Abstract
Various nonoperative treatments have been implemented to reduce pain and improve the
quality of life in patients with ankle osteoarthritis. Among these treatments, intra-articular
hyaluronate injection has proven efficacy and safety in patients with knee osteoarthritis.
The purpose of this study was to evaluate the efficacy and complications of hyaluronate
injection using various clinical scoring systems. This study included 37 patients
with unilateral ankle osteoarthritis (grade 2 or 3 according to the Takakura classification)
who did not respond to previous pharmacological treatment. 3 weekly hyaluronate injections
(2 mL Hyruan Plus®) were administered. The efficacy of intra-articular hyaluronate
injection was evaluated on the basis of patient-reported foot and ankle clinical assessment
at a mean follow-up of 13.8 ± 8.3 (range 6-33) months. Ankle Osteoarthritis Scale
scores for pain and disability, American Orthopedic Foot and Ankle Society ankle-hindfoot
scores, and visual analog scale for pain significantly improved at the final follow-up
compared to that before intra-articular hyaluronate injection (p ≤ .05). When patients were dichotomized according to age, sex, body mass index, symptom
duration, and Takakura classification, all these factors were not related to clinical
outcomes. This study suggests that 3 weekly intra-articular hyaluronate injections
can be performed safely to reduce pain and improve function without serious complications
in patients with early or intermediate-grade ankle osteoarthritis when patients inadequately
respond to medication. Larger controlled studies are needed to clarify the effects
of hyaluronate injection and identify patients who can benefit most from hyaluronate
injection.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: September 18, 2021
Footnotes
Financial Disclosure: This research was supported by a grant from Chonnam National University Hospital Biomedical Research Institute (grant no. BCRI19016).
Conflict of Interest: The authors declare that they have no competing interests.
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