EUROVISCO; guidelines; hip; hyaluronic acid; osteoarthritis; recommendations; viscosupplementation; Immunology and Allergy; Biomedical Engineering; Physical Therapy, Sports Therapy and Rehabilitation
Abstract :
[en] BackgroundViscosupplementation (VS) by intra-articular injections of hyaluronic acid (HA) is an increasingly used treatment of hip osteoarthritis (OA). However, there are no clear European recommendations for its use.MethodsTwelve members of the European Viscosupplementation Consensus Group (EUROVISCO), made up of rheumatologists, orthopedic surgeons, and rehabilitation physicians from European countries, were asked to make a therapeutic decision on 23 statements based on an exhaustive analysis of the literature and their clinical experience, using the Delphi method. For each statement, the strength of agreement and the level of consensus were calculated by the chairman of the groupResultsThe expert panel reached unanimous or high consensus, either for or against, on 16 of the proposed statements. The main ones are: Current evidence and the results of observational trials support the use of VS in patients with hip OA who do not require surgery. VS is more effective in cases of mild to moderate hip OA. Hip VS is safe and well tolerated, even with repeated injections. The outcome of VS depends on the viscosupplement used. A standard X-ray must be obtained before deciding on VS. VS must be performed under imaging guidance. A single injection regimen is preferable to repeat injections. VS can be considered for individuals who wish to postpone surgery. Hip replacement surgery should not be performed within 3 months of VS. VS should not be used to treat an osteoarthritis flare. VS is part of a multimodal treatment for hip OA.ConclusionThis set of recommendations is intended to help practitioners make decisions about HA VS in patients with OA.
Disciplines :
Rheumatology
Author, co-author :
Migliore, Alberto; U.O.S. of Rheumatology, Ospedale San Pietro Fatebenefratelli, Rome, Italy
Raman, Raghu; Department of Orthopaedics, Academic Unit of Orthopaedics and Rheumatology, CMMH Hospital, Chennai, India
Diraçoglù, Demirhan; Department of Physical Medicine and Rehabilitation, Istanbul University and Istanbul Faculty of medicine, Istanbul, Turkey
Hamdan, Paulo Cesar; Department of Orthopedics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
Monfort, Jordi; Servei de Reumatologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
Baron, Dominique; Centre de réadaptation fonctionnelle de Lannion-Trestel, Trévou-Tréguignec, France
Brittberg, Mats; Cartilage Research Unit, University of Gothenburg, Team Orthopaedic Research, Cartibase International, Varberg, Sweden
Goncalves, Belarmino; Serviço de Radiologia de Intervenção, Instituto Português de Oncologia-FG, Porto, Portugal
Bonin, Nicolas; Orthopedic unit, Clinique de la Sauvegarde, Lyon, France
Chevalier, Xavier; Department of Rheumatology, Henri Mondor Hospital, Paris XII University, UPEC, Creteil, France
Henrotin, Yves ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Pathologie générale et physiopathologie - Techniques particulières de kinésithérapie ; Physical therapy and Rehabilitation Department, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
Conrozier, Thierry ; Department of Rheumatology, Hôpital Nord Franche-Comté, Belfort, France
Language :
English
Title :
EUROVISCO Recommendations for the Use of Viscosupplementation with Hyaluronic Acid in the Management of Hip Osteoarthritis.
Fan Z, Yan L, Liu H, Li X, Fan K, Liu Q, et al. The prevalence of hip osteoarthritis: a systematic review and meta-analysis. Arthritis Res Ther. 2023; 25(1):51. doi:10.1186/s13075-023-03033-7.
Wong AY, Samartzis D, Maher C. The global burden of osteoarthritis: past and future perspectives. Lancet Rheumatol. 2023; 5(9):e496-7. doi:10.1016/S2665-9913(23)00207-2.
Centers for Disease Control and Prevention. Osteoarthritis. [cited 2025 Jan 29]. Available from: https://www.cdc.gov/arthritis/osteoarthritis/index.html
Conrozier T, Raman R, Chevalier X, Henrotin Y, Monfort J, Diraçoglù D, et al. Viscosupplementation for the treatment of osteoarthritis. The contribution of EUROVISCO group. Ther Adv Musculoskelet Dis. 2021;131759720X211018605. doi:10.1177/1759720X211018605.
