We appreciate the comments of Drs Altman and Moskowitz who led one of the large-scale industry-sponsored trials of HA for the treatment of OA. Altman and Moskowitz make 4 points: first, that other reviews and guidelines do not necessarily agree with our views; second, that preclinical data suggest HA causes an increase in synovial fluid viscosity and works by other mechanisms; third, that our structured review was not sufficiently comprehensive; and fourth, that intent-to-treat analysis is not the gold standard for evaluating the validity of trial results.
Felson DT, Anderson JJ. Hyaluronate Sodium Injections for Osteoarthritis: The Truth—Reply. Arch Intern Med. 2002;162(21):2499. doi: