The Efficacy of Polydioxanone Sutures in Treating Mild-to-Moderate Knee Osteoarthritis: A Systematic Review and Meta-Analysis

Background and Objectives: This meta-analysis aimed to compare the efficacy of polydioxanone (PDO) suture, a non-surgical treatment for knee osteoarthritis, with intra-articular hyaluronic acid (HA) injections. Materials and Methods: A comprehensive literature search was conducted using major databases including MEDLINE, EMBASE, Cochrane Library, KoreaMed, KMBASE, and RISS. Randomized controlled trials (RCTs) published up to 30 April 2024, focusing on knee osteoarthritis, pain, PDO suture, and intra-articular injections, were included. A total of 10 RCTs were analyzed, with participants having Kellgren & Lawrence Grade II-III knee osteoarthritis. This study compared the pain relief effects of PDO suture and HA injections. Results: The meta-analysis results showed that PDO suture demonstrated consistent and significant pain reduction over a 30-week observation period (p < 0.05), while HA injections did not exhibit statistically significant pain relief. Conclusions: PDO sutures offer the potential for long-term pain management in patients with knee osteoarthritis. However, this study has limitations such as the heterogeneity among studies, and given that the efficacy of PDO sutures is based on a single study, further research is needed to establish the long-term safety profile of polydioxanone sutures and to ensure the generalizability of the findings.