebo and active comparators demonstrated benefit in short-term pain <6 weeks (MD visual analogue scale [VAS] 2.48, 95% CI 2.31-2.65) and 6 to 12 weeks (MD VAS 2.03, 95% CI 1.86-2.20).
- Mid-term pain relief also favored HA over comparators across indications >12 weeks from administration (MD VAS 3.57, 95% CI 3.35-3.78).
- High heterogeneity was present with rotator cuff (10 trials, I2 = 94%), and elbow tendinopathy (2 trials, I2 = 99%).
Efficacy of intra-articular injections of hyaluronic acid in patients with glenohumeral joint osteoarthritis: A systematic review and meta-analysis
Familiari F et al. • Journal of orthopaedic research : official publication of the Orthopaedic Research Society (2023)
Journal of Orthopaedic Research® published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.
- Comparing HA injections combined with physical therapy (PT) compared to PT alone resulted in superior scores, showing an overall effect size (ES) of 4.43 (p = 0.00006).
- Moreover, pooled analysis of VAS pain scores demonstrated a significant improvement in the ES of the HA in comparison with corticosteroid injections (p = 0.002).
- A total of 46.7% of studies showed probable signs of a randomization bias.
Patients With Knee Osteoarthritis Who Receive Platelet-Rich Plasma or Bone Marrow Aspirate Concentrate Injections Have Better Outcomes Than Patients Who Receive Hyaluronic Acid: Systematic Review and Meta-analysis
Belk JW et al. • Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (2023)
Patients undergoing treatment for knee OA with PRP or BMAC can be expected to experience improved clinical outcomes when compared with patients who receive HA.
- Patients undergoing treatment for knee OA with PRP or BMAC can be expected to experience improved clinical outcomes when compared with patients who receive HA.
- Published in Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (2023)
- Further research warranted to confirm findings
Efficacy of fractional CO(2) laser therapy combined with hyaluronic acid dressing for treating facial atrophic acne scars: a systematic review and meta-analysis of randomized controlled trials
Zhang J et al. • Lasers in medical science (2023)
The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.
- In addition, fractional CO2 laser combined with HA dressing therapy had a lower incidence of hyperpigmentation than fractional CO2 laser alone (RR=0.37, 95% CI [0.23, 0.61], P<0.0001).
- The level of evidence for outcomes was classified to be low to moderate.
- According to our findings, fractional CO2 laser combined with HA dressing is efficacious and safe option for facial atrophic acne scars.
Efficacy and safety of different hyaluronic acid fillers on cheek volume augmentation: systematic review and network meta-analysis
Elrosasy A et al. • Archives of dermatological research (2024)
While no significant differences were observed in efficacy among HA fillers, Giselleligne emerged as a potentially safer option for the cheeks volume restoration.
- While no significant differences were observed in efficacy among HA fillers, Giselleligne emerged as a potentially safer option for the cheeks volume restoration.
- The study emphasizes the need for further well-designed RCTs to explore the long-term safety and durability of HA fillers.
- These findings contribute valuable insights for clinicians and patients in making evidence-based decisions regarding mid-face rejuvenation options.
Efficacy and safety of arthroscopic surgery combined with hyaluronic acid for meniscal injuries: A systematic review and meta-analysis of randomized controlled studies
Dong Z et al. • Journal of orthopaedic surgery (Hong Kong) (2023)
Arthroscopic surgery combined with hyaluronic acid for meniscal injury can improve the efficiency of treatment compared with arthroscopic surgery alone, as well as the efficacy in relieving joint pain and improving joint function and mobility, without increasing the incidence of complications.
- The complications rate was comparable in both groups [OR = 0.86, 95% CI (0.29, 2.53), p = .78], with no statistically significant difference.
- Arthroscopic surgery combined with hyaluronic acid for meniscal injury can improve the efficiency of treatment compared with arthroscopic surgery alone, as well as the efficacy in relieving joint pain and improving joint function and mobility, without increasing the incidence of complications.
- Arthroscopic surgery combined with hyaluronic acid administration has good effectiveness and safety profile.
Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis
Bannuru RR et al. • Annals of internal medicine (2015)
This method allowed comparison of common treatments of knee OA according to their relative efficacy.
- This method allowed comparison of common treatments of knee OA according to their relative efficacy.
- Intra-articular treatments were superior to nonsteroidal anti-inflammatory drugs, possibly because of the integrated IA placebo effect.
- Small but robust differences were observed between active treatments.
The Effect of Intra-articular Injection of Hyaluronic Acid in Frozen Shoulder: a Systematic Review and Meta-analysis of Randomized Controlled Trials
Mao B et al. • Journal of orthopaedic surgery and research (2022)
The current meta-analysis suggested that HA is a beneficial treatment procedure in improving the ROM of the shoulder for patients with FS, whereas the effect in relieving pain may be equal to the existing therapy.
- The current meta-analysis suggested that HA is a beneficial treatment procedure in improving the ROM of the shoulder for patients with FS, whereas the effect in relieving pain may be equal to the existing therapy.
- In conclusion, Intra-articular HA injection is recommended for FS patients.
- Further research warranted to confirm findings
Intra-articular injections of ozone versus hyaluronic acid for knee osteoarthritis: a level I meta-analysis
Migliorini F et al. • European journal of orthopaedic surgery & traumatology : orthopedie traumatologie (2024)
The current level I evidence suggests that ozone and HA intra-articular injections achieve similar pain control between 4 and 6 months of follow-up.
- Data from 424 patients were collected. 74% (314 of 424 patients) were women.
- Compatibility was found in the mean age, mean BMI, PROMs, and the percentage of women.
- The current level I evidence suggests that ozone and HA intra-articular injections achieve similar pain control between 4 and 6 months of follow-up.
Clinical therapy of platelet-rich plasma vs hyaluronic acid injections in patients with knee osteoarthritis: A systematic review and meta-analysis of randomized double-blind controlled trials
Gong H et al. • Medicine (2021)
In improving knee function and quality of life, PRP showed superiority over HA in long-term follow-up from well-designed double-blind trials, but a large number of high-quality multi-center studies are still needed to provide more sufficient evidence.
- Meta-analysis results showed that the Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) Total Score was differed significantly between the PRP and HA groups at the 1, 6, 12 months follow-up (MD = 3.39, 95% CI: 2.85–3.92, P < .05).
- In a comparison of Physical function scores at the 12 months follow-up, PRP improved knee function scores more than HA (MD = 3.28; 95% CI: 2.13–4.43; P < .05).
- In improving knee function and quality of life, PRP showed superiority over HA in long-term follow-up from well-designed double-blind trials, but a large number of high-quality multi-center studies are still needed to provide more sufficient evidence.
Effects and safety of the combination of platelet-rich plasma (PRP) and hyaluronic acid (HA) in the treatment of knee osteoarthritis: a systematic review and meta-analysis
Zhao J et al. • BMC musculoskeletal disorders (2020)
Compared with intra-articular injection of PRP alone, that of PRP combined with HA can improve the WOMAC Function Scores, WOMAC Total Score, 6-month follow-up VAS ratings, and Lequesne Index scores.
- In the VAS comparison after 6 months of follow-up, PRP combined with HA was more likely to reduce knee pain than PRP alone (SMD: - 0.31; 95% confidence interval (CI): - 0.55 to - 0.06; P = 0.01 < 0.05).
- In a comparison of Lequesne Index scores at the 6-month follow-up, PRP combined with HA improved knee pain scores more than PRP alone (SMD: -0.42; 95% CI: - 0.67 to - 0.17; P < 0.05).
- Compared with intra-articular injection of PRP alone, that of PRP combined with HA can improve the WOMAC Function Scores, WOMAC Total Score, 6-month follow-up VAS ratings, and Lequesne Index scores.
Comparison of hyaluronic acid and platelet-rich plasma in knee osteoarthritis: a systematic review
Xu H et al. • BMC musculoskeletal disorders (2025)
Based on the current evidence, intra-articular injection of PRP appears to be more effective than HA for the treatment of KOA, as indicated by the analysis of VAS, WOMAC scores, and other evaluation indices.
- Based on the current evidence, intra-articular injection of PRP appears to be more effective than HA for the treatment of KOA, as indicated by the analysis of VAS, WOMAC scores, and other evaluation indices.
- Published in BMC musculoskeletal disorders (2025)
- Further research warranted to confirm findings
A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA)
Du D et al. • Journal of orthopaedic surgery and research (2025)
This meta-analysis reveals that, for patients with KOA, PRP + HA therapy is safe and yields better outcomes in pain relief and functional improvement compared to PRP monotherapy.
- This meta-analysis reveals that, for patients with KOA, PRP + HA therapy is safe and yields better outcomes in pain relief and functional improvement compared to PRP monotherapy.
- Published in Journal of orthopaedic surgery and research (2025)
- Further research warranted to confirm findings
Hyaluronic acid and urology: a systematic review and meta-analysis
Roth BJ et al. • Sexual medicine reviews (2025)
Literature on hyaluronic acid for urologic issues demonstrates promising results; however, the quality of studies was variable.
- Literature on hyaluronic acid for urologic issues demonstrates promising results; however, the quality of studies was variable.
- Our analysis of these studies largely corroborates these findings; however, the results are limited by the data available.
- Hyaluronic acid may be promising, but we highly implore standardization of study regimens in randomized controlled trials.
Transforming TMJ pain relief: Hyaluronic acid's efficacy in focus - a comprehensive systematic review and meta-analysis of randomized controlled trials
Flores-Fraile J et al. • Dental and medical problems (2025)
In individuals with TMJ pain and dysfunction, HA has shown safety and effectiveness in reducing pain and enhancing the maximum mouth opening (MMO).
- In individuals with TMJ pain and dysfunction, HA has shown safety and effectiveness in reducing pain and enhancing the maximum mouth opening (MMO).
- However, when compared to platelet-rich plasma (PRP), HA has demonstrated superior long-term results.
- Further research warranted to confirm findings
Comparative effectiveness of hyaluronic acid, platelet-rich plasma, and platelet-rich fibrin in treating temporomandibular disorders: a systematic review and network meta-analysis
Xu J et al. • Head & face medicine (2023)
PRP and PRF exhibited similar short-term efficacy in treating TMD, while PRF was more advantageous in terms of long-term efficacy.
- PRP appeared to be more effective than PRF was after 6 months but there were no statistically significant differences between the two.
- PRP and PRF exhibited similar short-term efficacy in treating TMD, while PRF was more advantageous in terms of long-term efficacy.
- Therefore, PRF was recommended for treating TMD.