A variety of randomised studies have demonstrated the efficacy of hyaluronic acid injection into joints affected by osteoarthritis – not only during treatment, but also in the long term after treatment.

Ten European osteoarthritis specialists have developed recommendations on whether and when to apply retreatment by intraarticular hyaluronic acid injection.

  1. Treatment should follow the patient’s assessment on the result from previous hyaluronic acid treatment (viscosupplementation).
  2. The treatment can and should be repeated after successful joint injection once symptoms begin to worsen again.
  3. Viscosupplementation has become a scientifically established method for delaying osteoarthritis such as in very young patients and professional athletes. Patients at high risk of osteoarthritis may also benefit from treatment or retreatment before symptoms become apparent.
  4. Unfavourable outcomes warrant a strict review of the original diagnosis while monitoring the application frequency of two to three treatments at one to two-week intervals. Injection placement should also be checked.

FIRST provides consultation and treatment based on these guidelines. We have adapted and applied these findings to treatment and retreatment using platelet-rich plasma (PRP) injections.

Source: Raman, R., Henrotin, Y., Chevalier, X., Migliore, A., Jerosch, J., & Montfort, J. et al. (2017). Decision Algorithms for the Retreatment with Viscosupplementation in Patients Suffering from Knee Osteoarthritis: Recommendations from the EUROpean VIScosuppl