Intra-articular injection of hyaluronic acid after arthroscopic surgery fails to provide additional benefit for symptomatic degenerative arthropathy patients: a systematic review and meta-analysis of randomized controlled trials

Knee arthroscopy is the replacement choice for patients with symptomatic degenerative arthropathy who have failed conservative treatment, such as intra-articular loose bodies and meniscal pathology. Postoperative joint pain and swelling are the main problems affecting enhanced recovery after surgery, which is thought to be a disorder of the joint environment caused by the trauma of surgery (1, 2, 3). Arthroscopic surgery involves irrigating the joint with a high-pressure flushing solution, which results in the loss of synovial fluid secreted by the joint itself. Synovial fluid has been shown to lubricate and protect the articular cartilage, and it needs to be re-secreted several days after surgery (3). In addition, studies have shown that the lavage fluid could cause damage to articular cartilage, which could also lead to early postoperative joint discomfort (4, 5). Therefore, some scholars have proposed that early postoperative synovial fluid analog supplementation to restore the internal environment may reduce early postoperative joint discomfort and accelerate the rehabilitation process (6, 7, 8, 9).