Consequences on Private Insurance Coverage: The AAOS Clinical Practice Guidelines and Hyaluronic Acid Injections

Mar 10

Consequences on Private Insurance Coverage: The AAOS Clinical Practice Guidelines and Hyaluronic Acid Injections

Congratulations to TOBI Faculty, Dr. Vangsness and colleagues, on this important new publication in the Journal of Bone and Joint Surgery.

Researchers recently reviewed the conclusions of the 2013 American Academy of Orthopedic Surgeons (AAOS) Clinical Practice Guideline (CPG) on the use of intra-articular (IA) hyaluronic acid (HA) injections and how their position has impacted private insurance coverage of these injections. The significance of such a review is warranted due to the continued high cost of hyaluronic injections as an out-of-pocket expense to patients who are not eligible for coverage through their private insurance carrier. The AAOS does not recommend using hyaluronic acid for patients with symptomatic osteoarthritis of the knee. This publication authored by TOBI Faculty, Dr. Vangsness and colleagues, outlines the inherent biases of the meta-analysis conducted by the AAOS and its flawed methodology, acknowledges recent studies conducted, and endorses reconsiderations for a modified and comprehensive guideline for nonsurgical treatment of knee pain due to osteoarthritis (OA), specifically reevaluating the AAOS CPG on IA HA treatment. Dr. Vangsness and colleagues support a substantial body of evidence outlined in this review in support of IA HA injections as a valuable treatment option for knee pain due to OA.

To summarize, private insurance coverage as a consequence of the 2013 AAOS CPG recommendations negatively impacts nearly 30% of insured US citizens seeking insurance coverage for IA HA injections to effectively manage knee pain due to OA. Researchers support a more judicious approach to OA treatment with the adoption of more recent recommendations from published sources to optimize outcomes of IA HA treatment. Furthermore, researchers identify the need for definitive clinical selection criteria and a consistent technique of injection to improve patient-outcomes and cost-effectiveness. Current recommendations by the AAOS restrict the safety and effective treatment of chronic knee pain due to OA and limit clinical intervention. Dr. Vangsness and colleagues urge the reevaluation of the AAOS CPG on IA HA treatment. Read the article here and join us at the 11th Annual TOBI Orthobiologics Symposium in Las Vegas, NV to hear more from Dr. Vangsness.

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