Effect of Hyaluronic Acid on the Acceleration of Bone Fracture Healing: A Systematic Review.

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Background/Objectives: Hyaluronic acid (HA) is a natural substance in the human body with anti-inflammatory and healing properties that help repair bone by supporting cell growth, blood vessel formation, and tissue structure. A common complication after minimally invasive surgery is delayed bone healing in osteotomies. HA may offer a useful treatment to support faster recovery. Methods: This systematic review followed PRISMA guidelines and was pre-registered in PROSPERO (ID: CRD420250654929). Searches were conducted in PubMed, EbscoHost, Web of Science, and Scopus up to 25 January 2025. Studies from the last five years on HA and bone healing were included. The main outcomes were faster bone repair and improved regeneration. Study quality was assessed using the OCEBM, ROBINS-I, and GRADE tools. Results: Out of 96 studies, 9 met the inclusion criteria. HA, especially when combined with other materials or stem cells, helped bone repair by supporting new bone formation. Materials like 3D-printed scaffolds, hydrogels, and meshes showed good results in bone healing. However, differences in the study design made direct comparison difficult. Conclusions: Hyaluronic acid shows promise for bone repair, especially in combination with other materials. More standardized clinical trials are needed to confirm its effectiveness and define how best to use it in minimally invasive surgeries.