Public interest related to hyaluronic acid injections for knee osteoarthritis on the rise

Hyaluronic acid injections remain a common nonsurgical alternative for the treatment of knee osteoarthritis despite limited clinical evidence and varying global recommendations regarding its use.

Samuel A. Cohen et al used the Google Trends tool to provide a quantitative analysis of public interest in hyaluronic acid injections for knee osteoarthritis in the United States and Europe.

The authors customized Google Trends parameters to obtain search data from January 2009 to December 2019 in both the United States and Europe. Combinations of "arthritis", "osteoarthritis", "hyaluronic acid", "knee arthritis", "knee osteoarthritis", and "knee injection" were entered into the Google Trends tool, and trend analyses were performed.

Key findings of the study:

• The models generated to describe public interest in hyaluronic acid for knee injections in both the United States and Europe showed increased Google queries as time progressed (P < .001).

• The United States growth model displayed linear growth (r2 = 0.90) while the European growth model displayed exponential growth (r2 = 0.90).

• In both the United States and Europe, public interest in HA for knee osteoarthritis was greatest in the month of October and least in the month of December.

• New York City and Los Angeles showed the most consistent growth in public interest in HA for knee osteoarthritis followed by Chicago, Phoenix, and Houston.

The authors concluded that – "Our findings demonstrate increased online public interest in HA injections for knee osteoarthritis from 2009 to 2019 in both the United States and Europe despite mixed clinical evidence regarding its efficacy and inconsistent recommendations regarding its use from governing bodies in both locations. Our models suggest that public interest in HA for knee osteoarthritis is expected to continue to increase in upcoming years. Inconsistencies in recommendations regarding its effectiveness illustrate the potential benefit of more high-level placebo-controlled studies evaluating its effectiveness in order to prepare orthopedic surgeons to counsel an increasingly curious public. Additionally, measures must be implemented to encourage the adoption of responsible and evidence-based marketing such that direct-to-consumer marketing and science align to improve the quality and value of effective treatments in health care, thereby reducing the utilization of expensive and ineffective treatments. Further discussions and awareness of financial conflicts of interest and how these impact recommendations would be valuable for both the general public and medical professionals."

Further reading:

Public Interest in Hyaluronic Acid Injections for Knee Osteoarthritis in the United States and Europe: An International Google Trends Analysis Samuel A. Cohen, Robert H. Brophy et al Arthroplasty Today 18 (2022) 157- 162 https://doi.org/10.1016/j.artd.2022.09.003