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March 24/31, 2004

Intra-articular Hyaluronic Acid for Treatment of Osteoarthritis of the Knee—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(12):1440. doi:10.1001/jama.291.12.1441

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 placebo.