Henrotin Y, Raman R, Richette P, Bard H, Jerosch J, Conrozier T, et al. Consensus statement on viscosupplementation with hyaluronic acid for the management of osteoarthritis. Semin Arthritis Rheum. 2015; 45(2):140-9. doi:10.1016/j.semarthrit.2015.04.01.
Conrozier T, Monfort J, Chevalier X, Raman R, Richette P, Diraçoglù D, et al. EUROVISCO recommendations for optimizing the clinical results of viscosupplementation in osteoarthritis. Cartilage. 2020; 11(1):47-59. doi:10.1177/1947603518783455.
Piccirilli E, Oliva F, Murè MA, Mahmoud A, Foti C, Tarantino U, et al. Viscosupplementation with intra-articular hyaluronic acid for hip disorders. A systematic review and meta-analysis. Muscles Ligaments Tendons J. 2016; 6(3):293-9. doi:10.11138/mltj/2016.6.3.293.
Leite VF, Daud Amadera JE, Buehler AM. Viscosupplementation for hip osteoarthritis: a systematic review and meta-analysis of the efficacy on pain and disability, and the occurrence of adverse events. Arch Phys Med Rehabil. 2018; 99(3):574-83.e1. doi:10.1016/j.apmr.2017.07.010.
Liao YY, Lin T, Zhu HX, Shi MM, Yan SG. Intra-articular viscosupplementation for patients with hip osteoarthritis: a meta-analysis and systematic review. Med Sci Monit. 2019; 25:6436-45. doi:10.12659/MSM.916955.
Wu YZ, Huang HT, Ho CJ, Shih CL, Chen CH, Cheng TL, et al. Molecular weight of hyaluronic acid has major influence on its efficacy and safety for viscosupplementation in hip osteoarthritis: a systematic review and meta-analysis. Cartilage. 2021; 13(Suppl 1):169S-184S. doi:10.1177/19476035211021903.
Ebad Ali SM, Farooqui SF, Sahito B, Ali M, Khan AA, Naeem O. Clinical outcomes of intra-articular high molecular weight hyaluronic acid injection for hip osteoarthritis–a systematic review and meta-analysis. J Ayub Med Coll Abbottabad. 2021; 33(2):315-21.
Patel R, Orfanos G, Gibson W, Banks T, McConaghie G, Banerjee R. Viscosupplementation with high molecular weight hyaluronic acid for hip osteoarthritis: a systematic review and meta-analysis of randomised control trials of the efficacy on pain, functional disability, and the occurrence of adverse events. Acta Chir Orthop Traumatol Cech. 2024; 91(2):109-19. doi:10.55095/ACHOT2024/009.
Acuña AJ, Samuel LT, Jeong SH, Emara AK, Kamath AF. Viscosupplementation for hip osteoarthritis: does systematic review of patient-reported outcome measures support use? J Orthop. 2020; 21:137-49. doi:10.1016/j.jor.2020.03.016.
Vilabril F, Rocha-Melo J, Gonçalves JV, Vilaça-Costa J, Brito I. Hip osteoarthritis treatment with intra-articular injections: hyaluronic acid versus glucocorticoid–a systematic review. Acta Reumatol Port. 2020; 45(2):127-36.
Ferrara PE, Codazza S, Coraci D, Malerba G, Ferriero G, Ronconi G. State of art in intra-articular hip injections of different medications for osteoarthritis: a systematic review. BMC Musculoskelet Disord. 2021; 22(Suppl 2):997. doi:10.1186/s12891-021-04866-6.
Zhu J, Lim A, McCaskie AW, Khanduja V. Viscosupplementation is effective for the treatment of osteoarthritis in the hip: a systematic review. Arthroscopy. 2024; 40(6):1908-22.e13. doi:10.1016/j.arthro.2023.11.010.
Migliorini F, Pilone M, Mazzoleni MG, Schäfer L, Katusic D, Maffulli N. Intra-articular hyaluronic acid injections for hip osteoarthritis: a level I systematic review. Eur J Orthop Surg Traumatol. 2025; 35(1):180. doi:10.1007/s00590-025-04292-7.
Migliore A, Massafra U, Frediani B, Bizzi E, Sinelnikov Yzchaki E, Gigliucci G, et al. HyalOne® in the treatment of symptomatic hip OA–data from the ANTIAGE register: seven years of observation. Eur Rev Med Pharmacol Sci. 2017; 21(7):1635-44.
Migliore A, Bella A, Bisignani M, Calderaro M, De Amicis D, Logroscino G, et al. Total hip replacement rate in a cohort of patients affected by symptomatic hip osteoarthritis following intra-articular sodium hyaluronate (MW 1,500-2,000 kDa) ORTOBRIX study. Clin Rheumatol. 2012; 31(8):1187-96. doi:10.1007/s10067-012-1994-4.
Migliore A, Granata M, Tormenta S, Laganà B, Piscitelli P, Bizzi E, et al. Hip viscosupplementation under ultra-sound guidance riduces NSAID consumption in symptomatic hip osteoarthritis patients in a long follow-up. Data from Italian registry. Eur Rev Med Pharmacol Sci. 2011; 15(1):25-34.
De Lucia O, Pierannunzii LM, Pregnolato F, Verduci E, Crotti C, Valcamonica E, et al. Effectiveness and tolerability of repeated courses of viscosupplementation in symptomatic hip osteoarthritis: a retrospective observational cohort study of high molecular weight vs. medium molecular weight hyaluronic acid vs. no viscosupplementation. Front Pharmacol. 2019; 10: 1007.
Schiavi P, Calderazzi F, Pedrini MF, Tacci F, Vaienti E, Pogliacomi F. Efficacy and safety of viscosupplementation with hyaluronic acid for hip osteoarthritis: results from a cross-sectional study with a minimum follow-up of 4 years. Acta Biomed. 2020; 91(14-S):e2020032. doi:10.23750/abm.v91i14-S.11110.
Battaglia AG, D’Apolito R, Labionda F, Ramazzotti J, Zagra L. Ultrasound-guided hip injections with high density hyaluronic acid: outcome at one year follow up. J Clin Med. 2024; 13(9):2515. doi:10.3390/jcm13092515.
Migliore A, Frediani B, Gigliucci G, Foti C, Crimaldi S, De Lucia O, et al. Efficacy of a single intra-articular HYMOVIS ONE injection for managing symptomatic hip osteoarthritis: a 12-month follow-up retrospective analysis of the ANTIAGE register data. Orthop Res Rev. 2020; 12: 19-26. doi:10.2147/ORR.S239355.
Conrozier T, Couris CM, Mathieu P, Merle-Vincent F, Piperno M, Coury F, et al. Safety, efficacy and predictive factors of efficacy of a single intra-articular injection of non-animal-stabilized-hyaluronic-acid in the hip joint: results of a standardized follow-up of patients treated for hip osteoarthritis in daily practice. Arch Orthop Trauma Surg. 2009; 129(6):843-8. doi:10.1007/s00402-008-0778-4.
Migliore A, Massafra U, Bizzi E, Tormenta S, Cassol M, Granata M. Duration of symptom relief after intra-articular injection of hyaluronic acid combined with sorbitol (anti-ox-vs) in symptomatic hip osteoarthritis. Int J Immunopathol Pharmacol. 2014; 27(2):245-252D. doi:10.1177/039463201402700211.
Spoto I, Midiri M, Letizia Mauro G. Hybrid hyaluronic acid versus high molecular weight hyaluronic acid for the treatment of hip osteoarthritis in overweight/obese patients. J Funct Morphol Kinesiol. 2022; 7(1):20. doi:10.3390/jfmk7010020.
Rando G, Pastorino R. Intra-articular HYMOVIS injection for managing hip OA in active sportsmen. A 24-month observational retrospective clinical investigation. J Clin Orthop Trauma. 2021; 22: 101594. doi:10.1016/j.jcot.2021.101594.
Mauro GL, Sanfilippo A, Scaturro D. The effectiveness of intra-articular injections of Hyalubrix® combined with exercise therapy in the treatment of hip osteoarthritis. Clin Cases Miner Bone Metab. 2017; 14(2):146-52. doi:10.11138/ccmbm/2017.14.1.146.
