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Weak about knees

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Times Staff Writer

Americans with osteoarthritis of the knee may need to wait a little longer for proof that three common approaches actually work.

In a review of 42 randomized controlled trials on hyaluronic acid injections, 21 studies on the supplements glucosamine and chondroitin and 23 articles on arthroscopy, researchers at the Blue Cross and Blue Shield Assn. Technology Evaluation Center found some positive effects for hyaluronic injections and for glucosamine-chondroitin, but the quality of the trials was extremely uneven. The most rigorous study on glucosamine-chondroitin found no effect. The only available study comparing arthroscopic surgery with a placebo procedure did not find surgery to be more effective than the placebo.

This is not to say that these procedures don’t work, says lead author David J. Samson, but rather that evidence is surprisingly scanty. “It’s the difference between being unsure of effectiveness and being certain about ineffectiveness,” he says. “We would love to see additional research done with higher quality methods.”

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The U.S. Department of Health and Human Services Agency for Healthcare Research and Quality sponsored the study.

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janet.cromley@latimes.com

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