American journal of physical medicine & rehabilitation · 2026
Intra-articular Injections for Knee Chondromalacia: A Systematic Review of Randomized Controlled Trials.
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De la Cerna-Luna Roger, Cabanillas-Lazo Miguel, Arnillas Brigneti Paula, Rios-Garcia Wagner, Taype-Rondan Alvaro
Аннотация
OBJECTIVE: To assess the effects of intra-articular injections in patients with chondromalacia.
DESIGN: In this systematic review, we searched MEDLINE/PubMed, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) evaluating intra-articular injections for knee chondromalacia. Meta-analyses were conducted when appropriate, and certainty of evidence was evaluated using the GRADE approach.
RESULTS: We included six RCTs involving 393 participants. Four studies assessed hyaluronic acid (HA) versus no treatment, one compared platelet-rich plasma (PRP) with prolotherapy, and one compared PRP with HA. HA probably does not have a meaningful effect on pain or symptom severity, and may not have an important impact on relative strength in knee extension, at six months; and its impact on structural outcomes remains uncertain. Because other injections were not compared with a no-treatment control, we were unable to draw conclusions about their effectiveness.
CONCLUSION: Intra-articular HA probably has little to no effect on pain or symptom severity outcomes in patients with chondromalacia, while its impact on function and structural outcomes remains uncertain. No studies compared PRP or prolotherapy with no treatment or placebo, precluding firm conclusions regarding their effectiveness. Overall, the certainty of the available evidence is limited.
DESIGN: In this systematic review, we searched MEDLINE/PubMed, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) evaluating intra-articular injections for knee chondromalacia. Meta-analyses were conducted when appropriate, and certainty of evidence was evaluated using the GRADE approach.
RESULTS: We included six RCTs involving 393 participants. Four studies assessed hyaluronic acid (HA) versus no treatment, one compared platelet-rich plasma (PRP) with prolotherapy, and one compared PRP with HA. HA probably does not have a meaningful effect on pain or symptom severity, and may not have an important impact on relative strength in knee extension, at six months; and its impact on structural outcomes remains uncertain. Because other injections were not compared with a no-treatment control, we were unable to draw conclusions about their effectiveness.
CONCLUSION: Intra-articular HA probably has little to no effect on pain or symptom severity outcomes in patients with chondromalacia, while its impact on function and structural outcomes remains uncertain. No studies compared PRP or prolotherapy with no treatment or placebo, precluding firm conclusions regarding their effectiveness. Overall, the certainty of the available evidence is limited.