OCEBM Levels of Evidence Working Group. The Oxford 2011 levels of evidence. Howick J, Iain Chalmers (James Lind Library), Paul Glasziou et al. Oxford Centre for Evidence-Based Medicine. [cited 2025 Nov 10]. Available from: http://www.cebm.net/index.aspx?o=5653
Eymard F, Maillet B, Lellouche H, Mellac Ducamp S, Brocq O, Loeuille D, et al. Predictors of response to viscosupplementation in patients with hip osteoarthritis: results of a prospective, observational, multicentre, open-label, pilot study. BMC Musculoskelet Disord. 2017; 18(1):3. doi:10.1186/s12891-016-1359-2.
Lequesne M. The false profile view of the hip: role, interest, economic considerations. Joint Bone Spine. 2002; 69(2):109-13. doi:10.1016/s1297-319x(02)00358-5.
Mascarenhas VV, Castro MO, Rego PA, Sutter R, Sconfienza LM, Kassarjian A, et al. The Lisbon agreement on femoroacetabular impingement imaging-part 1: overview. Eur Radiol. 2020; 30(10):5281-5297. doi:10.1007/s00330-020-06822-9. Epub 2020 Jul 17. Erratum in: Eur Radiol. 2020;30(12):6966-7. doi:10.1007/s00330-020-07009-y.
Deseyne N, Conrozier T, Lellouche H, Maillet B, Weber U, Jaremko JL, et al. Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis. Joint Bone Spine. 2018; 85(4):475-80. doi:10.1016/j.jbspin.2017.08.004.
Sofat N, Howe FA. Bone marrow lesions in osteoarthritis: characterising genetic and histological changes to understand disease pathophysiology. Osteoarthritis Cartilage Open. 2024; 6(4):100531. doi:10.1016/j.ocarto.2024.100531.
Oo WM, Linklater J, Siddiq MAB, Fu K, Hunter DJ. Comparison of ultrasound guidance with landmark guidance for symptomatic benefits in knee, hip and hand osteoarthritis: systematic review and meta-analysis of randomised controlled trials. Australas J Ultrasound Med. 2024; 27(2):97-105. doi:10.1002/ajum.12386.
Martínez-Martínez A, García-Espinosa J, Ruiz-Santiago F, Guzmán-Álvarez L, Castellano-García MM. Comparison of ultrasound and fluoroscopic guidance for injection in CT arthrography and MR arthrography of the hip. Radiologia. 2016; 58(6):454-9. doi:10.1016/j.rx.2016.07.006.
Saha P, Smith M, Hasan K. Accuracy of intraarticular injections: blind vs. image guided techniques–a review of literature. J Funct Morphol Kinesiol. 2023; 8(3):93. doi:10.3390/jfmk8030093.
Altman RD, Bedi A, Karlsson J, Sancheti P, Schemitsch E. Product differences in intra-articular hyaluronic acids for osteoarthritis of the knee. Am J Sports Med. 2016; 44(8):2158-65. doi:10.1177/0363546515609599.
Pogliacomi F, Schiavi P, Paraskevopoulos A, Leigheb M, Pedrazzini A, Ceccarelli F, et al. When is indicated viscosupplementation in hip osteoarthritis? Acta Biomed. 2018; 90(1-S):67-74.
Schiavi P, Calderazzi F, Pedrini MF, Tacci F, Vaienti E, Pogliacomi F. Efficacy and safety of viscosupplementation with hyaluronic acid for hip osteoarthritis: results from a cross-sectional study with a minimum follow-up of 4 years. Acta Biomed. 2020; 91(14-S):e2020032. doi:10.23750/abm.v91i14-S.11110.
Conrozier T, Vignon E. Is there evidence to support the inclusion of viscosupplementation in the treatment paradigm for patients with hip osteoarthritis? Clin Exp Rheumatol. 2005; 23(5):711-6.
Conrozier T, Bossert M, Balblanc JC, Sondag M, Walliser-Lohse A. Viscosupplementation with HANOX-M-XL is effective in moderate hip osteoarthritis but is not an alternative to hip joint surgery in patients with severe disease. Results of a clinical survey in 191 patients treated in daily practice. EJMD. 2014; 3(2):49-55.
Conrozier T, Diraçoglù D, Monfort J, Chevalier X, Bard H, Baron D, et al. EUROVISCO good practice recommendations for a first viscosupplementation in patients with knee osteoarthritis. Cartilage. 2023; 14(2):125-35. doi:10.1177/19476035221138958.
