Intra-articular Injections for Osteoarthritis: From Bench to Bedside, can we Teach Old Drugs New Tricks?

The two articles in this month’s press of The Journal of Arthritis, one by Ekinci et al. titled ‘A New Treatment Option in Osteoarthritis: Prolotherapy Injections’ and the other by Senatorov et al. titled ‘Clinical Outcome of Hylan G-F 20 Injections in Shoulder and Hip Osteoarthritis: A Retrospective Review’ raise several important points surrounding the topic of intra-articular injections [1,2]. Firstly that there is a paucity of high quality literature in the field that often leads to inconclusive or misrepresented conclusions on drug efficacy in established treatments [1,2]. The articles also highlight the heterogeneity in injection procedure, site, concentration, preparation and outcome measurements [1,2]. This editorial will, therefore, provide a concise review on some of the current injection therapies and suggest possible improvements to methodological structure to inspire readers strive for high quality data. Further, through an example of a possible novel therapy, Actovegin, this editorial will hopefully challenge readers’ way of thinking to consider the reapplication of established drugs; posing the question can you teach an old drug new tricks?