The use of intra-articular injections of high molecular weight elastoviscous solutions
of hyaluronan or hylans (cross-linked derivatives of hyaluronan) to treat arthritis
is termed viscosupplementation. The function of viscosupplementation is to restore
the rheologic properties of synovial fluid. Although anecdotal data exist, no long-term
studies regarding the use of viscosupplementation in the ankle have been published
to date. The goal of this clinical trial was to compare pain reduction following ankle
arthroscopy versus that following ankle arthroscopy combined with weekly intra-articular
instillation of hylan G-F 20 during the first 3 postoperative weeks. In the series
of patients described in this report, we found that both treatment groups experienced
statistically significantly decreased pain following the intervention (P = .002 and
P = .0009 for the arthroscopy alone and arthroscopy plus hylan groups, respectively),
and that those who received 3 intra-articular injections of hylan G-F 20 following
ankle arthroscopy improved statistically significantly (P = .0014) more than did those
who underwent arthroscopy as a sole therapy. These preliminary results suggest that
viscosupplementation combined with arthroscopy may be more beneficial than arthroscopy
alone, and provide further insight into the role of viscosupplementation in the treatment
of ankle osteoarthritis. Level of Clinical Evidence: 4
Key Words
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Conflict of Interest: None reported.
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© 2008 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