Raman R, Henrotin Y, Chevalier X, Migliore A, Jerosch J, Montfort J, et al. Decision algorithms for the retreatment with viscosupplementation in patients suffering from knee osteoarthritis: recommendations from the EUROpean VIScosupplementation COnsensus Group (EUROVISCO). Cartilage. 2018; 9(3):263-75. doi:10.1177/1947603517693043.
Conrozier T, Patarin J, Mathieu P, Rinaudo M. Steroids, lidocain and ioxaglic acid modify the viscosity of hyaluronic acid: in vitro study and clinical implications. Springerplus. 2016; 5: 170. doi:10.1186/s40064-016-1762-z.
Prospective Evaluation of the Cingal™ Injection for Hip Osteoarthritis (ECHO) Investigators. Intra-articular injection of a cross-linked hyaluronic acid combined with triamcinolone hexacetonide improves pain at six months in patients with mild to moderate hip osteoarthritis: a prospective observational study. J ISAKOS. 2025; 10: 100363. doi:10.1016/j.jisako.2024.100363.
Hangody L, Szody R, Lukasik P, Zgadzaj W, Lénárt E, Dokoupilova E, et al. Intraarticular injection of a cross-linked sodium hyaluronate combined with triamcinolone hexacetonide (cingal) to provide symptomatic relief of osteoarthritis of the knee: a randomized, double-blind, placebo-controlled multicenter clinical trial. Cartilage. 2018; 9(3):276-83. doi:10.1177/1947603517703732.
de Campos GC, Rezende MU, Pailo AF, Frucchi R, Camargo OP. Adding triamcinolone improves viscosupplementation: a randomized clinical trial. Clin Orthop Relat Res. 2013; 471(2):613-20. doi:10.1007/s11999-012-2659-y.
Saracco M, Ciriello V, D’Angelo F, Zagra L, Solarino G, Logroscino G. Do prior intra-articular injections impact on the risk of periprosthetic joint infection in patients undergoing total hip arthroplasty? a meta-analysis of the current evidences with a focus on the timing of injection before surgery. EFORT Open Rev. 2023; 8(6):459-67. doi:10.1530/EOR-23-0028.
Colen S, Hoorntje A, Maeckelbergh L, van Diemen M, Dalemans A, van den Bekerom MPJ, et al. Intra-articular hyaluronic acid injections less than 6 months before total hip arthroplasty: is it safe? a retrospective cohort study in 565 patients. J Arthroplasty. 2021; 36(3):1003-8. doi:10.1016/j.arth.2020.09.024.
Yoon BH, Shim JC, Lee M, Oh HK, Sung YB, Choo SK. Ultrasound-guided hydrodilatation for adhesive capsulitis of the hip is a safe and effective treatment. Int Orthop. 2021; 45(6):1455-61. doi:10.1007/s00264-020-04909-y.
Kantarci F, Ozbayrak M, Gulsen F, Gencturk M, Botanlioglu H, Mihmanli I. Ultrasound-guided injection for MR arthrography of the hip: comparison of two different techniques. Skeletal Radiol. 2013; 42(1):37-42. doi:10.1007/s00256-011-1306-0.
Li Z, Yu J, An P, Zhang W, Tian K. Current understanding of articular cartilage lesions in femoroacetabular impingement syndrome. J Orthop Surg Res. 2024; 19(1):886. doi:10.1186/s13018-024-05322-6.
Abate M, Scuccimarra T, Vanni D, Pantalone A, Salini V. Femoroacetabular impingement: is hyaluronic acid effective? Knee Surg Sports Traumatol Arthrosc. 2014; 22(4):889-92. doi:10.1007/s00167-013-2581-1.
Lee YK, Lee GY, Lee JW, Lee E, Kang HS. Intra-articular injections in patients with femoroacetabular impingement: a prospective, randomized, double-blind, cross-over study. J Korean Med Sci. 2016; 31(11):1822-7. doi:10.3346/jkms.2016.31.11.1822.
Ometti M, Schipani D, Conte P, Pironti P, Salini V. The efficacy of intra-articular HYADD4-G injection in the treatment of femoroacetabular impingement: results at one year follow up. J Drug Assess. 2020; 9(1):159-66. doi:10.1080/21556660.2020.1843860.
