Intraarticular injection of hyaluronic acid (HA) is an effective treatment for reducing pain and improving functional outcomes in subjects with osteoarthritis (OA). The aim of the present review is to discuss the evidence-based 10 main reasons that support the use of intraarticular HA as a one of the preferred treatments in the clinical approach of patients with OA. Salient findings include the importance of using HA of high molecular weight (HMW) as a determinant factor of efficacy and the lubricating and damping function that HA exerts in the joint space, besides the anti-inflammatory, analgesic, and chondroprotective actions of HA. Ultra-high HMW and HMW products prolong the intraarticular persistence time of HA and increase resistance to degradation, providing up to 12 months of effective pain relief and being the HA molecular weight group of choice. Ultrasound-guided injection is the recommended technique for injecting HA in the joint space and avoid complications. HA has an excellent overall safety profile. Younger populations with mild to moderate OA are those who can benefited most from HA, but treatment is also effective and safe for patients with advanced OA who are awaiting arthroplasty or for those who are not qualified for surgery.

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Palabras clave: Hyaluronic acid. Osteoarthritis. Intraarticular injection. Knee osteoarthritis. Hip osteo-arthritis.