Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Dr Band states that the effect size
reported in our study should be interpreted with the knowledge that the controls
in the studies included were not "simple placebo[s]." He also states that
arthrocentesis, without any injection of medication, affords some efficacy
in patients who have effusions. We agree that there is likely efficacy related
to intra-articular placebo treatments. In fact, we found that 80% of the effect
of intra-articular hyaluronic acid was accounted for by its placebo effect.
The effect of an intra-articular treatment, such as hyaluronic acid, should
only be attributed the effect that it affords in excess that of an intra-articular
Lo GH, Felson D, LaValley M. Intra-articular Hyaluronic Acid for Treatment of Osteoarthritis of the Knee—Reply. JAMA. 2004;291(12):1440. doi:10.1001/jama.291.12.1441