Animal evidence for hyaluronic acid efficacy in knee trauma injuries. Review of animal-model studies

Introduction: Intra-articular injections of hyaluronic acid (HA) could have potential interest in therapy of acute knee trauma injuries, but few results are available in humans. Objective: We reviewed the literature for animal studies of intra-articular HA injections after knee trauma injury to determine the interest of human clinical research into and/or use of such injections for knee trauma. Methods: Systematic literature search on MEDLINE for studies involving animal models of osteoarthritis created by acute knee trauma injury, with HA injections beginning during the 2 weeks after injury. Results: The search revealed 14 studies with a high methodological quality: 7 related to meniscus injury, 3 ACL injury, 1 combined ACL-meniscus injury and 3 cartilage injury. The animal models were rabbits in 10 studies. Four studies demonstrated positive effects and 3 moderate effects of intra-articular HA injection for meniscus injury; 1 positive effects and 2 no effect for ACL injury; 1 positive effects for combined ACL-meniscus injury; and 2 moderate effects and 1 no effect for cartilage injury. Conclusions: With a high strength of recommendation, intra-articular HA injections in animal models with meniscus injury improved the healing process and/or had a protective role in articular cartilage, a slightly protective role in ACL injury animal models and low or no effect on healing in articular cartilage injury animal models. (C) 2013 Elsevier Ltd. All rights reserved.