title: Viscosupplementation in Knee Osteoarthritis: Evidence Revisited.
abstract: The body of evidence surrounding the use of viscosupplementation in knee osteoarthritis is extensive and fraught with heterogeneous trials with conflicting conclusions. Attempts to aggregate the evidence through systematic reviews, meta-analyses, and guidelines have also resulted in unclear, discordant recommendations. Closer examination reveals that the evidence around viscosupplementation favors clinically important reductions in pain among higher-molecular-weight and cross-linked formulations and is a safe option in patients with knee osteoarthritis. Further large trials assessing the use of viscosupplementation across various formulations in knee osteoarthritis may confirm subgroup findings from meta-analyses; however, immediate focus on improved knowledge translation is required to ensure evidence-based approaches to the treatment of knee osteoarthritis.
authors.affiliation: Center for Evidence-Based Orthopaedics, Division of Orthopaedic Surgery (H.J. and M.B.) and Department of Clinical Epidemiology and Biostatistics (T.D.), McMaster University, Hamilton, Ontario, Canada.
authors.forename: Herman
authors.initials: H
authors.lastname: Johal
authors.affiliation: Center for Evidence-Based Orthopaedics, Division of Orthopaedic Surgery (H.J. and M.B.) and Department of Clinical Epidemiology and Biostatistics (T.D.), McMaster University, Hamilton, Ontario, Canada.
authors.forename: Tahira
authors.initials: T
authors.lastname: Devji
authors.affiliation: Division of Orthopaedics, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Emil H
authors.initials: EH
authors.lastname: Schemitsch
authors.affiliation: Center for Evidence-Based Orthopaedics, Division of Orthopaedic Surgery (H.J. and M.B.) and Department of Clinical Epidemiology and Biostatistics (T.D.), McMaster University, Hamilton, Ontario, Canada.
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhandari
mesh_terms: D006801:Humans; D020370:Osteoarthritis, Knee / Q000150:complications / Q000628:therapy*; D010146:Pain / Q000209:etiology; D057170:Translational Research, Biomedical; D055676:Viscosupplementation