The effectiveness of intra-articular injections of biologic agents in osteoarthritis of the hip: a systematic review

A recently published study in the American journal “Arthroscopy” set out to determine whether biologic agents given as an intra-articular injection in osteoarthritis of the knee can significantly improve patient-reported outcomes at six and 12 months after the injection. The study also set out to determine the differences in outcome between injections of biologic agents and cortisone or hyaluronic acid or placebo over the same intervals, together with the similarities and differences in outcome according to the different types of biologic agent.
A systematic search of the literature was made in the medical databases PubMed, Cochrane, Central Register of Controlled Trials, SCOPUS and Sport Discus for English-language level 1 studies, in vivo studies in humans on the treatment of symptomatic osteoarthritis of the knee with a minimum follow-up of six months.
Six articles were analysed in all (739 patients, 817 knees, 39% men, mean age 59.9 years, mean follow-up 38 weeks). All the studies showed a significant improvement in the statistical outcomes, including pain, physical function and stiffness. All but one study showed significant differences in clinical outcome, in pain and in function, between injection of biologic agents and hyaluronic acid, or biologic agents and placebo. None of these studies, however, used corticosteroids.
The authors concluded that in patients with symptomatic osteoarthritis of the knee, injections of biologic agents result in significant clinical improvement for up to 12 months after the injection. Clinical outcomes are better with the injection of biologic agents than with hyaluronic acids from three to 12 months afterwards. There is very limited evidence comparing leucocyte-poor with leucocyte-rich biologic agents, and comparing the use of biologic agents with the use of steroids.
Source: Arthroscopy, The Journal Of Arthroscopic And Related Surgery, March 2016.