Effectiveness of Intra-Articular Hyaluronic Acid for Ankle Osteoarthritis Treatment: A Systematic Review and Meta-Analysis Ke-Vin Chang, MD, Ming-Yen.

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Effectiveness of Intra-Articular Hyaluronic Acid for Ankle Osteoarthritis Treatment: A Systematic Review and Meta-Analysis Ke-Vin Chang, MD, Ming-Yen Hsiao, MD, Wen-Shiang Chen, MD, PhD, Tyng-Guey Wang, MD, Kuo-Liong Chien, MD, PhD Archives of Physical Medicine and Rehabilitation Volume 94, Issue 5, Pages 951-960 (May 2013) DOI: 10.1016/j.apmr.2012.10.030 Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 1 Flow diagram of the evaluation process for the included or excluded studies. Archives of Physical Medicine and Rehabilitation 2013 94, 951-960DOI: (10.1016/j.apmr.2012.10.030) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 2 Forest plot of the effect sizes of improvement scores from baseline. Results of the meta-analysis on the effectiveness of intra-articular HA versus the condition before treatment in reducing pain in patients with ankle osteoarthritis. Abbreviation: ES, effect size. Archives of Physical Medicine and Rehabilitation 2013 94, 951-960DOI: (10.1016/j.apmr.2012.10.030) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 3 Forest plot of comparisons of the effect size resulting from intra-articular HA injections with the reference groups. Results of the meta-analysis on the efficacy of HA compared with saline, arthroscopy alone, and exercise in reducing pain in patients with ankle osteoarthritis. Abbreviation: ES, effect size. Archives of Physical Medicine and Rehabilitation 2013 94, 951-960DOI: (10.1016/j.apmr.2012.10.030) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 4 Relation between the effect sizes of improvement scores from baseline and the molecular weight of HA preparations (A), the amount of HA administered (B), the total number of injections (C), and the injection volume per dose (D). The size of the circle indicates the weighting of each study in the meta-regression. The gray shaded area represents the 95% CI. Archives of Physical Medicine and Rehabilitation 2013 94, 951-960DOI: (10.1016/j.apmr.2012.10.030) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 5 Funnel plots of the effective size of improvement scores from baseline (A) and comparisons of intra-articular HA injections (B) with the reference groups. Archives of Physical Medicine and Rehabilitation 2013 94, 951-960DOI: (10.1016/j.apmr.2012.10.030) Copyright © 2013 American Congress of Rehabilitation Medicine Terms and Conditions