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Osteoarthritis (OA) is the most common form of chronic arthritis worldwide. Hyaluronan and hylan (HA) products provide opportunity to treat OA in individual knee joints. This review evaluates the efficacy, effectiveness and safety of HA products, in knee OA. The analyses support the contention that the HA class of products is superior to placebo. There is considerable between-product, between-variable and time-dependent variability in the clinical response. The clinical effect for some products against placebo on some variables at some time points is in the moderate to large effect size range. The analyses suggest that viscosupplements are comparable in efficacy to systemic forms of active intervention, with more local reactions but fewer systemic adverse events, and that HA products have more prolonged effects than IA corticosteroids. Overall, the aforementioned analyses support the use of the HA class of products in the treatment of knee OA.
Cochrane Database of Systematic Reviews, 2007, Issue 2, Art. No: CD005321.