An evidence-based systematic review including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

Because of the rising numbers of patients affected by osteoarthritis (OA), management decisions on how to minimize pain and improve function in OA patients are important. Intra-articular hyaluronic acid (IAHA) knee injections have become a common treatment in the management of knee OA. In an editorial appearing in the 2007 National Knowledge Week on Osteoarthritis: National Health Service Evidence, four questions were asked about the clinical use of IAHA treatment for OA: 1) Who is the ideal candidate for HA viscosupplementation? 2) Do the mechanical and biological effects differ in importance in different stages of the disease? 3) What is the ideal dose in early- and late-stage OA? 4) Can the biological effect be delivered by means other than injection? These key issues are addressed. On the basis of results from several systemic reviews and meta-analyses, we conclude that IAHA knee injections in patients with knee OA result in modest improvements when measured by validated outcomes.

An evidence-based systematic review of active hexose correlated compound (AHCC) by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

The patient was a 34-year-old male recreational marathon runner referred to a physical therapist with a chief complaint of worsening right lateral hip pain of 3 months duration that was insidious in nature. Following a physical examination, the physical therapist discussed his suspicions with the referring physician. Magnetic resonance imaging revealed findings consistent with a stress fracture at the inferomedial right femoral neck, a mild cam-type deformity of the right femoral neck, and a mild degree of heterogeneity of the right superior anterior labrum, representing a possible tear. J Orthop Sports Phys Ther 2011;41(11):905. doi:10.2519/jospt.2011.0423

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