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The first commercially sold sodium hyaluronate had been developed by Endre Alexander Balazs under the brand name of Healon, manufactured by Pharmacia AB in Sweden in 1980. In 1986, sodium hyaluronate was used as an intra-articular injection to treat osteoarthritis of the knee with the product Hyalart/Hyalgan by Fidia of Italy. [27]
In osteoarthritis, joint injection of glucocorticoids (such as hydrocortisone) leads to short term pain relief that may last between a few weeks and a few months. [5] Injections of hyaluronic acid have not produced improvement compared to placebo for knee arthritis, [6] [7] but did increase risk of further pain. [6]
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A 2020 meta-analysis found that intra-articular injection of high molecular weight HA improved both pain and function in people with knee osteoarthritis. [26] Hyaluronic acid has been used to treat dry eye. [27] Hyaluronic acid is a common ingredient in skin care products. Hyaluronic acid is used as a dermal filler in cosmetic surgery. [28]
A 2017 review described the evidence as moderate for knee osteoarthritis. [15] A 2016 review found benefit but there was a moderate degree of variability between trials and risk of bias. [16] In 2019, the American College of Rheumatology recommended against prolotherapy for knee osteoarthritis. [17]
Articular cartilage, most notably that which is found in the knee joint, is generally characterized by very low friction, high wear resistance, and poor regenerative qualities. It is responsible for much of the compressive resistance and load bearing qualities of the knee joint and, without it, walking is painful to impossible.
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