Intra-articular injection of hyaluronic acid for osteoarthritis is an old and useful method. According to recent literatures, the following four problems were reviewed in this article: 1) Mechanisms. Real-time PCR was used to detect the transforming growth factor-beta 1 (TGF-beta1), vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) gene expression, which were significantly increased, as well as promoted secretion and synthesis of the tissue inhibitors of metalloproteinase, thus the reaction and cartilage destruction were decreased. 2) Methods. Because of discovering of new HA derivants, single intra-articular treatment with 6 ml hylan G-F 20 had replaced the routine method of once a week. To improve the therapeutic effectiveness, compound drags were applied, such as NSAIDs. 3) Indication. Knee OA (K-L II-III type) was first elected. But at present, the K-L I type was advocated early application. While the K-L IV type, although joint function can not improve, the symptoms relieved. 4) Therapeutic effectiveness. The double-blind place bo-controlled study showed that it was better than corticoid, and persistent and no side-effect. Therefore, this was a safe, persistent effective method.

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