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A 2023 OARSI consensus report concluded that HA may offer limited but clinically relevant benefit in select patients, though guideline recommendations remain inconsistent due to heterogeneity in formulations and trial quality (Macri et al., 2023)

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J Transl Med 14 , 3 (2016)

Oral supplements are exposed to the hazards of stomach acid, digestive enzymes, food-related breakdown, first pass metabolism, and other bioavailability issues in the gastro-intestinal system