Khan W, Khan M, Alradwan H, Williams R, Simunovic N, Ayeni OR. Utility of intra-articular hip injections for femoroacetabular impingement: a systematic review. Orthop J Sports Med. 2015; 3(9):2325967115601030. doi:10.1177/2325967115601030.
Strand V, McIntyre LF, Beach WR, Miller LE, Block JE. Safety and efficacy of US-approved viscosupplements for knee osteoarthritis: a systematic review and meta-analysis of randomized, saline-controlled trials. J Pain Res. 2015; 8:217-28. doi:10.2147/JPR.S83076.
Maheu E, Bannuru RR, Herrero-Beaumont G, Allali F, Bard H, Migliore A. Why we should definitely include intra-articular hyaluronic acid as a therapeutic option in the management of knee osteoarthritis: results of an extensive critical literature review. Semin Arthritis Rheum. 2019; 48(4):563-72. doi:10.1016/j.semarthrit.2018.06.002.
Pereira TV, Saadat P, Bobos P, Iskander SM, Bodmer NS, Rudnicki M, et al. Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: a systematic review and network meta-analysis. Osteoarthritis Cartilage. 2025; 33(2):207-17. doi:10.1016/j.joca.2024.08.014.
Richette P, Ravaud P, Conrozier T, Euller-Ziegler L, Mazières B, Maugars Y, et al. Effect of hyaluronic acid in symptomatic hip osteoarthritis: a multicenter, randomized, placebo-controlled trial. Arthritis Rheum. 2009; 60(3):824-30. doi:10.1002/art.24301.
Sousa EB, Hamdan PC, Menegassi ZJB, Alchaar AADA, Tieppo AM, Souza CG, et al. Brazilian consensus statement on viscosupplementation of the hip (COBRAVI-Q). Acta Ortop Bras. 2022; 30(5):e250414.
Barbara AM, Ritchie L, Severn M. Intra-articular hyaluronic acid for osteoarthritis of the hip, shoulder, and ankle: rapid review. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health. Mar. Report No.: RC1528. 2024.
Paoloni M, Bernetti A, Belelli A, Brignoli O, Buoso S, Caputi AP, et al. Appropriateness of clinical and organizational criteria for intra-articular injection therapies in osteoarthritis. A Delphi method consensus initiative among experts in Italy. Ann Ist Super Sanita. 2015; 51(2):131-8.
Migliore A, Tormenta S, Massafra U, Alessandri G, Martin LS. Safety of intra-articular hyaluronic acid injections in the osteoarthritic hip: a literature review. Exp Ther Med. 2012; 4(1):130-40.
McCabe PS, Parkes MJ, Maricar N, Hutchinson CE, Arden NK. Safety and efficacy of intra-articular therapies in hip osteoarthritis: a systematic review and meta-analysis. Rheumatology. 2021; 60(6):2717-31.
Davis N, Hummer CD, Spritzer CE, Guermazi A. Ultrasound-guided intra-articular hip injections: efficacy and safety considerations. Skelet Radiol. 2019; 48(5):715-26.
Henrotin Y, Lambert C, Richette P, Chevalier X. Importance of assessing the molecular weight of hyaluronic acid for viscosupplementation in osteoarthritis: a literature review. Curr Rheumatol Rep. 2015; 17(6):59.
Migliore A, Massafra U, Bizzi E, Lagana B, Germano V, Piscitelli P, et al. Intra-articular injection of hyaluronic acid (MW 1,500-2,000 kDa; HyalOne) in symptomatic osteoarthritis of the hip: a prospective cohort study. Arch Orthop Trauma Surg. 2011; 131(12):1677-85.
Veronese N, Cooper C, Bruyère O, Al-Daghri NM, Branco J, Cavalier E, et al. Multimodal multidisciplinary management of patients with moderate to severe pain in knee osteoarthritis: a need to meet patient expectations. Drugs. 2022; 82(13):1347-55. doi:10.1007/s40265-022-01773-5.
Bian G, Zhao W, Zhang L. Comparative efficacy of platelet-rich plasma injection vs ultrasound-guided hyaluronic acid injection in the rehabilitation of hip osteoarthritis: an observational study. Ann Med. 2025; 57(1):2524091. doi:10.1080/07853890.2025.2524091.
