Intra-articular injection of hyaluronic acid is not effective for the treatment of post-traumatic osteoarthritis of the elbow.
OBJECTIVE
In this study we evaluated the effect and safety of intra-articular injection of hyaluronic acid in 19 consecutive elbows with post-traumatic osteoarthritis.


METHODS
In 18 patients (10 male and 8 female patients; mean age, 45.6 years [SD, 15.0 years]), 3 injections of sodium hyaluronate were given within 4 weeks at regular intervals. Evaluation took place just before the first injection, as well as after 3 and 6 months, and consisted of the Elbow Function Assessment Score, the Functional Rating Index of Broberg and Morrey, and the Modified Andrews Elbow Scoring System. Pain was also assessed by means of visual analog scales.


RESULTS
Viscosupplementation resulted in slight, short-term pain relief and a very limited decrease in activity impairment at evaluation after 3 months. After 6 months, no beneficial effects were noticed in any of the 19 injected elbows. Other parameters were not influenced by treatment with viscosupplementation at any time. Systemic or local adverse effects did not occur.


CONCLUSIONS
Because the use of viscosupplementation for the treatment of post-traumatic osteoarthritis of the elbow provides only slight, short-term pain relief and a very limited decrease in activity impairment and the other parameters were not modified, we believe that viscosupplementation is not suitable for this indication.


METHODS
Level IV, therapeutic case series.
van Brakel
Richard W
RW
Department of Orthopaedics, Amphia Hospital, Breda, The Netherlands.
Eygendaal
Denise
D
D000203:Activities of Daily Living; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004551:Elbow Joint / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D007270:Injections, Intra-Articular; D004204:Joint Dislocations / Q000150:complications; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000187:drug effects; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D000092464:Elbow Injuries
D000893:Anti-Inflammatory Agents; D006820:Hyaluronic Acid