Study | Comparison | Follow-up | Outcomes | Effect estimate | Comments |
Hyaluronic acid | |||||
Leite et al40 | HA vs PBO, PRP, MPA | 1–12 months | Pain | No between-group difference vs PRP (VAS) | |
3 months | No between-group difference vs PBO (VAS) | ||||
1–12 months | O-O Resp | No between-group difference vs MPA | |||
3 months | No between-group difference vs PBO | ||||
Liao et al37 | HA vs PBO or IAGC | 2 weeks | Pain | SMD= –0.18 (–0.47 to 0.10), no between-group difference | Data on pain was obtained as per a previously described hierarchy.55 Analyses use IAGC and PBO as comparators. |
4 weeks | SMD= –0.14 (–0.46 to 0.18), no between-group difference | ||||
2–6 months | SMD= –0.14 (–0.46 to 0.18), no between-group difference | ||||
2 weeks | Function | SMD=−0.14 (−0.52 to 0.24), no between-group difference | |||
4 weeks | SMD=−0.16 (−0.34 to 0.03), no between-group difference | ||||
2–6 months | SMD=−0.28 (−0.60 to 0.05), no between-group difference | ||||
Glucocorticoids | |||||
McCabe et al38 | IAGC vs PBO | 1–3 months | Pain | SMD=−1.90 (−4.07 to 0.26), no between-group difference | Comparisons vs PBO |
2 months | O-O Resp | OR=7.8 (2.7–22.8), favouring IAGC | |||
Function | 3 RCTs—favoured IAGC (ADL, WOMAC function) | ||||
1 RCT—no between-group difference | |||||
ROM | 1 RCT—favoured IAGC | ||||
1 RCT—no between-group difference | |||||
Platelet-rich plasma | |||||
Medina-Porqueres et al41 | PRP vs HA | 1 month | Pain | MD=−0.58 (−1.82 to 0.65) (VAS), no difference | All comparisons vs HA |
6 months | MD=0.20 (−1.36 to 1.77) (VAS), no difference | ||||
12 months | MD=−0.42 (−1.80 to 0.96) (VAS), no difference | ||||
2–12 months | Function | 3 RCTs—no between-group difference (HHS) | |||
1 RCT—favoured HA (WOMAC) | |||||
1 RCT—no between-group difference (WOMAC) | |||||
Stiffness | 1 RCT—favoured HA (WOMAC) | ||||
1 RCT—no between-group difference (WOMAC) | |||||
Ye et al 42 | PRP vs HA | 2 months | Pain | WMD=−0.38 (−0.61 to −0.14), favouring PRP (vs HA) | All comparisons vs HA |
6 months | WMD=−0.14 (−0.40 to 0.12), no between-group difference | ||||
12 months | WMD=−0.0 (−0.34 to 0.12), no between-group difference | ||||
2 months | Function | WMD=2.07 (−2.66 to 6.79) (HHS), no difference | |||
6 months | WMD=2.78 (−6.64 to 12.20) (HHS), no difference | ||||
12 months | WMD=0.71 (−6.33 to 7.75) (HHS), no difference | ||||
6 months | WMD=−2.84 (−6.25 to 0.57) (WOMAC), no difference | ||||
12 months | WMD=−3.13 (−6.62 to 0.36) (WOMAC), no difference | ||||
Ali et al36 | PRP vs HA | 2–12 months | Pain | 1 RCT—favoured PRP (VAS) | All comparisons vs HA |
2 RCTs—no between-group difference (VAS) | |||||
Function | 1 RCT—no between-group difference (HHS) | ||||
1 RCT—favoured PRP (WOMAC) | |||||
1 RCT—no between-group difference (WOMAC) |
All effect sizes are presented as the point estimate (95% CI) unless otherwise stated.
ADL, activities of daily life; HA, hyaluronic acid; HHS, Harris Hip Score; IAGC, intra-articular glucocorticoids; MD, mean difference; MPA, methylprednisolone acetate; O-O Resp, OMERACT-OARSI Responder Index; PBO, placebo; PRP, platelet-rich plasma; RCT, randomised-controlled trials; SMD, standardised mean difference; VAS, Visual Analogue Scale; WMD, weighted mean difference; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index.