Abstract
We investigated the potential of exogenous hyaluronic acid (HA) associated with corticosteroid
injections to improve pain and function for the treatment of post-traumatic subtalar
osteoarthritis, in comparison with isolated intra-articular corticosteroid. Twenty-five
symptomatic participants (50 ± 8 years) with a minimum follow-up of 1 year after surgery
for calcaneus fractures were enrolled. Participants were randomly assigned into a
therapeutic group that underwent isolated corticosteroid intra-articular subtalar
injection (Corticosteroid Group, n = 12) or a combination of HA plus corticosteroid
(HA+C Group, n = 13). All participants underwent three repeated injections with intervals
of 1 week. We assessed the visual analog scale of pain (VAS) and the AOFAS scores
at 4 moments: before treatment (pre), 4-, 12-, and 24-weeks following the last injection.
HA+C Group showed lower VAS at the 12th (p = .003) and 24th weeks (p = .003) and greater AOFAS at the 4th (p = 0.040), 12th (p = .014), and 24th weeks (p = .021), in comparison to Corticosteroid Group. We observed a reduction in VAS in
the Corticosteroid Group only at the 4th week (p = .007), compared with pretreatment values. In the HA+C Group, VAS presented lower
levels at the 4- (p < .001), 12- (p < .001), and 24 weeks (p < .001). In the Corticosteroid Group, participants presented higher AOFAS score only
at the 4th week (p < .001), while in the HA+C Group, the AOFAS scores were greater at the 4th, 12th,
and 24th weeks compared to baseline (p < .001). The combination of exogenous HA and corticosteroid showed greater and longer
analgesic effects and function improvement in comparison with isolated intra-articular
corticosteroids.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: March 12, 2022
Footnotes
This work was performed at the National Institute of Traumatology and Orthopedics, Rio de Janeiro, RJ, Brazil.
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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